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IS CONGRESS BACKING OFF HEALTH REFORM?
The big buzz in health care circles today is this Hill article featuring on-the-record quotes from Schumer, Rockefeller, and Baucus that appear to lower expectations for health reform. Obviously, I reject and denounce all such comments! But I'm not totally convinced they were made. Take Rockefeller's statement:
“We all know there is not enough money to do all this stuff,” said Sen. Jay Rockefeller (D-W.Va.), a Finance Committee member and an Obama supporter, referring to the presidential candidates’ healthcare plans. “What they are doing is … laying out their ambitions.”That scans oddly for two reasons. The first is money. Obama's aides say the plan would cost between $50 billion and $65 billion a year. Assume they're lowballing, and the real number is $80 billion. That's some cash, to be sure but it's not a level of outlay that tends to make Senators balk. We're spending far more on Iraq, on tax cuts, and a host of other projects. The money could probably be found fairly easily -- and it's certainly not hard for Senators to say it could be found fairly easily. So that looks strange.
The second oddity is "all this stuff." A health care bill contains a lot of stuff, to be sure, but it's generally referred to in the singular. It's a bill. It's big, and you can either do it or not do it. Moreover, the only proof we have that he was talking health care is that the reporter says so. It sounds to me like Rockefeller is saying something much broader and more mundane: That if you look at the domestic agendas of Clinton and Obama, there's not enough money nor political will to do all of it. You're not going to get health care and tax cuts and energy policy and housing reform and education and poverty and everything else you promised in the campaign. And even if you could muster the will, you can't find the funds. That leads to the question of priorities, but that's no surprise.
Schumer's quote, by contrast, is much starker: "Healthcare I feel strongly about, but I am not sure that we’re ready for a major national healthcare plan." Schumer isn't terribly relevant in Senate health care deliberations, and he'll fall in line behind the president's priorities, but his advice will be important to the president, and if he's counseling caution, well, that's a shame. Lots of folks, however, take Schumer's position, which is go slowly, cover the kids, achieve some small bore and popular bills (like prescription drug bargaining), and declare victory. That was always going to be one of the strains of thought, and Schumer was always going to be it's proponent. So his involvement here is basically what you'd expect.
The more crucial player named in the article is Max Baucus, chair of the Finance Committee -- which, for our purposes, is the Health Care Committee. Baucus has repeatedly said he wants major health reform as a legacy issue, and has been "clearing the decks" in order to get the Committee ready for hearings. If he decided to abandon the battle, that would be huge news. But what he tells the reporter, recast in the reporter's words, is "Max Baucus said the groundwork is already being laid through hearings, but projected an uphill battle ahead." Well, duh. The actual quote we get from him is "If they try to solve all the problems, it’s going to be difficult,” which is undoubtedly true. But no President is going to try to solve all the problems in the first bite -- cost will almost certainly take longer -- so it's neither here nor there.
I've got some calls out for clarification from the relevant offices. But in general, this articles reads strangely to me. The quotes speak more to the difficulty of the issue than anything else. Most of them are pretty banal restatements of viewpoints we already knew. At the end of the day, if there's presidential leadership, and a strong strategy, there'll be a fight to pass health reform. If there's not, there won't be. Nothing in the article changes that, or even really sheds light on which eventuality is likelier.
COMMENTS (8)
maybe they think health reform is going nowhere because they realize that the next president will be either obama or mccain
Posted by: kn | April 24, 2008 2:52 PM
We're spending far more on Iraq, on tax cuts, and a host of other projects.
Huh? Tax cuts aren't a 'cost' because they are not an outlay.
Posted by: El Viajero | April 24, 2008 2:53 PM
Huh? Tax cuts aren't a 'cost' because they are not an outlay.
This is a logical fallacy. Imagine 2 programs:
1. A $500 check sent out to each married couple with at least one dependent.
2. A $500 refundable child tax credit, available to each married couple with at least one dependent.
Economically, these programs are exactly the same. Fiscally, they will both add to the deficit unless balanced by a spending cut or tax increase. Yet program #1 is called "spending" and is a "cost", while program #2 is a "tax cut".
Tax cuts have to be paid for just like everything else. Whether one uses the term "cost" or not, the only difference between a tax cut and direct spending is that a tax cut often costs more and takes longer to administer (because it has to go through the IRS bureaucracy).
Posted by: Dilan Esper | April 24, 2008 4:21 PM
Ezra,
I think you're missing the overarching point here. I agree that the article isn't compelling in the data provided, but you skipped a few key quotes that explain the story better.
Schumer said he would focus “on prevention above all and cost cutting until we can get a national healthcare plan.”
A recent Wall Street Journal-NBC News poll found that 58 percent of Americans say healthcare costs are an “important” part of their economic concerns.
“I hear on the campaign trail, ‘This is what I’m going to do,’ as if there is not a Congress here with feelings and experience on this issue,” Meek said. “I think it’s important that everyone takes that into consideration and that this is not a kingdom, this is a democracy.”
Taken together? Costs are what constituents are concerned about, not 100% universal coverage. There are a lot of arguments why reform should include UHC now, but constituent demands simply aren't one of them. Politically, the UHC/mandate debate has really been a purity test about which candidate was most willing to stake out the left position publicly. It hasn't been about actually proposing to implement a policy. Edwards wasn't supprotive of UHC 4 years ago (his "reasons" for his evolution on this issue are laughable), Obama isn't offering universal coverage, and Hillary supported it after Edwards because she simply couldn't be out-flanked by him on her signature issue. This debate has never been about really implementing UHC in policy. Let's see this for what it really is. Politicians, including the next President, aren't going to significantly use up their political capital on an issue that isn't a top priority for constituents. They may support it in theory, but that's a far crying from both supporting the detail nor actively demanding vs. passively supporting in polls. As you've rightly pointed out before, most people are satisfied with their health care and most have it. The concerns they have are centered around rising out-of-pocket costs-- which is exactly what the WSJ polls, Schumer and Meeks are addressing in their excerpts above.
Posted by: wisewon | April 24, 2008 5:18 PM
Yet program #1 is called "spending" and is a "cost", while program #2 is a "tax cut".'
No, these are both a tax cut whether you call the stimulous checks anything else or not. The money they give you came from__________.
Posted by: Anonymous | April 25, 2008 1:47 PM
A story in April of an election year in a second-tier rag based on a few pickup quotes from ink-hungry Congressmen about what is going to happen next year in health care reform is not relevant.
Posted by: Merrill | April 25, 2008 3:16 PM
First you insure all kids to age 25 under Medicare. Once that program is in place and working you let everyone over the age of 50 who is not employed buy into Medicare. Once THAT is working you offer Medicare to everyone between 25 and 50 who doesn't have health care, maybe free to everyone who loses their job. Then you include the rest for free. And then you have single payer insurance available for everyone who doesn't have a job.
Posted by: Richard H. Davis | April 26, 2008 10:21 AM
Universal health care won't cost $50-$85 billion. Try $500-$850 billion, if the usual 10:1 ratio of estimated cost to actual cost of health care spending is considered.
the Democrats do not want to be the ones to run up the largest deficits of all time on a concept Americans are already skeptical of.
Americans want change from the Republican free spending, free borrowing ways. Many Democrats seem to think that the misbehavior of Republicans gives them a free pass to forget about the deficit. They'll find out that the American voters will keep on punishing whoever is in power until some fiscal responsibility is demonstrated.
Posted by: Adam Herman | April 27, 2008 1:28 AM