Republican Waterloo?

Former Bush speechwriter David Frum on why Sunday's vote is such a crushing defeat for Republicans:

We followed the most radical voices in the party and the movement, and they led us to abject and irreversible defeat.

There were leaders who knew better, who would have liked to deal. But they were trapped. Conservative talkers on Fox and talk radio had whipped the Republican voting base into such a frenzy that deal-making was rendered impossible. How do you negotiate with somebody who wants to murder your grandmother? Or – more exactly – with somebody whom your voters have been persuaded to believe wants to murder their grandmother?

I’ve been on a soapbox for months now about the harm that our overheated talk is doing to us. Yes it mobilizes supporters – but by mobilizing them with hysterical accusations and pseudo-information, overheated talk has made it impossible for representatives to represent and elected leaders to lead. The real leaders are on TV and radio, and they have very different imperatives from people in government. Talk radio thrives on confrontation and recrimination. When Rush Limbaugh said that he wanted President Obama to fail, he was intelligently explaining his own interests. What he omitted to say – but what is equally true – is that he also wants Republicans to fail. If Republicans succeed – if they govern successfully in office and negotiate attractive compromises out of office – Rush’s listeners get less angry. And if they are less angry, they listen to the radio less, and hear fewer ads for Sleepnumber beds.

The Health Care Crisis in the Suburbs

My wife just donated to a fundraiser for the mother of a boy that my son played basketball and soccer with in grade school. She was recently diagnosed with breast cancer but she has no health insurance. She is divorced and she is unemployed because she has spent the last year taking care of her mother who suffers from dementia. At least she has the comfort of living in a country that doesn't infringe on its citizens' freedom by providing government sponsored health care.

Al Franken Spanks Hudson Institute on Medical Bankruptcies

I understand that Minnesotans were reluctant to elect another entertainer after their experience with Jesse Ventura, but I think they can be happy with their junior senator.

Bob Dole Favors Health Care Reform

Bob Dole, former Senator and candidate for President, and former Senator Tom Daschle issued a statement urging Republicans to get on board with health care reform legislation:

...Congress could be close to passing comprehensive health reform. The American people have waited decades and if this moment passes us by, it may be decades more before there is another opportunity. The current approaches suggested by the Congress are far from perfect, but they do provide some basis on which Congress can move forward and we urge the joint leadership to get together for America’s sake.

No doubt the teabaggers and wingnuts will view this as some sort of betrayal, but they shouldn't. Once upon a time, support for universal health care was a perfectly acceptable within the Republican party and its supporters included Nixon and Eisenhower.

Tale of the Tape: Part 2

I noted last month how the health insurance companies rallied on the day after President Obama's big health care speech to congress. At the time, I thought that this pointed towards the fact that these companies had the Blue Dog democrats so firmly in their pockets that any health care reform legislation would leave their profits untouched.

I found it interesting that these same companies reacted negatively to the news that the Congressional Budget Office had scored the Baucus bill much more favorably than reform opponents might have hoped, which should make the insurers happy because it does not contain a public option. In fact, they have been under performing the market for the last month.

HUM 35.91 -1.99 (5.25%)
WLP 44.72 -2.94 (6.17%)
UNH 24.16 - .89 (3.55%)

Perhaps this means that the insurers are no longer sure that the final bill is going to be the windfall that they had hoped for. With momentum on the side of the progressives, maybe Blue Dogs are going to have to accept a meaningful public option.

Ignorance is Bliss

A friend of mine has been an auto mechanic at a dealership for thirty years. Fully paid health insurance has always been part of his union contract. Recently, the owner of the dealership threatened not to renew the union contract and to bring in non-union mechanics. My friend was shocked when I told him it would cost him well over $1000 per month to replace his insurance coverage. Many health care reform opponents would argue that union contracts like this that insulate the consumer from any understanding of the cost of health care have contributed to the brewing crisis. Even some supporters would acknowledge the problem.

I think one of the most disingenuous tactics employed by health care reform opponents is to cite the percentage of Americans who are currently happy with their health care. As I have noted in the past, people who are healthy would be happy with any coverage or no coverage at all. However, what makes this tactic even more devious is that the reform opponents know perfectly well that many of the people who are happy today will lose their coverage in the next few years due to rapidly escalating costs. Indeed, some of them might even welcome my friend's predicament as they blame unions for the problems.

Who Is Terrifying Who?

In today's Wall Street Journal, Peggy Noonan puts the blame for the rancor of the health care debate squarely on the back of Barack Obama in a column titled 'You Are Terrifying Us.'

The passions of the protesters, on the other hand, are not a surprise. They hired a man to represent them in Washington. They give him a big office, a huge staff and the power to tell people what to do. They give him a car and a driver, sometimes a security detail, and a special pin showing he’s a congressman. And all they ask in return is that he see to their interests and not terrify them too much. Really, that’s all people ask. Expectations are very low. What the protesters are saying is, “You are terrifying us.”

Obama is terrifying them? What about the Republicans on the floor of Congress railing about the old people who are going to be killed by health care reform? What about Sarah Palin's screed about "Obama's 'death panel'" that would kill little Trig? What about Rush Limbaugh calling Obama a Nazi and Glenn Beck calling him a racist and fascist? What about the Republicans' uninterrupted fear-based campaigns of the last forty years? What unadulterated crap!

Noonan has the gall to accuse the Democrats of being "crude and aggressive" and of damaging "political civility." She says they are being "unnecessarily and unhelpfully divisive and provocative." Glenn Beck makes jokes about poisoning Nancy Pelosi, but it is the Democrats who are "mocking and menacing concerned citizens." Noonan says the Democrats "should be attempting to persuade," but that can be difficult when organized wingnuts are shouting them down.

Noonan correctly asserts that "[f]or normal people, it's not all about Barack Obama," but many, although not all, of the protesters are not normal people. They are not the people who "hired" Obama to represent them in Washington. They are the birthers who still believe that Obama is a Muslim who pals around with terrorists. They are that wing of the Republican party that is dominated by the southerners who abandoned the Democrats after the passage of the Voting Rights Act in 1965. They are the ones who according to Kathleen Parker "have seceded from sanity."

Last fall, Noonan was sufficiently (and justifiably) terrified by the prospect of Sarah Palin wallowing in her ignorance within a heartbeat of the Oval Office that she decried the nastiness of the Republican presidential campaign. Now that that danger has passed, she is happy to play on the fears of the most backward elements of her party in order to defeat a policy that she does not favor. Like her hero Ronald Reagan, she does so under the guise of promoting civility, but it is nonetheless the same politics of resentment that the Republicans have relied on for four decades.

Laffer is Full of Crap

In today's Wall Street Journal, the apostle of the supply side economics that produced ballooning deficits and the destruction of American manufacturing, Arthur Laffer, pumps for an equally asinine and ideological solution to the health care crisis. He begins with a mindlessly happy diagnosis of the current system that comes from looking at the world through the rose colored glasses of the wealthy:

Many Americans agree: 55% of respondents to a recent CNN poll think the U.S. health-care system needs a great deal of reform. Yet 70% of Americans are satisfied with their current health-care arrangements, and for good reason—they work.

No, you dumbass, 70% of Americans are satisfied with their current health-care arrangements because they aren't sick. Almost any system works fine for them.

Laffer goes on to offer a prescription for the problem that is calculated to bring joy to the heart of every insurance company executive:

A patient-centered health-care reform begins with individual ownership of insurance policies and leverages Health Savings Accounts, a low-premium, high-deductible alternative to traditional insurance that includes a tax-advantaged savings account.

Individual ownership of insurance policies???!!! Of course! If only we can increase the ability of insurers to cherry pick the healthy and deny coverage when someone gets sick, everything will work out just fine.

Another Reason We Need Health Care Reform

By every measure of small business employment, the United States has among the world’s smallest small-business sectors (as a proportion of total national employment). The lower taxes, less stringent regulations, and freer labor markets in the United States, it appears, have not yielded greater small-business employment here than elsewhere.

An International Comparison of Small Business Employment by John Schmitt and Nathan Lane from The Center for Economic and Policy Research.

Mendacity of Conservatives

Old people will not be worse off under nationalized health care.

Old people already have nationalized health care. It's called Medicare. They like it.

It is conservatives who don't want government paying for health care. They are the ones who would leave old people up the creek without a paddle.

Health Care Realities

From Paul Krugman:

Right-wing opponents of reform would have you believe that President Obama is a wild-eyed socialist, attacking the free market. But unregulated markets don’t work for health care — never have, never will. To the extent we have a working health care system at all right now it’s only because the government covers the elderly, while a combination of regulation and tax subsidies makes it possible for many, but not all, nonelderly Americans to get decent private coverage.

Now Mr. Obama basically proposes using additional regulation and subsidies to make decent insurance available to all of us. That’s not radical; it’s as American as, well, Medicare.

Why Don't We Hear More About Rescission?

There is an excellent discussion of the rescission problem at The Baseline Scenario.

It works like this:

When a person purchases an individual health insurance policy, the company does not bother to verify the information on the application because it costs money to do so. Instead, the company just accepts the premium figuring there is a decent chance the person will turn out to be healthy anyway.

However, if the individual comes down with a major illness, the cost-benefit equation for the insurance company changes. Now it's worth going over the application with a fine tooth comb because the insurance company can save itself a lot of money if it can find some error on the application no matter how inadvertent. For example, a woman who failed to disclose that she was once treated for acne found her policy rescinded when she came down with breast cancer. People have found their policy canceled based on a notation in a chart that they had never seen.

According to health insurance executives, the rescission rate is less than .5% of policies, or 1 in 200, but that number is irrelevant because most people never get their applications examined because they don't have a major illness. If, for example, only 5% of the policies file a major illness claim each year, then the odds of having your insurance policy canceled when you actually need it is 10%. That would mean that 10% of the people who have individual insurance policies should really be considered uninsured because their coverage is an illusion.

I frequently hear conservatives advocate "market based" health care reform plans that involve consumers purchasing the insurance that "is right for them." None of them discuss the rescission problem, however, which flows naturally and inevitably from the profit motive that is the foundation of free market ideology.

Trying to Get What You Pay For.

A friend of mine on Facebook was complaining that he paid $1400 per month to Humana for rationed health care and still had to spend four hours on the phone last month trying to obtain the benefits he paid for.

I told him "Hey, the CEO of Humana only took home $5.2 million in 2008 after making $10.8 million in 2007. It's not like he's not hurtin' too! How's he going to get back to eight figures if guys like you keep wasting his employees' time?"

Health Care and Car Repairs

I have lived in the same Chicago suburb for going on twenty-five years. For the first twenty of those years, I never had a car mechanic that I really trusted. I would ask friends who they used but when I had to have a car fixed, I was never sure whether I was getting taken. I could compare prices, but the problem was that I had no way to be sure whether the mechanic was finding extra things wrong just to run up the bill. It's not that I am particularly ignorant about cars either. Back in the 1970's I used to help my brother with the various $200 clunkers he liked to buy. Engines were much less complicated in those days.

A few years back, however, I got lucky. One of my son's friend's father is a mechanic and he recommended a mechanic I had never heard of before. I have been thrilled ever since. He does the work I ask him to do without coming up with a list of things that need to be fixed every time I bring a car in. As both my wife and I have cars that are over ten years old, I am sure that he has saved me a lot of money. The couple times he has advised me to have something fixed other than the problem for which I brought the car in, I have been reasonably confident that it was something that truly needed to be done.

I was thinking about this today when I was considering the absurdity of the notion that health care costs could be brought down by free market forces if people shopped more wisely. It took me twenty years to find a mechanic I trust because I lack the expertise to challenge a mechanic's judgment. How could I ever decide whether a doctor was ordering unnecessary tests to line his own pockets?

Blue Dog Democrats Can't Afford to Offend the Healthcare Industry

Interesting article by David Sirota over at Smirking Chimp explaining that the opposition to health care reform coming from Blue Dog Democrats has more to do with their need for money than their constituents opinions about health care.

The Villagers in the D.C. media (ie. the power-worshiping pundits and journalists who preen around the nation's capital telling the Rest of Us what to think) continue to claim that "Blue Dogs" and "conservative Democrats" come from "moderate districts," and this is supposed to clearly explain their opposition to health care reform and progressive taxation to pay for said health care reform. These Democrats are just representing their culturally conservative constituents who not only like guns and hate abortion, but allegedly love the health-insurance companies so much they are threatening an electoral backlash against legislators who refuse to act like health-industry harlots!

The Blue Dogs come from comparatively poor areas where rising health care costs hurt the most. Unfortunately the poverty makes it harder the Blue Dogs to raise the campaign donations they need in order to get reelected so they whore themselves out to the health care industry.

The Market Works Its Healthcare Magic

From today’s Chicago Tribune front page: “They authorized back surgery but denied his $148,000 claim.”

Michael Napientek of Clarendon Hills was in excruciating pain and needed back surgery. His wife has worked in the health-care field for 30 years and thought she knew how to navigate the insurance bureaucracy.

Before Napientek was wheeled into an operating room Oct. 27, his doctor obtained a preauthorization number. The surgery went well, and within weeks Napientek was feeling much better.

Until April. That's when the couple began receiving a series of letters from the insurance administrator with chilling news: Claims for the surgery had been denied, leaving them on the hook for the heart-stopping total of $148,000.

Happily for Napientek, the columnist who writes The Tribune’s “Problem Solver” column was able to get the matter reviewed by UnitedHealth, the parent company of the firm that administered Napientek’s claim. Of course, when UMR decided to pay the claim it insisted that it had nothing to do with the possibility of appearing on the front page of a major metropolitan newspaper. It was mere coincidence that it happened to complete its review within a couple days of being contacted by The Tribune.

Conservative love to invoke the boogey men of government bureaucrats making decisions that should be made by doctors and patients as if insurance company bureaucrats are benevolently devoted to the well-being of patients. BTW, the CEO of UnitedHealth made $8.2 million dollars over the last two years. Let’s hope his bonus isn’t hurt too much this year.