How The Health Bill Can Be Made Worse In The Future

By Big Tent Democrat, Section Other Politics
Posted on Tue Dec 29, 2009 at 09:22:32 AM EST
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Matt Yglesias misses the mark in an attempt to detail some of the ways a future GOP government can make the current health bill worse in the future:

Rather than repealing the specific tax provisions that finance reform, you’ll see drives to cut taxes for the rich. [. . .] [I]nstead of complaints about how reform is going to blow up the deficit, you’ll see a combination of tax (cut! cut! cut! especially for the rich) and spending policies that do in fact blow up the deficit.

Yglesias misses the most obvious way that Republicans could actually "bend the cost curve" to pay for tax cuts - reduce the funding for Medicaid. The insurance industry will be fine with that (unlike reductions in subsidies to purchase private insurance and elimination of the mandate.) Since the progressive heart of the current bill is in fact the expansion of Medicaid, the Republicans of the future could easily gut the good in the current bill.

Speaking for me only

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How The Health Bill Can Be Made Worse In The Future | 18 comments (18 topical)

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Since when do Republicans think (5.00 / 1) (#1)
by ruffian on Tue Dec 29, 2009 at 09:34:32 AM EST

they have to pay for tax cuts? They pay for themselves, don't you know! That is the beauty of their philosophy - tax cuts, and only tax cuts, are deficit neutral. If Republicans get back in control, you will see tax cuts, no matter what happens with the health care bill. That is a given.

More to the point of the post (none / 0) (#2)
by ruffian on Tue Dec 29, 2009 at 09:36:48 AM EST

I don't think they will suggest gutting Medicaid as a way to pay for tax cuts. They may do it anyway, but it will be unrelated to their general tax cut plans.


Getting way ahead of ourselves... (none / 0) (#3)
by ruffian on Tue Dec 29, 2009 at 09:40:03 AM EST

but if and when the Republicans do try to sell the gutting of anything as a way to pay for tax cuts, I hope Dems call them on the repudiation of a basic tenet Republicans have been claiming since Reagan - that tax cuts actually increase revenue.


They're going to sell gutting this bill (5.00 / 1) (#12)
by Cream City on Tue Dec 29, 2009 at 12:04:57 PM EST

for health care before it can go into effect -- the benefits part, but not the tax increase part and health insurance increase part that will hit the voters first. I dipped into some local conservative blogs and can see that the Repub platform for Congressional seats next year already is being set.

Repubs will campaign on the slogan of "reform and repeal," i.e., repealing the health insurance bill. And I bet that it will be a winning slogan.


: Or, per the Drew Weston piece (5.00 / 1) (#15)
by shoephone on Tue Dec 29, 2009 at 12:58:14 PM EST

that BTD linked to the other day, the Repubs mission will be to gut anything meaningful from the bill -- but keep the mandates. That's the only part they, and the insurance industry, really like.

The vulnerability of Medicaid ... (5.00 / 1) (#4)
by Salo on Tue Dec 29, 2009 at 09:40:26 AM EST

... To the whims of the Budgeteers is the Achilles heal of the bill. It's a huge mess in other ways and it's obvious it should have been set up like Social Security.

I agree. They will make the same class warfare (5.00 / 3) (#5)
by esmense on Tue Dec 29, 2009 at 09:40:49 AM EST

attacks against expanded Medicaid as they do and have always done against all and any forms of "welfare." Plus,they will inevitably burden expanded Medicaid with so many humiliating restrictions and intrusive proofs of eligibility, etc., that it is unlikely to be greatly popular even with its beneficiaries.

We either recognize health care as a social responsibility that must be universally applied or we don't. There's no such thing as a workable half measure.

What do you think the Republicans will (5.00 / 3) (#6)
by MO Blue on Tue Dec 29, 2009 at 09:55:45 AM EST

be able do to Medicare using the Independent Medicare Advisory Boards the Democrats so nicely included in the Senate's bill? Also, the Democrats opened the door for future cuts to the Medicare budget by sanctioning it in this bill.

: Just saw that cardiologists are suing Medicare (none / 0) (#18)
by suzieg on Tue Dec 29, 2009 at 05:01:35 PM EST

because of the 40% cut in reimbursement for nuclear imaging tests starting in January. That should be fun in the future to try to find somewhere where it will continue to offer these tests for medicare patients when it's practically impossible to find a general practitioner to take them today!

Well, the deficit is already blown up (5.00 / 3) (#7)
by Militarytracy on Tue Dec 29, 2009 at 10:03:12 AM EST

Matt. The thing that would provide safety for this legislation would have been success that was experienced in each and every American life. It does look like maybe the poor will experience some relief possibly for whatever time frame Dems run this show, but in this current economy it isn't looking like anyone else is going to feel relieved. What voter will fight to protect something that has harmed them?

That has always been the best hope (5.00 / 4) (#8)
by ruffian on Tue Dec 29, 2009 at 10:27:00 AM EST

for Dem policies (let alone progressive policies). Implement them ASAP and show that they work. Doing otherwise shows such a profound lack of conviction. I don't know how they plan to run for reelection based on anything they have done so far.


Heh (5.00 / 1) (#9)
by cawaltz on Tue Dec 29, 2009 at 10:41:35 AM EST

If they don't win there is always K street.


Yep. The stupidity of the delay (5.00 / 1) (#13)
by Cream City on Tue Dec 29, 2009 at 12:06:31 PM EST

until 2014 is going to help Repubs; they already are planning on a repeal campaign (see my comment above).


This should be a real win for Dems in 2012 :) (none / 0) (#14)
by MO Blue on Tue Dec 29, 2009 at 12:45:39 PM EST

The Democrats and President Obama have been clear that the "doughnut hole," as the gap is known, would disappear gradually over the next 10 years. They have not mentioned that Medicare patients would, according to House figures,

face a slightly larger hole in coverage during two of the next three years than they do today.
...
As a result, patients would face a larger coverage hole in 2011 and 2012 than this year, according to Ways and Means Committee data. After that, it would shrink more rapidly and disappear in 2019. link

: good god (none / 0) (#17)
by ruffian on Tue Dec 29, 2009 at 04:49:34 PM EST

And who might it be planning a run in 2020? Great slogan: I took 10 years to fill the doughnut hole.

Any and every gain in expanded coverage (5.00 / 3) (#10)
by esmense on Tue Dec 29, 2009 at 10:47:33 AM EST

is vulnerable -- as long as Democrats continue to allow the debate to be limited by the ridiculous fantasy of "free market" vs. "socialized."

A sophisticated modern medical system is not possible without socializing costs. Modern medicine and various forms of public and private "insurance" developed hand in hand. The reason for this should be obvious -- sophisticated health care facilities and assets require a steady stream of revenue that can't be provided adequately by the ill alone. For obvious reasons, the first health insurance schemes were developed by providers to benefit providers.

Our health care system, like every other modern health care sysrem, is socialized. It is just (compared to some others) socialized in ways that protect the financial interests of providers (and any number of middlemen) better than, or in favor of, the financial interest of patients.

There is really nothing being proposed by this administration that will correct that. Nothing being said that changes the debate. Nothing being done that conservatives won't try to undo using the same false, but long standing and basically unchallenged, arguments against "socialized" medicine.

Prez. Shamwow & the Dims Have Done EVERYTHING (5.00 / 1) (#11)
by tokin librul on Tue Dec 29, 2009 at 11:25:34 AM EST

the can do to ensure that the 40 Million or so Murkins who get "coverage" will do so at the expense of those who already enjoyed their coverage...There are no provisions in the bill designed to attract the loyalty of the mass of voters. Indeed, it seems designed to alienate them. And, since hte most beneficial provisions don't engage for another half-decade, there will be plenty of support for the next Bushevik who comes along to gut it...

Hmmm (none / 0) (#16)
by Emma on Tue Dec 29, 2009 at 01:55:06 PM EST

Maybe LBJ should have opposed the Civil Rights Act so that Democratic dominance could have been maintained through the 60s and 70s and Medicare/Medicaid could have been improved and thus would have provided meaningful health care for everybody. Dang. Another missed health care opportunity!