Are Republicans shooting themselves in the foot on health care?

Great Debates
1

Even assuming their anti-reform arguments are correct (which is certainly possible), are Republicans shooting themselves in the collective foot by opposing reform so staunchly?

I ask this because, by most objective accounts, health care costs are on an unsupportable trajectory – costs are rising much faster than inflation. If more and more people are priced out of the system and go uninsured, and health-related bankruptcies continue to increase, it seems possible that in 5 or 10 or 15 years, there will be much more popular support for much more liberal reform plans than are currently being proposed. If premiums are another 2-3x what they are now, and if the % of US GDP spent on health care becomes too burdensome, all the insurance lobbyists in the world might not be able to stem the tide of popular sentiment for more drastic reforms than are currently on the table.

In other words, by not compromising now, are Republicans going to end up with something that is (to their minds) much worse down the line if/when the status quo proves untenable?

(I don’t mind a bit, by the way, if folks want to quibble with any assumptions made above. Perhaps you don’t think the cost trajectory will remain as steep as it currently is, for instance.)

2

If we assume their arguments are correct (ie, that things will be worse and cost more), why would there be more support later on down the road?

3

No, this is the smartest thing the Republicans have done since invading Iraq. Give it a couple of years, and a grateful nation will turn to them to throw off the yoke of Democrat Socialism.

4

Which arguments? The ones when they were running and said health care as we have it is unsustainable? The ones that said there is a crisis and it has to be fixed? Are those the arguments of which you speak?

5

In Tennessee, it ain’t hurtin’ them at all.

And we have terrible health care here.

6

A possible counterargument to that is if we do get health reform and it barely contains costs, the GOP will use that an a reason to say ‘see, the democrats can’t do anything right’.

Obama’s proposals seem based on teh ideas of the commonwealth fund, which found effective reform would cut cost increases from 6.7% down to 5.5% over the next decade, saving $3 trillion in lower health costs.

http://www.commonwealthfund.org/Content/Publications/Fund-Reports/2009/Feb/The-Path-to-a-High-Performance-US-Health-System.aspx

The % of doctors who support national health insurance has increased dramatically from 2002 to 2007.

At the same time, meaningful single payer may save $400 billion a year in lower overhead and bulk purchases. Combine single payer with comparative effectiveness research to reduce excess and waste, and as time goes on it is likely what we will end up with. Which is fine by me.

You also have to take into account the Gini coefficient and the death of the labor movement. The US economy grows, but almost all the wealth is concentrated in the top 5%. So if health care costs 2.5 trillion now but 5 trillion in 2020, then that means the middle class will have to pay for that w/o seeing any real increase in wages because all the benefits of productivity will have gone to the wealthy.

As it stands now roughly 30-40% of national income goes to the bottom 90%. If employers realize they can pass all the costs of health care onto their employers w/o offering them wage increases, it will get even worse.

So the vast majority of americans will be forced to pay for health care that takes up a bigger % of national income while earning an even smaller % of national income.

Right now health takes up about 16% and the bottom 90% earn maybe (roughly) 35%. By 2020 health may take up 20% of GDP and the bottom 90% of wage earners may only earn 30% of GDP.

Either way, single payer with comparative effectiveness is likely to happen within 20 years in my view. Even if we do health reform properly and cost increases decline slightly (say from 6.7% to 5.5%), its only going to put off the inevitable for a couple of years.

7

They have no choice. They must defeat health care reform, period.

Any bill that passes with any substance, however watered down, however luke warm, will benefit a lot of people. Black, brown, white, gay, straight, you name it. Its a demographic which cuts across all divisions, its the Everybody demographic, and a sweeter spot does not exist. Who are they going to credit with their release from fear? The Dems. Duh.

The pubbies are already behind the power curve. Even if this gratitude only bolstered their electoral deficit by say, 10 percent, that is water on a drowning man. And if the Dems pass a bill that benefits a whole lot of people, its that much worse.

They have to kill it, or at the very least stall it.

8

Who are the people gonna vote for? The Greens?

9

Because without reform, things will be even worse and cost even more?

The argument is a lie anyway, so there is no reason to assume that it is true. Every western industrialized nation that has adopted single payer health insurance has reduced costs and improved outcomes.

How can Republicans seriously think health reform is going to make things worse than they already are? Really, how can they? The only possible reason to make that argument is to base it on the fact that the Democrats are not going far enough.

And this whole argument is bullshit. It has already been proved that single payer health insurance improves health all around, and the Democrats are idiots for not fighting to make health insurance companies the buggy whip manufacturers of today, and the Republicans are idiots for pretending that the current system is the best of all possible worlds.

10

This is pretty much my opinion.

If the Republicans really believed that we should lower government spending and reduce government services, they would be trying to abolish Social Security. But nobody wants to touch Social Security - it’s too popular with too many voters. The most anyone will argue about is what’s the best way to preserve Social Security.

Or go back to public education. There was a time when public education was controversial. People argued that those parents who wanted to send their children to school could do so but the government had no business running schools or making school attendance mandatory. Nowadays you’ll see people arguing about how schools should be run but you don’t see anyone arguing that five year olds should just skip school and go directly off to the coal mines.

And this is where I see public health care heading. If it happens, people are going to quickly realize it’s good. There’ll be arguments about how it should work or how it should be financed but no politician will ever be able to suggest we abolish it and go back to the old way.

So the Republican strategy has to be based on prevention. They have to work on keeping public health care from being enacted and claim that this was a victory.

11

If middle class people like me can buy health insurance from the government rather than from a private insurer, I will call that a success for the Democrats and their goals. If the Democrats succeed in this goal, the Republicans will be mortally wounded because the Republicans have made it clear that they oppose it at all costs. A large group of the electorate will then depend on keeping the Republicans out of power.

So in my opinion the answer to your question is yes.

Having a strong public option is not in the Baucus bill. It may get into the bill by the end of the year.

The health care debate has in my mind highlighted the fact that most members of Congress in both parties are bought and paid for by lobbyists. This is a deplorable indictment of our system of government.

12

All the insurance money and astroturfing (town hall screamers) in the world won’t change facts on the ground; they don’t have the numbers, and they know it, so they are utilizing a scorched earth policy of party-over-patriotism, pure and simple, raw politics.

13

Fear of political consequences were why the GOP opposed health reform in 1993 also. Bill Kristol wrote a memo saying as much, and Bob Dole said the GOP had to oppose it or risk going into the minority for a generation.

http://www.mydd.com/story/2009/9/8/20634/84764
The last thing the GOP wants is for the government to pass laws providing affordable, high quality health care for everyone that cuts costs and is affordable to fund. It’ll destroy their entire ideology (government can’t do anything right and taxes/regulations are always bad) and put them further into minority status.

14

How soon you forget. Bush did, and the scars aren’t going to mend in a hurry.
If the Republicans had serious reasons to oppose the various plans they would present them, at least for the benefit of the educated, and stop braying about socialized medicine and death panels. So, I agree the the main gist of the comments, which is the GOP can’t afford to let Obama succeed on anything, since they know their only hope of getting back into power is to have him fail. Screw the good of the country. Those who said this are off the reservation only in the sense of saying it out loud.

15

Double post

16

Which is what’s likely to happen. You’ll note that there’s very weak support for the various bills amongst the Dems as well. They could blast it through if they wanted to. Saying that it’s the Republicans holding it back is rather dishonest.

There’s no chance that the government is going to shut down private insurance. A) It would cause massive turmoil and put millions out of work, B) it would force them to raise taxes by double, which would be political suicide regardless of what side of the fence you were on.

That means that there will be no decrease in overall spending. And even if they did shut down private insurance, most likely there wouldn’t be a decrease in health spending. No country has decreased spending by moving to universal health care. There’s zero reason to think that the US would be the first to accomplish this.

As the long as the debate is about UHC versus non-UHC, spending isn’t going to decrease. We need to figure out why American health spending is double that of any other nation, and only then can we reasonably talk about cutting costs. But if you try to pressure UHC through with the promise that this alone will cut spending, you’re going to do damage to your own party. This is why no one is supporting this law on Capitol Hill except the die-hard Dems who are nutballs anyways.

17

The answer is…it depends on how this all plays out and who the voters blame. If the Pubs are able to portray the Dems proposals as bad, wasteful, the wrong direct, etc etc, then if it fails some percentage of voters might swing toward the Pubs. Or, it could play out that the Dems are able to get some mutated compromise through (eventually), which will be the worst of all worlds…in which case the Pubs will be able to point at it and say ‘we told you so…that’s why we opposed the whole mess all along!’.

Conversely, if the Dems get something through that actually works (as unlikely as that seems to me at this point), and they are able to portray themselves as the shinning beacon who pushed through this vital legislature in the face of unreasonable Pub opposition, then the voters may swing in their direction instead.

It’s all going to hinge on what, if anything, is eventually passed, how it is perceived to be working, and who is able to capitalize on the credit. It’s really not about health care so much as it is about politics, US style.

-XT

18

I sense conflict. Cite from either of you?

19

You must have misunderstood Bush’s proposals. He never said he planned on eliminating Social Security. He planned on making changes in how it was financed and paid out. But even under his long-term goal, the government still would have been collecting social security taxes and paying social security pensions.

20

Perhaps its not conflict I sense, but I definitely would like to see some citation on this one.