Reading the blogs this morning, and seeing a lot of health care policy stuff out there:
Polls from Marist and the AP show that although opposition to the PPACA remains high among conservatives, the support for full repeal is not. The AP poll found that only about 25% of respondents favor repeal, while 20% favor leaving it as is, and 43% favor expanding the law so that it does more. As in previous polls, people like the rules prohibiting insurers from discriminating based on pre-existing conditions, and the individual mandate remains unpopular. Similarly, the Marist poll found a small majority want the health care reform act to be left in place or expanded. Does this mean the law is becoming more popular? I don't think so -- it remains deeply polarizing along ideological lines. But the take-home point from these polls might be that the intensity of opposition is easing now that the election is over, and that some of the top-line "opposition" to health care reform is, and always has been, from the left, believing that it should do more.
Nevertheless, House Republicans are ready to begin their symbolic attempt to repeal the law. I don't begrudge them their gesture: it was a clearly stated campaign promise. However, it is pretty telling that despite the Republicans' ostensible concerns about the deficit, they make no effort to find any offsets from the $230 billion cost of repealing the PPACA. While we know it's just a bit of political theater, since repeal has zero chance at the present time, the GOP hypocrisy on the deficit is nothing new. GOP policy priorities never have to be paid for, it seems, whether they be Medicare Part D or tax cuts or health care repeal. John Boehner made the curious argument that the CBO cost estimate for the cost of repeal was unreliable, since the "doc fix" costs were not included (a long-standing criticism of the PPACA from the right). Paul Krugman took advantage of his column today to shred that line of criticism, once again. It's worth quoting at some length:
Republicans have a small problem: they claim to care about budget deficits, yet the Congressional Budget Office says that repealing last year’s health reform would increase the deficit. So what, other than dismissing the nonpartisan budget office’s verdict as “their opinion” — as Mr. Boehner has — can the G.O.P. do?
The answer is contained in an analysis — or maybe that should be “analysis” — released by the speaker’s office, which purports to show that health care reform actually increases the deficit. Why? That’s where the war on logic comes in.
First of all, says the analysis, the true cost of reform includes the cost of the “doc fix.” What’s that?
Well, in 1997 Congress enacted a formula to determine Medicare payments to physicians. The formula was, however, flawed; it would lead to payments so low that doctors would stop accepting Medicare patients. Instead of changing the formula, however, Congress has consistently enacted one-year fixes. And Republicans claim that the estimated cost of future fixes, $208 billion over the next 10 years, should be considered a cost of health care reform.
But the same spending would still be necessary if we were to undo reform. So the G.O.P. argument here is exactly like claiming that my mortgage payments, which I’ll have to make no matter what we do tonight, are a cost of going out for dinner.
There’s more like that: the G.O.P. also claims that $115 billion of other health care spending should be charged to health reform, even though the budget office has tried to explain that most of this spending would have taken place even without reform. [...]
The key to understanding the G.O.P. analysis of health reform is that the party’s leaders are not, in fact, opposed to reform because they believe it will increase the deficit. Nor are they opposed because they seriously believe that it will be “job-killing” (which it won’t be). They’re against reform because it would cover the uninsured — and that’s something they just don’t want to do.
Emphasis added. I take issue only with Krugman's conclusion, that Republicans don't want to cover the uninsured. The real reason for the intensity of GOP opposition to health care reform is because it was a big win for the other team, and in the zero-sum world of electoral politics, a win for Team Blue is a loss for Team Red. The way to get back in power, beyond simply riding the economy, is to try to avenge that loss by repealing it. If the GOP was actually serious about health care reform -- which they manifestly are not -- they would be offering amendments to the law to improve it rather than blocking bipartisan fixes. They would be proposing an alternative rather than a return to the status quo. The primary goal of the modern GOP is the acquisition of power, not in governance, so they focus on repeal as a means to recover from the political wilderness.
However, the House GOP is ready to get to work protecting the profits of their allies in the insurance industry. Rep Carter (R-TX) is preparing a resolution to block implementation of regulations which would require insurers to spend at least 80% of premium dollars on medical costs. It, too, is a long-shot to pass, but the fact that the first priority of the GOP is to ensure that insurers can continue to spend as much as they like on CEO pay, profits and administrative overhead is also a telling sign of where their true intentions lay.
Austin Frakt at the Incidental Economist provides evidence that the individual mandate in Massachusetts is working as intended -- that the rate of uninsurance is very low (about 2%) and that adverse selection, or people gaming the system is so low as not to ba a problem. This is informative as to what should happen in 2014 when the PPACA is implemented nationally. He goes on to point out that this is not to say that the mandate will decrease costs or improve access to care -- those are separate issues that the mandate was not intended to directly address.
On an unrelated note, I can't help but comment on the fact that Starbucks' is introducing a new larger-size drink, the "Trenta." At nearly a liter in size, it exceeds the average capacity of the human stomach. I leave it to you to decide what, if anything, that says about the state of American civilization.