July, 21st 2009

Health care implosion?

– Liz Mair

I don't in any way want to suggest for a minute that people shouldn't be taking Democratic efforts at a health care overhaul seriously (of course they should).  But setting aside things like this:

Asked what effect a government-managed health care coverage option would have on access to health services, 40 percent said it would make the situation worse, 38 percent said it would make it better and 22 percent said it would remain the same. Asked what its effect would be on the quality of health care, 42 percent said it would make health care worse, 33 percent said it would make it better and 25 percent said it would not have an effect.


Nearly half of respondents — 44 percent — believe government-managed coverage will increase the price of health care. Only 27 percent think a government-managed health care system would lower costs, while 29 percent said prices would remain the same.

There are tidbits like this:

Conservative Democrats... have criticized the healthcare reform bill’s costs, and complained it does not do enough to reduce long-term healthcare spending. Freshman Democrats have also been worried about growing fiscal deficits and the risk the healthcare bill could add to them, while members from wealthy districts are upset about a surcharge on the wealthy that would be used to pay for some of the bill’s costs.

And then this kind of thing:

House Majority Leader Steny Hoyer says House Democrats are struggling to reach consensus on overhauling health care, a divide that could delay House approval of a plan beyond lawmakers' scheduled vacation in August.

House leaders have said they wanted to pass a plan before they leave on a monthlong break. But Hoyer, D-Md., said Tuesday there is still disagreement on proposed tax increases on the wealthy, and whether to establish a government-run insurance program to compete with private plans.

The net effect of which is to make me wonder whether all the comments that I've heard from people on both sides of the aisle in the last six months that Democrats "will definitely get health care reform" might have been a tad too... definitive?  Yes, probably, some kind of health care "reform" will get through, but I'm starting to wonder whether it will be genuinely meaty or rather "meh."  At this point, I feel like it could go either way.  I bet the President does, too.

He's certainly got a very short timeframe in which to meet his self-selected deadline, that much is for sure.  And the fact that he's talking all health care, all the time now indicates he knows he's got a much more uphill battle on his hands than I suspect he or some of his advisers might have anticipated.  The wholly unsurprising thing, from where I sit anyway, is that for all the talk of Republicans being obstructionist, it's with fellow Democrats that Obama's problems really lie.  This is not terribly surprising.  While the White House has depicted this as a choice between black and white, it's actually a choice between black, white, off-white, mid-grey, dark-grey (and potentially more hues than that).  It's very difficult getting majority consensus on a favorite color or shade when everyone has multiple options to choose from and when people are being asked to pick just one that will work for all, or even a majority of, 300 million people.  And that, it seems to me, is in essence health care-- except the difference is, it's a potentially a life and death matter and so one that matters much, much, much more.

As someone who opposes what many Democrats support, and even what some Republicans support, on health care, that situation is acceptable to me for the short term.  It's just that I would ultimately like some big policy changes, even if not the kind some people are discussing now-- and I happen to think that on health care, that is always surprisingly harder to achieve than you'd think.  That's disappointing. [intro]


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