The Republican health care plan

They finally offered one. But it seems they did this precisely so they could say they offered one — and not with any intent of actually trying to reduce the ranks of the uninsured. How do I know this? Because the GOP health reform plan doesn’t actually reduce the ranks of the uninsured:

The different goals and effects of the GOP bill are reflected in a preliminary analysis released Wednesday evening by the Congressional Budget Office, which put the bill’s 10-year price tag at $61 billion. That is far less than the $1 trillion estimate for the Democratic bill that House leaders plan to bring to the floor as soon as this weekend.

But the CBO analysis also concluded that under the GOP plan, 52 million nonelderly Americans would have no insurance in 2019 — even more than the 50 million in 2010. By comparison, the House Democratic bill would reduce the number of nonelderly Americans without coverage to around 18 million over the next decade.

So of course it costs less. It doesn’t actually do anything.

The best health care system in the world

This isn’t new news, but it’s good that lawmakers are taking notice:

Are Americans dying too soon? The answer is yes. When it comes to “preventable deaths” — an array of illnesses and injuries that should not kill at an early age — the United States trails other industrialized nations and has been falling further behind over the past decade.

Although the United States now spends $2.4 trillion a year on medical care — vastly more per capita than comparable countries — the nation ranks near the bottom on premature deaths caused by illnesses such as diabetes, epilepsy, stroke, influenza, ulcers and pneumonia, according to research by the nonpartisan Commonwealth Fund published in the journal Health Affairs.

Doing nothing is an option. But it shouldn’t be.

Rallies for health insurance reform

From Young Philly Politics:

We’ve beaten back right wing opposition in the last few weeks and emerged with more support for real reform. Now it is time for the final push. Take part in one of the 13 Let’s Get It Done events all over Pennsylvania. Tell your Representatives and Senators that it is time for action. They must go back to Washington and move health care reform forward. And tell your friends about the Health Insurance Reform campaign and these events by clicking here.

In the Delaware Valley you can join us at one of two events:

Thursday, September 3, 12:00 noon / 1900 Market Street/ Philadelphia, PA

Public Health Insurance Option or Insurance Companies: Which Side Are You On? Rally at Blue Cross and then march to Senator Bob Casey’s office in support of the public option in the Kennedy HELP Committee bill.
RSVP here

Saturday, September 5, 10:30 am / Lions Park / Bristol, PA / 10:30 am

Rally for Health Insurance Reform with Representative Patrick Murphy

After these events, we want to ramp up phone banking from Philadelphia into other parts of the state where we have few shaky Democrats. You can phone bank at home. Just get in touch with me at MarcStier@hcanpa.org and I’ll send you a list and talking points. Or come to one of the phone bank events we will start having next week. Details soon.
RSVP here

Why we need health insurance reform

You hear a lot of talk about “freedom” in opposition to the Democrats’ health reform proposals. But it’s hard to see freedom or any other virtue in the story Nick Kristoff shares today, about a friend of his who had to divorce her ailing husband in order to avoid bankruptcy:

“I was blown away,” M. told me. But, she said, the hospital staff members explained that they had seen it all before, many times. If M.’s husband required long-term care, the costs would be catastrophic even for a middle-class family with savings.

Eventually, after the expenses whittled away their combined assets, her husband could go on Medicaid — but by then their children’s nest egg would be gone, along with her 401(k) plan. She would face a bleak retirement with neither her husband nor her savings.

A study reported in The American Journal of Medicine this month found that 62 percent of American bankruptcies are linked to medical bills. These medical bankruptcies had increased nearly 50 percent in just six years. Astonishingly, 78 percent of these people actually had health insurance, but the gaps and inadequacies left them unprotected when they were hit by devastating bills.

Republicans and conservatives had most of this decade to try to fix these problems through the market-based reforms they talk about now. They didn’t. In fact, they try to repeatedly tell us that American health care is the best in the world, though it plainly isn’t true.

Matt Yglesias comments on the Kristoff column:

In a decent system, everyone would pay a bit more in taxes and nobody would wind up facing that kind of decision. And note that in the end the government winds up picking up the tab for extreme medical scenarios anyway.

Why universal health insurance may, in fact, be doomed

The New York Times today profiles Bob Collier, a town hall attendee who isn’t screaming about Nazis or death panels or anything like that. Nonetheless, he opposes health reform.

The Colliers are committed conservatives who have voted Republican in presidential elections since 1980. They receive much of their information from Fox News, Rush Limbaugh’s radio program and Matt Drudge’s Web site. But they said their direct experience with the health care system had persuaded them of the need for change.

When Ms. Collier’s breast cancer was diagnosed three years ago, Mr. Collier’s employer-provided insurance paid for her office visits, a biopsy and three surgeries. But the insurer covered only a small fraction of her radiation treatments, which it considered experimental, leaving the Colliers with a $63,000 bill. To their great relief, the charge was later written off by Emory Healthcare, whose doctors had recommended the regimen.

Mr. Collier’s employer, Buccaneer Inc., which is based in Atlanta, pays 100 percent of his health premiums but requires $509 a month to cover his wife. That cost has been escalating by at least 15 percent a year, and the couple’s deductibles have quadrupled.

Furthermore, Mr. Collier recognizes that were he to lose the job he has held for 39 years, his wife’s pre-existing condition might well make her uninsurable.

“We’ve got to do something about those people who can’t get insurance,” he said. “There has to be a safety net there. But I don’t want that safety net to catch too many people.”

Right. The Colliers aren’t necessarily bad people. It’s just that — quite rationally — they’ve got theirs. And they want to keep it.

Here’s the dirty secret of the health reform debate: The standard talking point is that 46 million Americans don’t have coverage. When you strip out a few million who simply — by virtue of principle or a belief they won’t get sick or injured — choose not to have insurance, what you have left, essentially, is a bunch of poor people.

And as a rule, poor people don’t vote. The politicians know this. President Obama knows this. So do all the Republicans.

Which means the voting population is largely made up of people who already are covered. Who aren’t necessarily concerned about the folks who aren’t. And who might not be entirely satisfied with their coverage but — like Bob Collier — are worried that major reforms might end up replacing it with something worse.

That’s going to be a tough political battle to win.

Update: I’m going to partially retract this. As other observers have pointed out, a guy who listens to Rush and watches Fox for most of his news might not be your average voter.

But I think my larger point still stands: One of the big obstacles in health reform is asking people with stuff to care about people without stuff. The people with stuff vote; the people without don’t. Bob Collier may not be the best example of this, but the dynamic still exists.

Politically speaking, the “larger truth” is that Israel is harvesting the organs of Palestinians

Yesterday, Jonah Goldberg admitted that “death panels” never existed in proposed health reform legislation — but defended them politically, since they hinted at dark possibilities that could possibly happen, supposedly, maybe if reform was passed.

Today, the shoe is apparently on the other foot. Here’s Goldberg’s 11:25 a.m. blog posting at National Review:

You’ve got to wonder if he recognizes how hilarious this is.

Obama is not a Nazi

And it’s good to see Barney Frank treat this idea with the contempt it deserves.

Death panels: They don’t have to be true if they could possibly be true someday

Jonah Goldberg writes about whether “death panels” actually exist, and comes up with a novel answer: Yes and no.

As a matter of the finer points of policy discussion, I think the death-panel label is awfully blunt and inexact.

But in the arena of a vital political contest, I think M&S are right that it distilled some important issues down to an important truth: if Obama, Pelosi, Waxman et al get their way, the relationship between the citizen and the state is profoundly, and perhaps permanently, altered and down that path lurks death panels.

So: No, death panels were never part of proposed health reform. BUT: Hey, it’s politics! And since health reform is different from the status quo — well, we certainly wouldn’t be surprised if death panels actually happened someday, because that’s the kind of thing that happens when change happens.

Funny thing is, I think this is Goldberg’s attempt at intellectual honesty.

UPDATE: Over at Andrew Sullivan’s blog, Conor Clarke makes much the same point in response to a WSJ op-ed piece:

Second — and this gets to the heart of the slippery debate — hypothetical arguments are totally non-falsifiable. It Betsy McCaughey says the text of the House health-care bill will create death panels, it’s pretty easy to prove her wrong. But if Andrew Klavan then pops up, all bright-eyed and bushy-tailed, with the Hegelian argument that the “logic” of history points towards death panels … well, that’s rather more difficult, and rather more frustrating. The “logic” of history might point toward many things. But until time machines come along, I’m of the opinion that we should stick to the text of the bill.

James Carville is wrong

Politico:

On CNN’s “State of the Union,” Democratic strategist James Carville became the first leading Democrat to suggest publicly that there might be political advantage in letting Republicans “kill” health care.

“Put a bill out there, make them filibuster it, make them be what they are, the party of no,” Carville said. “Let them kill it. Let them kill it with the interest group money, then run against them. That’s what we ought to do.”

If you want to win elections for Democrats, that’s a great idea.

If you want to get health reform done for the American people, that’s really lousy, stupid idea — and James Carville should be ashamed of himself. (Not that he will be.)

Listen: The Democrats have 60 votes in the Senate and a majority in the House — as well as control of the White House. If they’re going to be thinking of winning elections now, they should be thinking of how to do it by governing the country competently, implementing proposals that help American families.

Take a loss so that Democrats can get re-elected — and do what, exactly? If they can’t get reform when they hold all the levers of elected power, then what’s the point of electing them?

I’m not going to boycott Whole Foods

For five years in high school and college, I worked at a tiny grocery store owned by a Mennonite Sunday school teacher named Ray Franz. Ray was — is — a good, gentle, man, with a deep bass voice and ready chuckle. Despite a passion for serving the small community where we lived, he also (I learned) had an aversion to politics: He had served on the city council a couple of decades before and found that making hard decisions had been bad for business. And that was that.

I thought of Ray this week after John Mackey, CEO of Whole Foods, angered his customers by writing a Wall Street Journal op-ed opposing Democrat’s health care reform proposals and offering market- and behavior-based alternatives instead. The result? Many of my fellow liberals now want to boycott Whole Foods.

I won’t be joining them. We don’t buy a ton of Whole Foods — Trader Joe’s is closer and cheaper — but we do buy some.

For one thing, I’m not inclined to punish somebody for thinking differently than I do, unless those thoughts are particularly odious. I won’t be eating a cheesesteak at Geno’s anytime soon, for example, but that’s the exception.

Second: For the last couple of weeks we’ve been screaming about the anti-health reform advocates who have been screaming at the town halls. So an opponent of reform comes along and offers a thoughtful-but-still-contrary opinion — and we’re going to punish him for that? If that’s what we’re going to do, why shouldn’t people like Mackey scream and throw tantrums? There’ll be no percentage for our opponents to engage the debate in a rational way.

So a boycott is kind of counterproductive.

That said, I don’t think Mackey was a terribly smart businessman in all of this.

I think it’s important to recognize that Whole Foods does more than sell food. It’s sells an idea of food — you too can be a foodie and environmentally sustainable — that is, frankly, more associated with the left than the right. To the extent that I’ve ever seen “Whole Foods” and “arugula” mentioned by the right, it’s usually been in disdainful tones reserved for the “latte-sipping liberals.”

John Mackey has every right to his opinion — but purely as a business matter what he did was bad brand management.