# Democrats in House Botch Health Care Bill **URL:** \ **Category:** Great Debates\ **Created:** [July 16, 2009, 5:54pm UTC](https://boards.straightdope.com/t/democrats-in-house-botch-health-care-bill/503244 "2009-07-16T17:54:42Z")\ **Posts on this page:** 17\ **Page:** 3
**Author:** ![Squink](https://avatars.discourse-cdn.com/v4/letter/s/b5e925/32.png) [@Squink](https://boards.straightdope.com/u/Squink)\ **Post date:** [July 16, 2009, 11:15pm UTC](https://boards.straightdope.com/t/democrats-in-house-botch-health-care-bill/503244/41 "2009-07-16T23:15:09Z")
> [@Sam\_Stone](#): > > This time around, support for major health care reform is much lower than it was when Hillary tried it. Even accepting your claim at face value, we also need to consider the current state of GOP political power. It’s quite low. Just look at this whining from house members: > [@](#): > > Republicans complain that unless a member of their party is one of the 60 members of the Appropriations Committee, he is essentially blocked from having any say in shaping the budget. > > “That simply disenfranchises most of the members of this body,” said Rep. Jeff Flake, R-Ariz. > > Democrats say that months ago, they offered Republicans the chance for a more open process in return for a guarantee that Republicans wouldn’t drag things out. Republicans initially said no but recently have agreed to limit how long a bill can be debated. Too late, say Democrats. > > “We offered Republicans the opportunity to work with us in a bipartisan way to offer amendments so we could complete the appropriations process in a timely manner,” said Brendan Daly, spokesman for House Speaker Nancy Pelosi, D-Calif. “They rejected that offer and have repeatedly used delaying tactics.” [http://news.yahoo.com/s/ap/20090716/ap\_on\_go\_co/us\_muzzled\_republicans\_5](http://news.yahoo.com/s/ap/20090716/ap_on_go_co/us_muzzled_republicans_5) Does that sound like the talk of a group that has any chance of killing health care reform? ---
**Author:** ![XT](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/xt/32/456_2.png) [@XT](https://boards.straightdope.com/u/XT)\ **Post date:** [July 16, 2009, 11:23pm UTC](https://boards.straightdope.com/t/democrats-in-house-botch-health-care-bill/503244/42 "2009-07-16T23:23:43Z")
I suspect that if it works out Obama and the Dem’s will take credit. If it’s a huge flop then it will all be the Republicans fault. These things seem to always work out that way. > [@](#): > > Why then is the plan being offered by the Democrats in the House so fundamentally different? Because reality set in, and the plan given during the election, which sounded great, was (perhaps) unworkable. So…they will do it another way, if they can. As ElvisL1ves implied earlier, the ends justifies the means, as long as it’s in a worthy cause. And what could be more worthy than getting ‘free’ healthcare to the masses, yearning to be healthy? Of course, another trite saying that springs to mind is, the road to hell is paved with good intentions. > [@](#): > > In fact the main talking point was basically that his plan would guarantee affordable, accessible health care coverage for all Americans. It was stated over and over that inefficiency and rising costs were a huge part of the problem and that a hallmark of the plan was to reduce these costs and make health care more affordable for everyone. Another aspect seems to be that Obama and the house Dems don’t, perhaps, see eye to eye on everything. As always, the Executive and Legislative branches have divergent goals and pressures, and also derive varied benefits (and costs) for any kind of new or existing program. I suspect that even if Obama’s plan was feasible (and I have my doubts), the Dems might still push for their own version, as it does them more good (and also throws more blame on Obama if it becomes unpopular…never underestimate the amount a politician is willing to divert blame to someone else, even if they are in the same party). Also, I suspect that this way there is a clear demarcation between the Dems and the Pubs, which, if this all works out well, will make the Dems shine and make the Pubs look bad. If it all goes tits up there is STILL the possibility that the Dems will be able to divert attention and blame to the Pubs, who may be portrayed as undercutting the plan. With Obama’s plan though…well, revenue neutral programs and cost cutting are more difficult to oppose I think, especially from the supposed Pubs perspective (they are SUPPOSED to be all for this kind of thing). -XT ---
**Author:** ![elucidator](https://avatars.discourse-cdn.com/v4/letter/e/8edcca/32.png) [@elucidator](https://boards.straightdope.com/u/elucidator)\ **Post date:** [July 17, 2009, 12:11am UTC](https://boards.straightdope.com/t/democrats-in-house-botch-health-care-bill/503244/43 "2009-07-17T00:11:58Z")
Oh, crap! **Shodan’s** site is a tighty-righty cootie bomb! They’re everywhere! My monitor is suddenly black and white, my whoopity whoopity Intel processor is a Motorola 8086, I gotta go buy some kerosene to power the modem (1 kb/hr upload). Software? Something called WordStar. I get online, I get Reagan-rolled. A “partisan cootie” warning would have been nice, guy. Now I gotta find a Trotskyist rabbi for an exorcism. ---
**Author:** ![UltraVires](https://avatars.discourse-cdn.com/v4/letter/u/ecccb3/32.png) [@UltraVires](https://boards.straightdope.com/u/UltraVires)\ **Post date:** [July 17, 2009, 2:16am UTC](https://boards.straightdope.com/t/democrats-in-house-botch-health-care-bill/503244/44 "2009-07-17T02:16:17Z")
> [@LonghornDave](#): > > I’m pretty sure it would still be progressive. In fact, I think it would be more progressive than the current system since now a poor person who doesn’t have health care coverage provided for them by their employer has to use taxed dollars. I am interested in hearing the answer to this as well. So, if I work for McDonalds, work for minimum wage with no bennies, and have to pay for health insurance out of pocket, then I pay tax on it. If I am a CEO of a global conglomerate who makes $100 million per year with paid health care through the company, I pay no tax on it. I want to hear why this is “progressive”. ---
**Author:** ![Shodan](https://avatars.discourse-cdn.com/v4/letter/s/9f8e36/32.png) [@Shodan](https://boards.straightdope.com/u/Shodan)\ **Post date:** [July 17, 2009, 1:55pm UTC](https://boards.straightdope.com/t/democrats-in-house-botch-health-care-bill/503244/45 "2009-07-17T13:55:18Z")
> [@GIGObuster](#): > > No, it was found that she did not. > > Yeah, time lines are a bitch. > > [Clinton health care plan of 1993 - Wikipedia](http://en.wikipedia.org/wiki/Clinton_health_care_plan_of_1993) Your cite mentions that the case was sent back to Judge Lamberth for reconsideration. > [@](#): > > Eventually, 250 boxes containing 500,000 documents would be released. When they were reviewed, not only did they show that the task force had twice as many participants as the 511 people claimed by the Administration, but that many of them were not government employees at all, but lobbyists and private individuals representing a host of special interests. But of course > [@](#): > > On December 21, 1994, Judge Lamberth accused Magaziner of lying and asked Attorney General Janet Reno and U.S. Attorney Eric Holder for a criminal investigation. Reno announced on March 3, 1995 that she would not appoint an independent prosecutor. On August 3, 1995, Eric Holder announced that he too would not prosecute Magaziner. [Cite](http://en.wikipedia.org/wiki/National_Legal_and_Policy_Center). So, indeed they did violate the law. Regards, Shodan ---
**Author:** ![Liberal](https://avatars.discourse-cdn.com/v4/letter/l/848f3c/32.png) [@Liberal](https://boards.straightdope.com/u/Liberal)\ **Post date:** [July 17, 2009, 2:11pm UTC](https://boards.straightdope.com/t/democrats-in-house-botch-health-care-bill/503244/46 "2009-07-17T14:11:16Z")
> [@Sam\_Stone](#): > > Yes, I misspoke when I said they came out in ‘opposition’. What I should have said was that they contradicted the claims being made by the White House and the Congress. That’s a statement without meaning. One could just as easily put it the other way: reports from White House economics experts contradict claims of the CBO. But even more than that, this doesn’t qualify as a “contradiction”. It’s just a difference in speculation about everything from costs to economic recovery. ---
**Author:** ![Sinaijon](https://avatars.discourse-cdn.com/v4/letter/s/dc4da7/32.png) [@Sinaijon](https://boards.straightdope.com/u/Sinaijon)\ **Post date:** [July 17, 2009, 2:21pm UTC](https://boards.straightdope.com/t/democrats-in-house-botch-health-care-bill/503244/47 "2009-07-17T14:21:05Z")
> [@Liberal](#): > > That’s a statement without meaning. One could just as easily put it the other way: reports from White House economics experts contradict claims of the CBO. But even more than that, this doesn’t qualify as a “contradiction”. It’s just a difference in speculation about everything from costs to economic recovery. Given the nature of the White House vs the CBO, I’ll take the CBO at face value. ---
**Author:** ![GIGObuster](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/gigobuster/32/421_2.png) [@GIGObuster](https://boards.straightdope.com/u/GIGObuster)\ **Post date:** [July 17, 2009, 2:34pm UTC](https://boards.straightdope.com/t/democrats-in-house-botch-health-care-bill/503244/48 "2009-07-17T14:34:33Z")
> [@Shodan](#): > > Your cite mentions that the case was sent back to Judge Lamberth for reconsideration. But of course [Cite](http://en.wikipedia.org/wiki/National_Legal_and_Policy_Center). So, indeed they did violate the law. > > Regards, > Shodan The Judge made an accusation, while we can discuss the merits of it the result was still the same. No prosecution came of it. The reality is that even if the Justice Department refused to do anything the Republicans could just had added another item for the independent prosecutor to follow. I have to say that even the Republicans concluded that that dog would not hunt, it is silly to continue to say that there was a violation of the law. ---
**Author:** ![GIGObuster](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/gigobuster/32/421_2.png) [@GIGObuster](https://boards.straightdope.com/u/GIGObuster)\ **Post date:** [July 17, 2009, 2:42pm UTC](https://boards.straightdope.com/t/democrats-in-house-botch-health-care-bill/503244/49 "2009-07-17T14:42:39Z")
And, it has to be mentioned that the site \*\*Shodan \*\*produced originally continues to lie by omission. ---
**Author:** ![ElvisL1ves](https://avatars.discourse-cdn.com/v4/letter/e/5daacb/32.png) [@ElvisL1ves](https://boards.straightdope.com/u/ElvisL1ves)\ **Post date:** [July 17, 2009, 3:38pm UTC](https://boards.straightdope.com/t/democrats-in-house-botch-health-care-bill/503244/50 "2009-07-17T15:38:46Z")
> [@Sam\_Stone](#): > > This time around, support for major health care reform is much lower than it was when Hillary tried it. Where the hell did you get \*that \*idea? :dubious: ---
**Author:** ![SenorBeef](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/senorbeef/32/2220_2.png) [@SenorBeef](https://boards.straightdope.com/u/SenorBeef)\ **Post date:** [July 20, 2009, 1:11am UTC](https://boards.straightdope.com/t/democrats-in-house-botch-health-care-bill/503244/51 "2009-07-20T01:11:55Z")
> [@Sam\_Stone](#): > > Obama boxed himself into a corner right out of the gate by framing the health care plan as a fiscal reform to save money. Nobody seriously believes that you can create a huge new government entitlement, bring tens of millions of new people under its umbrella, and then somehow manage to save money. It’s not outside of the realm of possibility. On one side you have the costs of treating uninsured people in the emergency room expensively as possible, when preventative care would’ve saved a lot of money. Economic harm caused by job immobility - people getting locked into a job where their skills may not be put best to good use, reduced productivity due to people suffering from treatable problems. People being bankrupted by finding out that their insurance policy wasn’t as good as they thought, etc. On the other side, you have the cost of insuring tens of millions of new people, paying for a government program to oversee it, and the economic cost of treating people with chronic conditions that would’ve otherwise died. I don’t think it’s accurate to say that “nobody seriously believes” that it’s possible that the benefits outweigh the cost. It’s just a matter of crunching the numbers - what are the costs, what are the proposed benefits, etc. Part of the deal is that it’s supposed to come with comprehensive reform that reduces the cost of healthcare in general - government mandated changes in administrative infrastructure that will have upfront costs but lower overall costs, perhaps reforms that help the cost of defensive medicine and malpractice insurance, etc. Of course, this is the ideal scenario requested by Obama. It appears that the House democrats don’t give a shit about the costs and benefits, but merely enacting another entitlement. Obama is speaking out about this - but he should be more forceful against the fuckups that decide the congressional democratic policy. It’s turned into something that might actually work, if given an honest attempt - reducing costs enough to be more inclusive - and turning into a clusterfuck added entitlement with no associated cost reduction. You’ve swayed me in an earlier thread on the subject that we should be focusing more on getting medical costs and insurance to respond better to free market mechanisms. I’d rather see them work on that - detaching employment from insurance by removing the tax incentives that make that pretty much mandatory, reducing the information imbalance between insurance companies and individuals, giving people a better idea of how much they actually spend on insurance, and more understanding of what their policy entails, etc. But as it is, we seem to be getting the worst of both worlds - the house democrats are uninterested in changes that improve and streamline the system to save costs, or in changes to the system that allow the market to better price medical costs. Instead we’re just going to have another entitlement to bankrupt us. ---
**Author:** ![Sam\_Stone](https://avatars.discourse-cdn.com/v4/letter/s/ecccb3/32.png) [@Sam\_Stone](https://boards.straightdope.com/u/Sam_Stone)\ **Post date:** [July 20, 2009, 2:45am UTC](https://boards.straightdope.com/t/democrats-in-house-botch-health-care-bill/503244/52 "2009-07-20T02:45:16Z")
This is one reason I think the U.S. is uniquely unsuited to large programs like this. Canada can control costs somewhat because we’re a parliamentary democracy, and as such our parties have strong discipline and members are expected to vote the party line. This has some drawbacks in that it weakens local representation, but in the case of large programs like health care, it has a large benefit - individual politicians are shielded from criticism when their districts are disproportionately hurt by a change in structure. In the U.S., if a politician votes for a program that would have the effect of shutting down a local hospital, his constituents will fire him. In Canada, the party decides, and the politicians vote with the party. So their constituents don’t hold it against them. The other side effect of this is that lobbying is much less effective in Canada. In the states, where every politician has a free vote on every issue, lobbyists can focus on individual politicians and convince them to change their vote. In Canada they can’t do that. Here’s a perfect example from my own province just this week: Our Conservative government is trying to get our health care costs under control, so they adopted a restructuring plan to cancel some projects and scale back some salaries and such. One of those conservative politicians lost a seniors health center in his riding as a result of the restructuring, and decided to go against the government and rally his constituents against the plan. The result? He’s been kicked out of the caucus, and will now sit as an independent. That takes him out of the power structure, removes any chance of being appointed to a committee where he can do anything, and it will cut him off from party funds in the next election. Harsh punishment for a disagreement on policy, but that’s what parliamentary democracies tend to do when their members step out of line. The U.S. has no such system, and as a result every major piece of legislation turns into a giant basket of payoffs, trade-offs, and compromises. ---
**Author:** ![athelas](https://avatars.discourse-cdn.com/v4/letter/a/5e9695/32.png) [@athelas](https://boards.straightdope.com/u/athelas)\ **Post date:** [July 20, 2009, 3:01am UTC](https://boards.straightdope.com/t/democrats-in-house-botch-health-care-bill/503244/53 "2009-07-20T03:01:32Z")
> [@SenorBeef](#): > > It’s not outside of the realm of possibility. > > On one side you have the costs of treating uninsured people in the emergency room expensively as possible, when preventative care would’ve saved a lot of money… The Democrats’ House plan is focused on maximizing coverage while doing very little of that cost control that the Dems talked about. “The increasing cost of healthcare” is now a reason to OPPOSE this plan. > [@](#): > > On closer inspection, the fiscal impact appears even larger. The CBO projection implies that full implementation would not occur until 2015. The average net cost per year of the five full implementation years (2015-2019) is $172 billion. And finally, costs rise swiftly within that five year period, from $141 billion in 2015 to $202 billion in 2019–roughly 9 percent per year, compounded. > > The Massachusetts-style reform template that is shaping proposals in both the House and Senate has the virtue of making the costs of near-universal coverage more transparent than did the Clinton-era approach. In the coming months, Congress, the White House, and the American people will have to decide whether they can live with legislation that focuses so heavily on coverage while giving such short shrift to meaningful cost control. And preventative care? [Not](http://www.nytimes.com/2007/08/08/business/08leonhardt.html?ex=1344225600&en=d7df12bae3f08026&ei=5090&partner=rssuserland&emc=rss)gonna save you money: > [@](#): > > No one really knows whether preventive medicine will save money in the long run, let alone free up the billions of dollars a year needed to help pay for universal health insurance. In fact, studies have shown that preventive care — be it cancer screening, smoking cessation or plain old checkups — usually ends up costing money. It makes people healthier, but it’s not free. > > “It’s a nice thing to think, and it seems like it should be true, but I don’t know of any evidence that preventive care actually saves money,” said Jonathan Gruber, an M.I.T. economist who helped design the universal-coverage plan in Massachusetts… > > As Dr. Mark R. Chassin, a former New York state health commissioner, says, preventive care “reduces costs, yes, for the individual who didn’t get sick.” > > “But that savings is overwhelmed by the cost of continuously treating everybody else.” ---
**Author:** ![Sam\_Stone](https://avatars.discourse-cdn.com/v4/letter/s/ecccb3/32.png) [@Sam\_Stone](https://boards.straightdope.com/u/Sam_Stone)\ **Post date:** [July 20, 2009, 3:11am UTC](https://boards.straightdope.com/t/democrats-in-house-botch-health-care-bill/503244/54 "2009-07-20T03:11:57Z")
> [@ElvisL1ves](#): > > Where the hell did you get \*that \*idea? > :dubious: Before you start in with the snark and incredulity, you might want to wait until you find out if I actually know what I’m talking about. From this [Pew Survey](http://people-press.org/report/522/): > [@](#): > > Pew Opinion on Health Care - 1993 vs 2009 > \* > Change the system so all are covered for necessary care:\* > > 1993: 83% > 2009: 75% > > _Change system to limit annual cost increases:_ > > Very important > 1993: 69% > 2009: 61% > > _More Important Goal:_ > > Coverage for all: > 1993: 74% > 2009: 56% > > Limit cost increases: > 1993: 20% > 2009: 36% > > _Health care system needs to be completely rebuilt:_ > 1993: 55% > 2009: 41% Support is still high for reforming health care, but it’s not as high as it was in 1993, when it failed the last time. And buried in those numbers are some disturbing signs that support is fairly fickle. It’s easy to say yes to a general question like, “do you support health care for everyone?” But notice when people were specifically asked to choose between universal care and lowering costs, support dropped from 75% to 56%. Data from other polls show that if you get even more specific, support goes down even further. For example, when asked if they would be willing to give up their own health care plan for the sake of a new universal health care system, the majority of people say no. Not only that, but support is falling fast, so the numbers in the Pew poll are probably already out of date. For example, [Politico](http://www.politico.com/news/stories/0709/24884.html) reports that in last week’s Rasmussen poll, support for the current health care plan has dropped below 50%. Not only that, but there’s more negative intensity than positive, with only 22% strongly favoring it, while 38% are strongly opposed. These are not good omens for a plan that is going to sit for a month or more while opponents continue to pick at it and more details come out about how badly botched it is. ---
**Author:** ![Really\_Not\_All\_That\_Bright](https://avatars.discourse-cdn.com/v4/letter/r/e8c25b/32.png) [@Really\_Not\_All\_That\_Bright](https://boards.straightdope.com/u/Really_Not_All_That_Bright)\ **Post date:** [July 22, 2009, 3:17pm UTC](https://boards.straightdope.com/t/democrats-in-house-botch-health-care-bill/503244/55 "2009-07-22T15:17:57Z")
[QUOTE=Sam Stone] Health care reform is in serious trouble. The Congressional Budget Office just came out in opposition to it. [/QUOTE] Could you have said anything more misleading? _This_ healthcare reform plan may be in serious trouble, but healthcare reform in general certainly isn’t. > [@Sam\_Stone](#): > > There are many other possibilities: > > \ > > 1. Other countries are free riding on the U.S.'s pharmaceutical industry and other U.S. health care research and development. > > \ > > 1. The U.S.'s health care spending is inflated, and other country’s health care costs lowered, by the fact that the people who need the most expensive, most complicated surgeries often travel to the United States to have it done. > > 2. Other countries contain costs largely through rationing. For example, the UK has 3.38 MRI scanners per million population. Canada has 2.8. The United States has 8.1. > > Of course, the fact that most health care spending in the U.S. is done through third parties is a big part of the problem, and UHC could potentially help with that. But not with the bill that’s currently being proposed. 1. There’s some validity to that, but US pharmaceutical companies actually turn higher profits in most single-payor systems because the cost of doing business is lower. Direct advertising of prescription drugs is generally illegal, for example, so drug makers lobby doctors instead, who are obviously much easier (ie., cheaper) to target. 2. Health care spending figures only include payors which file US tax returns or government entities. Non-nationals who come to the US for care do not file, and are not included in CBO or GAO spending figures. 3. Canada, the UK and US all have roughly equivalent numbers of _physicians_ per capita, however - 2.1 per 1,000, 2.2, and 2.3. Of note is the fact that both Canada and the UK (among others) directly subsidize the cost of hiring physicians in the US because doctors from both countries emigrate to the US to take advantage of significantly higher compensation. ETA: For the record, I’m against the House plan, but only because it doesn’t fix any of the things that will need to be fixed whether we get universal coverage or not. ---
**Author:** ![SenorBeef](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/senorbeef/32/2220_2.png) [@SenorBeef](https://boards.straightdope.com/u/SenorBeef)\ **Post date:** [July 22, 2009, 11:22pm UTC](https://boards.straightdope.com/t/democrats-in-house-botch-health-care-bill/503244/56 "2009-07-22T23:22:03Z")
> [@Really\_Not\_All\_That\_Bright](#): > > 1. There’s some validity to that, but US pharmaceutical companies actually turn higher profits in most single-payor systems because the cost of doing business is lower. Direct advertising of prescription drugs is generally illegal, for example, so drug makers lobby doctors instead, who are obviously much easier (ie., cheaper) to target. If it’s more cost effective to do it that way, why wouldn’t they do that here too? It’s not illegal to lobby doctors directly, right? Every notepad, pen, etc in a doctor’s office with Cialis or Lipitor on it seems to say it’s not. ---
**Author:** ![Really\_Not\_All\_That\_Bright](https://avatars.discourse-cdn.com/v4/letter/r/e8c25b/32.png) [@Really\_Not\_All\_That\_Bright](https://boards.straightdope.com/u/Really_Not_All_That_Bright)\ **Post date:** [July 23, 2009, 12:58am UTC](https://boards.straightdope.com/t/democrats-in-house-botch-health-care-bill/503244/57 "2009-07-23T00:58:11Z")
The point is that they don’t have to spend the money on direct-to-[del]consumer[/del] patient advertising - ie., TV and large-circulation print, which is really expensive. Printing up a couple thousand pens isn’t. ETA: It’s not more cost-effective, it’s just cheaper. DTC is expensive, but if your competitor is doing it, you have to do it too. [Previous page](https://boards.straightdope.com/t/democrats-in-house-botch-health-care-bill/503244.md?page=2)