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Michael Barone: Qualms, Questions About Obama’s Health Plan
President Obama has said he wants to pass a national health care bill this year, with a government insurance policy option. Democratic congressional leaders have called for passage of such a bill before the beginning of the August congressional recess.
What they want more than anything else is a government insurance program that will tend over the next few years to crowd out private insurance. We are told that a government insurance plan reduces the amounts spent on health care by using “comparative effectiveness research” — in other words, by rationing care and limiting options through the use of statistics. Unfortunately, statistics are constantly in flux and do not capture the differing needs of actual patients as well as skillful practitioners can.
Obama and his party are pursuing an ambitious goal. It could drastically change health care in the United States. But Congress has yet to write an actual bill, although there are some drafts around. And there’s not much time. Congress is scheduled to be in session for only six weeks from next week to the August recess. Six weeks of Tuesday-to-Thursday sessions means 18 days for actual legislating. There are other things before Congress, like annual appropriations and cap-and-trade. Still, Obama and the Democratic congressional leaders see this as a rare chance to make “transformational” changes in America. They may be right.
Still, there are some things out of kilter here. First, there are nagging questions about money. As Clinton White House deputy domestic policy adviser William Galston points out in the New Republic blog, “Congress has thus far given the cold shoulder to most of the administration’s proposals for raising revenues dedicated to health reform.” So if Democrats want to pass their health bill using the reconciliation process, which requires that they get only 50 votes in the Senate, they will have to come up with $150,000,000,000 in annual revenue or offsetting spending or else add to the $900,000,000,000 in yearly budget deficits projected by the Congressional Budget Office. As Galston points out, the CBO is unlikely to agree with administration projections of savings from comparative effectiveness research. So money is a problem.
So is public opinion. An April tracking poll conducted for the Kaiser Family Foundation shows that voters rank changing health care below strengthening the economy, stabilizing Medicare and Social Security, and reducing the federal budget deficit on a list of eight possible priorities. Democrats rank it higher, Republicans rank it at the bottom, and independents, on this issue like many others this year, look more like Republicans than Democrats.
The blunt fact is that most Americans are satisfied with their health insurance and don’t believe major legislation will improve things for them. This gives opponents of the Democrats’ rush to legislate a strong talking point.
Third, the segment of the electorate that did most to produce the Obama victory and give the Democrats large majorities in Congress is the least concerned and least informed about health care. That segment is the 18 percent of voters under 30. Young voters preferred Obama to John McCain by a 66 percent to 32 percent margin, according to the exit poll. Voters 30 and over preferred Obama by only a 50 percent to 49 percent margin. Some 63 percent of the young voted Democratic for the House of Representatives. Only 51 percent of the rest of Americans did so. Without the young, the votes would clearly not be there for what the Democrats are trying to force through.
But what do the young know or care about health insurance? They have the fewest medical problems of the whole population. Their image of health care, at least until they become pregnant and have babies, is university health services. You come in if you feel like it, someone else pays, you get some pills or some counseling, or whatever. As for the downside of government insurance, pollster Scott Rasmussen reports that the young favor capitalism over socialism by only a 37 percent to 33 percent margin. The rest of us prefer capitalism by a 57 percent to 17 percent margin.
But while young voters may be open to government health insurance, they surely don’t care very much about the issue. Voters with experience dealing with doctors and insurance companies care more. Democrats hope they can assemble the votes and finagle the financing before anyone much notices. Those who oppose them have some material to work with.
— Michael Barone is a senior writer for U.S.News & World Report and principal coauthor of The Almanac of American Politics. Click here to contact him.
Comments
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» on 06.12.09 @ 03:51 AM
Most Americans are not satisfied with their healthcare and insurance. The premiums are rising at over 20% per year. Right now the U.S. spends the most per person on health care with extremely poor results. We have nearly 50 million people without healthcare and the number is rising rapidly because when people lose their jobs the lose their coverage. I am not sure what planet Michael Barone is on but something needs to be done. The answer is not clear but around 30% of all healthcare costs is absorbed by the profit of insurance companies and the massive compensation of their executives. Having employers provide this costly benefit has added to the inability of U.S. Corporations to compete. Something dramatic has to happen and there are lots of great ideas on the table. This is the time before we go into another election cycle and waste 2 to 4 more years.
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» on 06.12.09 @ 07:19 AM
“Research shows Americans are more concerned about bettering the economy than overhauling health care “
When it starts off with this false dichotomy, you know the article is garbage even if it weren’t written by a professional liar and corporate shill who has been wrong about everything and is always on the wrong side of every issue affecting ordinary people.
The health insurance industry is a legal mafia, and health insurance is legal theft; people who are happy with it are ill informed, AND it’s a tremendous drain on the economy, and thus overhauling it is a key element of bettering the economy.
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» on 06.12.09 @ 10:09 AM
The choice is always——Who do you want to decide your need for medical treatment————the insurance company or the government———the other side of the question is going to be who has a greater interest in seeing you healthy. The insurance company who will challenge your right to have acceptable treatment, and who makes a profit on your premium or the government who charges the costs.
If we extract the cost of disputing legitimate claims, and the disputes withn other companies about who should foot the bill, from your premium how much lower do you think it will be. Of course with the government providing health care, it won’t be too much of a stretch to eliminate the multiple premiums that we pay for, e.g.auto health premiums. or the homeowners health insurance premium, to name but a few.
But, hey, if want to think that insurance company provided health care is your best choice, by all means object to a sensible government program.
It is not a capitalism v. socialism dispute as much as as an argument about providing health care to all the citizens.
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» on 06.12.09 @ 12:28 PM
To set the record straight medicare is not socialism. Socialism is where the government dictates which doctor and which hospital you have to go to. The only socialized medicine in the U.S. is the Veterans Administration. Medicare administration of healthcare is far more efficient than the private insurance companies. This is why the idea of offering a public opinion that we can buy into scares the living crap out of the insurance companies. The profit motive needs to be removed from providing basic healthcare needs, primary care. There is plenty of room to make money on many optional medical practices such as plastic surgery.
I know lots of people like to make fun of Europe and the rest of the world but I have traveled alot and I can definately say that when it comes to healthcare they have us beat hands down. I know it might hurt some people’s ego in America but we could learn alot from other countries. We could put together a great healthcare system based on reviewing and implementing best practices from numerous countries such as France, Germany, Canada, Switerland and Austrialia.
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» on 06.13.09 @ 02:38 PM
This guy has never worked a day in his life, or got his hands dirty—No business experience—no military—no job ???
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» on 06.13.09 @ 02:47 PM
Local, you need to travel more or pay more attention when you do. Health care in Europe is not the panacea you make it out to be. BTW, there are two systems in Europe, the government run public system for the shlubs and the underground private system for the wealthy elite. The shlub system is very much a rationed system where the average Joe gets to wait forever for the special test that the government says the shlub doesn’t need.
To Marcel, if the insurance industry is broken then we the users of such a system have a choice not to use it. It is amazing how many people forget what power they have in their wallet. As for allowing the government to do correctly what the insurance companies don’t seem to, well have you actually seen how government runs these days Marcel? They can’t balance a damned budget, agree on the right course for a war or maintain a damned highway and you want them in charge of healthcare, what are freaking nuts or something? I agree that the insurance business is legalized racketeering, so lets get busy and fix it not throw it away and let the biggest losers and screw ups in the world try to do better. We already know they can’t.
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» on 06.20.09 @ 04:23 AM
By the way, I have traveled to more than 50 countries and lived a few years in different ones in Europe. Your description of the European healthcare system is TOTALLY wrong. Where have you read this? Have you seen it first hand or are you just thinking this is the way it is. Maybe too much Fox News? I have relatives in four different countries and know what I am talking about. Second, since the government as you say is so bad at everything then you should probably stop with your fire,police,mail,TSA services. I love the way that the GOP says that government is so bad at everything but when the public healthcare option is introduced the argument is reversed and suddenly the public option will out compete the private insurance companies and put them out of business. The new campaign slogan for the GOP should be “The government is incompentent so vote for me because I am too”. Medicare administration is extremely efficient. I have many doctor friends who are sick and tired of the paperwork needed to submit claims to the insurance companies, the fighting to pay. They want to get back to helping heal people.
When Reagan was Governor among many stupid things he did was to convert health insurance companies that were non- profit, such as Blue Shield, into these blood sucking for profit insurance companies that milk 30% of the cost of providing healthcare out of the system for themselves and their stockholders. I am a true capitalist but when it comes to providing basic healthcare the profit of insurance is wrong. Having basic healthcare is a right and not a privelege. Too many people are being denied access or having their coverage removed when they need it the most.
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