30 January 2009

The times, they are a-changin'

Some good news yesterday from the Capitol as Senate Democrats overcame the GOP's two-year hissy fit over providing health care to uninsured children and "easily" renewed and expanded the State Children's Health Insurance Program on a 66-32 vote, "largely along party lines."

This isn't terribly significant in and of itself (unless your kids are among the 11 million who are now eligible for the program), but it provides a clear outline of how the health care reform debate is likely to play out in the upcoming months. And it does look like the momentum for reform is continuing to build. Just two days ago, House Energy and Commerce Chair Henry Waxman said that "This is our time. ... We need to get this job accomplished this year and get a bill to the President." This is significant since Waxman (a good progressive) is the chair of the committee that is responsible for writing the health care reform legislation, and he is famous for his legislative skills (including most recently wresting control of the committee from dinosaur John Dingell). Given the status of the House GOP's rump caucus of dead-enders, the outlook for a "clean" and progressive House plan is good.

Much has already been written about the Baucus White Paper and the Kennedy subcommittee on health care reform, and I won't rehash it, other than to note that the policy outlines put forth do not include single payer, they do retain private insurance plans, and are non-incremental, universal coverage. Presuming that Franken is eventually seated, the Senate Democrats only need to peel off one GOP vote to end the all-but-certain filibuster, and there are a plethora of likely repulican candidates -- the moderates from blue states like Collins, Snowe, Gregg, and some vulnerable incumbents who may be worried about re-election like Voinovich and Specter. In fact, if the rumors are true, and Senator Gregg (R-NH) is tapped for Commerce Secretary, then his likely democratic replacement would represent the Democrats' 60th vote, and all that Reid would have to do is keep his caucus together, making a filibuster impossible. A tall order, perhaps, but if the plan looks likely to pass, the GOP moderates are all the more likely to jump on board, eager to be seen as being on the winning side of a popular reform.

All in all, the prospects look as good as they have since 1974 for truly comprehensive health care reform. It's going to be fun to watch this play out, and I only hope that Waxman and Baucus will pay some attention to the ruinous SGR formula and the perverse incentives of reimbursement that are driving primary care providers out of existence.


  1. I will only point out that "children" can be up to 25 yrs old, and that the bill will be an incentive for families to drop private insurance to switch over to gov't plans. A prediction or 2.....it will quickly become many times more costly than planned, and reimbursement will be so low that no doc will participate. When will we learn that gov't intervention means greater cost and poorer outcomes.

  2. Doesn't the US spend more on health care than evil socialist Europeans?

    Also, cutting marginal tax rates adds .30 dollars to the GDP for every dollar of cut, while public works spending adds 1.50 dollars.

    Also, dinosaurs were real and the earth is 4.5 billion years old.

    * * * *

    Of course, as Al Franken points out, fighting Republican talking points with the truth has been only modestly effective. So, I will instead respond with the following lie.

    Doc asks, "When will we learn that gov't intervention means greater cost and poorer outcomes."

    Since the United States ended its gov't sponsored health care, 50% of all children born in America have died due to medical malpractice. For the sake of our children, we must reinstate government funded health care in the U.S.

    Remember: that was a lie.

  3. wow, Jim. I know we're generally on the same page, but that might have been the most incoherent thing you've ever written. Seriously.

  4. It does look like the momentum for reform is continuing to build

    Reform? I think not. The momentum is beginning to "build" mainly for expansion of existing programs that every sentient being knows are fiscally unsustainable.

    Meanwhile, the real problems besetting health care a being ignored (presumably to provide time for Tom Dachle to make kickback deals with his health care clients).

    As to the SCHIP expansion, it's about children only in the sense that you have to be a child to think this expansion has anything to do with actual kids.

  5. Sorry. I will be more clear.

    "When will we learn that gov't intervention means greater cost and poorer outcomes."

    This is based on a lie that when we work together through the government things are done poorly and cost more. It is a Republican talking point that is just repeated over an over again. You can tell how untrue it is by the frequency of the repetition. (The frequency with which a talking point is used is proportional to the inverse of its truthfulness.)

    Other lies are things like cutting taxes is the best thing for the GDP and that the world is only 6000 years old. These are similarly often repeated and false.

    Fighting lies with the truth has generally been unsuccessful, particularly virulent strains of lies like these. So, perhaps we should fight them with lies.

    Then I told a lie to support my position. Private medicine is killing our children, so we need to socialize medicine. It sounds like I'm making a point, but since the thing I'm writing isn't true, I'm really not.

    I hoped to demonstrate how unhelpful it is to just repeat lies when you are trying to have a discussion about something important. I obviously failed.

  6. Catron gives a couple of good examples, too. Like SCHIP doesn't have anything to do with Children and the most efficient means of providing healthcare to people aren't working.

    You know, stuff like that.

    I assume he was coming to my defense.


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