Right Wing Nut House



Filed under: American Issues Project, Blogging, Media, Politics, health care reform — Rick Moran @ 1:22 pm

No, this isn’t exactly what I promised yesterday about what kinds of health reform I would support. This is a bare bones outline I did for AIP.

A sample:

So yes, we must reform the health care system. But let’s imagine for a moment that President Obama and the Democrats didn’t hate the free market so much and were willing to look at alternatives to what they are proposing that would mean less, not more government control, and allow the free market to do the heavy lifting in helping to bring down health care costs.

It’s not like there aren’t free market ideas out there to reform health care - despite what our president and the Democrats want you to believe. They are attempting to ram this health care reform package through the Congress while saying that their opponents have no new ideas to solve the same problems.

But covering the uninsured by making insurance affordable for all, covering those with pre-existing conditions, bringing down the cost of health care, and assuring that the patient, in consultation with his doctor, has the most control over his own treatment are goals that can be achieved more cheaply, and by using a mostly free market approach to reform.

Unfortunately, a completely market oriented solution is not politically viable or realistic at this time. More than six dollars in every ten we spend on health care in America is spent by government. Medicare, Medicaid, Veterans benefits, Indian health care, active duty military care, and the children’s insurance program S-CHIP are just a few of the programs that have skewed the market in health insurance and health care so that a purely free market solution is not in the cards. And doing away with these government programs - even if it were possible - would not be the answer.

But believe me, we can do better than what the president and the Democrats are proposing.

I then give a rudimentary primer on some of the alternatives.

As I said, it’s not very detailed and there are other reforms I would support. Unfortunately, I lost my internet this morning and it just came on about an hour ago so those who might be interested in what real health care reform might look like - from my humble point of view anyway - are going to have to wait at least another day.

Great discussion with my good friends Ed Morrissey and Rich Baehr last night on my radio show about what’s happening with the politics of health care. Rich, who has been a medical insurance consultant for more than a quarter century, sees a senior citizen backlash coming against the Dems. While Obama and the Democrats concentrate on convincing the middle class about the necessity of health care reform, the seniors are packing town hall meetings and expressing their outrage at the more than $350 billion in Medicare cuts. This will mean longer waits for care, doctors dropping medicare patients altogether, and generally lower levels of service.

Old people, Rich reminded us, vote - big time.

You can access a podcast of the show here.

I think very soon, the Democrats are going to have to decide whether to batten down the hatches and pass their idea of a health care bill, even in the teeth of some serious opposition. Or whether they should scrap what they have and start over with a whole new, much more modest approach. I don’t think they can get to “Plan B” from where they are now. They would have to construct an entirely new framework from which to begin.

It is not likely to happen unless support for their kind of reform hits the low 20’s in the polls. Right now, it’s in the mid-30’s to low 40’s which is bad but not political Armageddon. But support is not rising, it is falling. And the longer they dawdle in Congress, the more the opposition can muster its forces to defeat them.

Right now, I’d put passage of some kind of reform at 60-40 in favor. The only reason it’s that high is that Obama has yet to bring the full force and effect of his office into the debate. A president has enormous power and Obama has several hole cards yet to play. Town halls and speeches won’t get it done. He will have to do what LBJ used to call “the laying on of the hands.” For example, Congress may hold the purse strings but the president has enormous latitude about when those monies can be released. A road project in a member’s district may be held up (or expedited) depending on how that Congressman intends to vote. No matter how bad a member might think the public option to be, that kind of persuasion can work miracles.

If they ditch the public option, that 60-40 number goes up considerably. In the end, that’s what Obama might have to do to get something he can sign.


  1. Rick;
    I liked this editorial in the WSJ from the founder of Whole Foods. It outlines some worthwhile counter proposals to the Democratic plan.

    Rich, who has been a medical insurance consultant for more than a quarter century, sees a senior citizen backlash coming against the Dems.

    If this is so then I’d have long-term concerns for the Republican Party. How can you preach fiscal responsibility if a core constituency is adamantly against changing two large federal entitlements that are “going under” (Medicare in 2017 and Social Security in ?2045)?

    Comment by c3 — 8/12/2009 @ 1:58 pm

  2. An FYI. I came across this report from HHS (Bush administration) with the “leg work” by Lewin Group. (warning PDF) (Yes, I’ve seen Lewin disparaged on the Left because they are owned by United Healthcare). It uses the Mass reforms as a reference point. I think its fairly balanced between costs and benefits. Its interesting that (if I’m reading it correctly) an implementation of a “mixed” approach a la Massachusetts would cost the Federal Government $156 billion more a year. Doing the math that’s $1.5 trillion over ten years, in the “ballpark” of the Obama numbers.

    I’ve seen that. It is interesting except MA reforms are busting the budget there. Their subsidy has gone up 50% in 3 years. In short, it’s not working to bring down costs although it is insuring more people.


    Comment by c3 — 8/12/2009 @ 3:28 pm

  3. Greetings:

    Back when I was studying Public Administration, there was a concept that all my professors thought important. It was referred to as “fundamentalism versus incrementalism”. “Fundamentalism” described a situation like when the FDR administration first established the Social Security system. “Incrementalism” would cover the subsequent tax rate and benefit adjustments to the system.
    I think that it’s unfortunate that the Obama administration and the Congress have neglected this part of the issue. Neither group seems interested in or capable of standing back and saying, “If we had no healthcare insurance system at all, what would we want it to do or not to do.
    Lately. I have been thinking about a car insurance analogy. These days most employees drive automobiles but very few employers provide car insurance for them. Our automobiles, if looked at as assets, have two kinds of potential liabilities, operational (crashes) and mechanical. Car insurance protects the owner from operational liabilities. I’m not aware or any car insurance for mechanical difficulties, preventive or otherwise which most owners seem to be able to handle financially. Lastly, car insurance is legally mandatory in most states.
    When I bought my first car, my father thought I bought too much insurance coverage for it. What he told me was that insurance is to protect your assets and I didn’t, at that time, have many assets to protect. I think that there’s a bit of a healthcare insurance lottery mentality alive in our land. The obvious “max-max” case is that someone else pays for your “first dollar coverage” insurance. ?The “min-min” case would be someone who, while able to afford coverage foregoes it incurs medical expenses that are transferred to the society at large.? To me, both these examples are irresponsible.
    I haven’t come up with a solves-all-the-problems solutions at this point. My major concern is that nobody seems interested in first coming up with a “map” of where the system is now and then one of where we want to end up with a “road-map” for the in between.

    Comment by 11B40 — 8/12/2009 @ 7:33 pm

  4. Right now, I’d put passage of some kind of reform at 60-40 in favor. The only reason it’s that high is that Obama has yet to bring the full force and effect of his office into the debate. A president has enormous power and Obama has several hole cards yet to play. Town halls and speeches won’t get it done. He will have to do what LBJ used to call “the laying on of the hands.” For example, Congress may hold the purse strings but the president has enormous latitude about when those monies can be released. A road project in a member’s district may be held up (or expedited) depending on how that Congressman intends to vote. No matter how bad a member might think the public option to be, that kind of persuasion can work miracles.

    That would assume that Barack Obama was a nasty SOB who liked to get in people’s faces, like Lyndon Johnson. The fact is, he’s a laid-back, non-threatening personna who would have never gotten elected president if he had LBJ’s personna, because he would have scared white swing voters to death.

    Obama will get in people’s faces — when those people are conservatives/Republicans, and when he knows he’s got the full Democratic Party apparatus as his back. And if winning this debate was just about intimidating a few swing district GOP reps, he might do it. But it’s not — the debate is to win over swing district Democrats, who remember 1994 and aren’t inclined to put their political careers at risk over something that’s approaching 9.8 m/sec downward speed.

    If he wants to win this, Obama’s going to have to prove to those swing district Dems that it’s worse for them to go against the White House than go for it, but to get their votes he’s going to have to give in his program, which means challenging his base on the far left of the party, something he’s yet to do in a major way. And if he threatens to withhold district funding or pork projects? Then he gets an actual Republican anyway elected in that district in 2010. That’s a genius strategy (and why Rahm last week was warning other Dems to stop running hostile ads against the Blue Dogs in their districts).

    Since most of the far left Dems in Congress come from districts that aren’t going to elect a Republican, calling their bluff on walking if the heath care bill isn’t liberal enough is a better bet than playing hardball with the Blue Dogs, who are in districts or states that can be lost next year. It’s a lesson Bill Clinton learned first after losing his re-election bid in 1980 when he governed too far to the left, and then again in 1994. But Clinton was willing to tell the left side of his party to pound sand on things like welfare reform in order to keep his own political career alive. We’ll see if Obama’s ready to take that step yet.

    Comment by John — 8/12/2009 @ 10:54 pm

  5. So, if free market is the best, I have a problem. I’m in Massachusetts. I have over 15 years of benefits admin experience. I know what a decent health plan looks like.

    I don’t have medical insurance now. I’m out of work, I can’t really afford the $563 a month it costs to have a decent plan in Massachusetts through MassHealth or Commonwealth Connector coverage, and have too much income to qualify for a free plan. A plan that is $424/mo has a $2000 deductible on meds, $5000 deductible on care, then ONLY pays 80%! Clearly, NOT a good insurance plan.

    The last plan I managed had decent coverage, co-pays, etc., and was $454 per month for individual coverage. Why do I have to pay more for less on the open market? Is your supposition that with a really active “free market” environment, I could get individually rated coverage with good co-pays, etc, and only pay $454 a month for it? Even if that supposition is valid, it’s not valid NOW, and that doesn’t help me.

    Frankly, I would like to see a single payer national health plan that incorporates the best of the Netherlands, French, UK and Canadian systems instead of what we have now.

    I think the reform efforts are not doing well because of the fear mongering and hysterical juvenile behavior of the right wingers, coupled with more fear mongering and pressure tactics of insurance company print & TV ads and Internet howling. I just wish they’d shut up and get the hell out of my way. They suck.

    Comment by Mark in Boston — 8/12/2009 @ 11:05 pm

  6. Mark in Boston,

    Please stop making sense. We must embrace the ‘free market’ insurance industry and make sure that it prospers at all costs - to us.

    Let’s forget that employer based insurance is one of the greatest money making scams ever pulled on the American people. Non only does it stifle entrepreneurship, personal freedom, and individual growth and self betterment, but it also has the added benefit of being able to drop your sick ass on technicalities and fine print when the going gets rough.

    It works great when you’re not sick though! Best of luck with finding a job.

    Comment by Chuck Tucson — 8/13/2009 @ 9:28 am

  7. Mark;
    If you feel that your options in Massachusetts are too expensive then we are in very deep trouble. I say that because as “generous” or “ungenerous” you found the coverage options in Massachusetts, they are part of a grand plan to cover the uninsured that is already wildly over budget.

    Having said that, when you speak of incorporating the best of the Netherlands, France, UK and Canada, did you have specific policies in mind?

    Comment by c3 — 8/13/2009 @ 1:09 pm

  8. [...] View original post here: Right Wing Nut House » ALTERNATIVES TO OBAMACARE [...]

    Pingback by Right Wing Nut House » ALTERNATIVES TO OBAMACARE | AlternativeInsuranceGuide — 8/13/2009 @ 4:41 pm

  9. Sure there are other options, Rick . . . but they aren’t on the table.

    Blunt says they may not bother putting out a Red plan. Boehner says they are working on one. It’s coming. Really. It’ll be awesome. Details? We’ll tell you later. First we have to kill the reform movement dead, then we’ll propose reform. Promise.

    The choice isn’t between the Democratic plan and a better plan. The choice is between the Democratic plan and nothing. In a perfect world there would be other choices, but here and now there are not. Reds aren’t offering anything except “the Blue bill sucks”.

    Two questions for you Rick . . .

    1) Do you believe that if the Reds can kill the bill, they will engage in health care reform after all this?

    Assuming the answer to question #1 is “no”, then . . .

    2)Would you rather no change, or the flawed Democratic plan?

    Hey! Rip Van Winkle! The GOP introduced its plan back in May.



    Comment by busboy33 — 8/13/2009 @ 8:47 pm

  10. As far as I can tell “Obamacare” was developed in the House. Why do you call it Obamacare except as a possible perjoritave?

    A possible perjorative? Holy Christ, you really are pretty dense, aren’t you?

    Of course I use it as a perjorative, you ninny!


    Comment by bobwire — 8/14/2009 @ 1:50 am

  11. Rick, because you have no health care, consider this option
    They may show up near your hometown.

    Comment by bobwire — 8/14/2009 @ 2:11 am

  12. @Rick:

    Some members of the GOP introduced a bill (S. 1099), which is since May 20th is sitting in limbo in the Finance Committee as far as I can tell.

    But the GOP hasn’t gotten behind it. Blunt STILL hasn’t gotten anything for the House, and here is what he said at the end of July:

    “Rep. Roy Blunt (R-Mo.) said, ‘Our bill is never going to get to the floor, so why confuse the focus? We clearly have principles; we could have language, but why start diverting attention from this really bad piece of work they’ve got to whatever we’re offering right now?’”

    “we could have language”. I could hit a home run over the Green Monster . . . but I haven’t.

    Since he’s in charge of the GOP effort for Health Care Reform in the House (and has been for, what, 5 months?) . . . that means the House GOP haven’t got crap, and apparently they’re fine with that. Sure, it’s the Democrat’s fault — why even bother?

    (btw — “why even bother” = “why bother writing a bill” = “we don’t have one”)

    So some (6?) Senators introduced a bill . . . which the GOP has done ABSOLUTELY NOTHING to put in front of the people. They held a press confrence back when it was introduced, then they forgot all about it. The House isn’t even pretending anymore that they’re going to introduce a Bill.

    In all the “debate” on reform, where is the GOP saying “our bill is better”? They’re not. The GOP isn’t making the slightest effort to promote S.1099. Hell, has Coburn even mentioned it since it was submitted? Has the GOP?

    Gotta say, it doesn’t look like the GOP is trying too hard to get it passed. Doesn’t seem like the GOP even remembers it. They’re not trying to pass GOP healthcare reform . . . they’re trying to kill Democrat healthcare reform.

    I’m sure you disagree. Maybe from your perspective the GOP is valiantly struggling to push healthcare reform. Maybe behind the scenes the GOP is deeply concerned about reforming healthcare in this country but they’re too circumspect to publicize all their hard work.

    But from where I’m sitting it diesn’t look like the GOP gives a damn. Coburn and crew did submit something, true. That hardly equals a GOP healthcare reform effort. If Kucinich submitted a bill welcoming UFOs, that hardly means the Democrats are pushing for recognition of aliens.

    It was billed at the time as the comprehensive GOP alternative. It was written by both senators and house members. It had the approval of both Boehner and McConnell - who both attended the press conference unveiling the package. It contained not only free market provisions and medicare reform but was dubbed “revenue neutral” by the CBO.

    This was and is the GOP alternative. It is considered that way by the RNC and the rest of the party. I don’t care what you think Blount is saying, this is it, it was introduced in May, and was never given a fair hearing by the press or the democrats.


    Comment by busboy33 — 8/14/2009 @ 4:37 am

  13. “This was and is the GOP alternative.”

    I guess somebody forgot to tell Boehner:

    July 23, 2009: “Minority Leader John Boehner (R-Ohio) said on Thursday afternoon that Republicans will have an alternative healthcare reform bill to offer but did not say when it would be ready.”

    Since he made that statement months after S.1099 was submitted, it sure doesn’t sound like the GOP leader knows that “the GOP alternative” already exists.

    You want to tell him, or should I?

    Comment by busboy33 — 8/14/2009 @ 5:35 am

  14. correction: the GOP leader in the House. Sorry for the typo.

    Comment by busboy33 — 8/14/2009 @ 5:36 am

  15. Saturday morning/Friday evening links…

    Bitchy Virgin is now closed, and a darn nesting Peregrine Falcon plus rockfalls have closed off some of my weekend climbing warm-ups in the Gunks. I do not do serious technical climbing, but I like to know how to handle rocks. I am headed for Banff (…

    Trackback by Maggie's Farm — 8/15/2009 @ 5:34 am

  16. #5: Mark in Boston.
    If your options in Mass. are so gosh-darned awful, why oh why, do you support attempts to inflict the Massachusetts health insurance Mandate failure on the rest of us?

    And btw, if healthcare is a right, then single-payer, by denying my right to choose my own healthcare providers and insurers, is a denial of healthcare rights. Single-payer is collectivist nonsense.

    Comment by Travis Monitor — 8/16/2009 @ 10:40 pm

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