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The Best Deal the GOP Will Get
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The Senate Finance Committee passed Obamacare on Tuesday. Matthew Yglesias says if this bill doesn’t pass the whole Senate, the president’s next offer will be a far more bitter pill.
In Finland last December, where taxes are 43.6 percent of GDP (compared to just 28.2 percent in the United States), a politician told me “we’re not socialists like in Sweden” but still felt it would be absurd to charge tuition for people to go to college. Now for the past two weeks I’ve been in Sweden and Denmark, where taxes hover at around 50 percent of GDP, and socialism, as defined by Finns, actually looks pretty nice. Here in America, though, it’s Barack Obama who stands accused of wanting to turn the United States socialist with a health-care proposal that allegedly amounts to a freedom-sapping government takeover soon to end in disaster.
It’s true that the changes in the bill the Senate Finance Committee passed on Tuesday are fairly far-reaching. Still, it’s worth putting them in perspective. Compared to health-care systems that exist elsewhere—and that seem to work a lot better than ours—bill proposes extremely modest changes that would leave the overwhelming majority of the health-care system in private hands.
What Obama and Baucus are proposing is close to the minimum amount of change conceivable. If insurance-industry groups succeed in killing the bill, the lesson will be that appeasement hasn’t worked.
The opposition party's hostility to this modest reform looks hysterical, and the interest groups fighting against reform don't really seem to grasp how easy on them Obama and Congress are being. Private-sector players, in particular, ought to recognize that the Senate Finance Committee’s bill is incredibly generous to their interests by international standards and that if that generosity isn't rewarded with political success, next time around they're likely to see proposals they like a whole lot less.
• A Short History of Health-Care Disasters
• Paul Begala: Olympia Snowe Is the Last Sane Republican Consider, for example, not health insurance but the actual provision of health care. Under Obamacare, it doesn’t matter whether you’re covered by Medicare or an expanded version of Medicaid or employer-sponsored insurance, or a private plan purchased on the new health-care exchange, or the still-possible—and controversial—”public option” that may or may not be in the exchange; your actual health-care provider will be a private-sector entity. In Sweden, by contrast, most health care is provided by a hierarchy of government-run institutions. There are 18 county councils in Sweden given funds by the central government and charged with organizing the provision of health care. The 18 counties are grouped into six larger regions. The counties run just over 1,000 small “health centers” to provide basic care, about 70 county hospitals for more complicated cases, and eight regional hospitals for specialized care. Certain illnesses are sufficiently rare that not every region maintains the ability to treat them, and the counties are expected to work out arrangements to transfer patients from one county to another in order to deal with those cases.
The care provided at these institutions isn’t free, but it’s pretty darn cheap. Nobody ever has to pay more than a total of 900 Swedish kroner for treatment over the course of a year—that’s about $125 in terms of today’s very weak dollar. The point of the fees isn’t really to raise revenue, but to encourage people to seek care at the appropriate level. The health centers are dirt cheap, the county hospitals cost a bit more, and the regional hospitals a bit more than that. Overwhelmingly, the bills are being paid by the government; that’s what the high taxes are for.
In Denmark, by contrast, health care is absolutely free for 98.5 percent of the population. Everyone signs on with a general practitioner. If you have a problem, you see the GP. If he thinks you need to be admitted to a hospital or sent to a specialist, then to the hospital or the specialist you go. The country is divided into five regions, and the regions run the bulk of the hospitals. Thanks to the right-wing coalition that’s been ruling for about eight years, the regions also sometimes contract-out care to private hospitals. But either way, the government pays 100 percent of the cost. A further 1.5 percent of the population is in rare “Group B” insurance where you have a (small) co-payment to see a doctor, but also the right to make an appointment directly with a specialist without going through a GP.
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Paul Schrodt is a writer living in New York City. He has contributed to New York magazine, Radar, and Esquire.com.
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Matthew Yglesias is a Fellow at the Center for American Progress Action Fund. He is the author of Heads in the Sand: How the Republicans Screw Up Foreign Policy and Foreign Policy Screws Up the Democrats.
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Matthew Yglesias is a Fellow at the Center for American Progress Action Fund. He is the author of Heads in the Sand: How the Republicans Screw Up Foreign Policy and Foreign Policy Screws Up the Democrats.
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Matthew Yglesias is a Fellow at the Center for American Progress Action Fund. He is the author of Heads in the Sand: How the Republicans Screw Up Foreign Policy and Foreign Policy Screws Up the Democrats.
wfleet
I would say that the 'powers that be are bending over *forward* to be nice to them' . . .
" ... financed on the basis of solidarity." I wept when I read that. How ---- human . . .
Think of all the coverage we could get for the billions that we'll be forced to pay the Vampire Wealthcare Corporations who do what exactly besides bloodsuck our money? Really -- they add what to health care?
Let everyone sign up for Medicare, paying reasonable fees for under-65s. Easy, immediate. No waiting for 180,000 more people to gratuitously die.
None of all this tortured pretzeling of policy to end up with a complicated and horrible dumb and cruel system. As my Canadian businessman friend said, "What the Hell is the matter with you people?"
estcruzer
There is nothing wrong with us people, it is our representatives that have bent over forward so often for Global Big Business that they can't straighten out any more.
dayton52
I couldn't agree more. For now the only way; an emergency measure. Then a system like Denmark's, but with an American flavor; but designed by the smart American: The Democrats..
octavio
--------------------------------------------------------------------------- ---------------
The only way to lower costs for medical services is to pass
the Public Health Care Bill.If the bill is not public;It would mean
that the Health Care insurance companies will keep the cash cow.To stop the crooks we need to pass the Public Health Care Bill as soon as possible.
Stop the lobbysts from corrupting the USA politi-
cians.It is about time to do something about it!.
------------------------------------------------------------------------ ------------------
ukeman
The republicans are bold enough to lie through their teeth to protect the rotten system and "America" (which by the way is controlled by the Dems) is not ready for systemic change.
La tee da.
When is America going to wake up and reform gov't before it's a rotting corpse?
ThinkAgain
Hohum.... do we really need to go through all the lying through their teeth that the democrats have done to get their way here?! How about we go through all the democrats special interests who will benefit from those bills? You really think there won't be huge parties benefitting hugely from that Public Option?! Think booboo think, I'll be you can come up with at least 20 in less than a minute! Big ole corporate interests who will benefit way more than us poor little taxpayers who at best will get to keep our current plans.
estcruzer
Actually I think Ukeman was talking about the lying through their teeth that the Republican Leadership, Health Insurance Industry (bedfellows), and the Right Wing Nut Ships like Rush are doing to misdirect the discussion about who should get healthcare and who should pay for it.
ThinkAgain
Yes, and I was talking about the fact that you're hypocrits for not talking about those benefitting on your side.... you're just shifting what big special interest will benefti but you lie and pretend you're all about helping the little guy. Total bull!
PhilMcRoin
but the little guy will be helped..
so even though you are correct in some ways, the end result is the same.. yes someone will benefit from this..
as it always is in a capitalist system, but currently, we are being robbed by the insurance industry who is exerting influence over the government and the media to keep it's hands in our pockets and is not honoring the deals it has made with its customers.. so.. so what if a different set of people benefit from this reform?
tonedef
The Democrats and Republicans have an unfair, 2-party monopoly over our government. And as with any unfair dominance, you usually have to do unfair things to maintain it. Unfair things like constantly bending over and receiving the private health insurance industry's ... contributions.
In fact, the 2-party political dominance in America is very much like the private health insurance industry's dominance. Each group of players insist that they're competing with each other, but they're really in collusion to keep (in the case of health insurance) prices high and consumer justice practically nonexistant, or (in the case of our 2-party government) to keep independent political parties from having an equal chance to voice their platforms and views in a public forum.
Everybody at the top is simply gaming the system.
neverlate
Opposition to the reforms offerred by the Democrats is not ideological. The fact is that they do nothing to reduce cost while expanding coverage. The bottom line is what is being proposed is not economically sustainable. Another case of political pandering.
The only hope they have of passing is through the traditional Democratic coalition of people who want something for nothing and mathematically challenged Liberals. Hopefully the big bad Insurance companies put together an attack that kills this thing before it bankrupts our country.
Glenda1976
The Dems aren't gonna let a things such as simple mathematics get in the way of their uptopian fantasies.
Chuckv
Why is it that conservatives never need to support statements with facts? Why are the same old criticisms repeated time and time again?
Why is expanding health care to all Americans a uptopian (sic) fantasy? All of Europe provides heath care to their citizens. Why is it a fantasy to believe that can we can do it?
Why will expanding healthcare cost jobs? Won't people have to be hired to provide these services? Ever hear of John Maynard Keynes?
Why is this bill "economically unsustainable"? The Congressional Budget Office, which is nonpartisan and highly regarded, projects that the Senate Finance Committee bill would reduce federal deficits by $81 billion over a decade and probably lead to "continued reductions in federal budget deficits" in the years beyond.
Why are any proposes reforms called "socialism"? Socialism is an economic system in which the state owns the means of production. There is absolutely no socialism in a reform that expands insurance but does not have the government take over hospitals and make doctors into civil servants.
Note that all of these points are also used to attack any bill concerned with global warming and any other proposed reform. They are knee-jerk reactions.
estcruzer
?? have you even been following the discussion?? Show some facts, preferably all the facts that back up your rant, point to published documents, recorded speeches (by credible democrats if you please). Where is the beef?
AlanD2
Chuckv: Glenda is well known as a conservative troll, like her buddy neverlate.
Expecting facts or rational arguments from these people is unrealistic.
spawot
So you are suggesting that the current way is not bankrupting the country?
estcruzer
Let's not have that discussion till we kill off any chance of reform - then we can talk about a bailout of the Health Insurance and Healthcare Industrys just like we are doing with the Banking, Financial and Wall Street firms. Many of which are Global Big Business Vampires.
Of course then we will have to talk about who pays.
spawot
So kill the current reform and go with what we got so I can see my rate and copay go up each year! I'm not sure what point you are trying to make!
Charlemagne712
DOWN WITH THE LOBBYSTS
ThinkAgain
You mean the democrats lobbyists? Those who will benefit from that Public Option? Do you guys ever think beyond what they're programming you to think?
estcruzer
I think he means the self serving Health Care and Global Big Business Lobbyists - you really should follow the discussion.
ThinkAgain
Those big business lobbyists contributed more to Democrats than republcians. They'll benefit from YOUR Public Option. You need to stop being so OBTUSE.
roadhunter
What Democratic lobbyists? Not the insurance companies, and not the drug companies, two of the biggest lobbying groups in this country.
AlanD2
ThinkAgain: Of course big business lobbyists contributed more to Democrats than to Republicans.
You don't give money to people who can't give you anything in return.
PhilMcRoin
TnA
They lobby democrats and republicans.. they don't need to spend as much money to get the republicans support because the Republicans already aren't going to support any legislation from the democrats..
You try so hard every day to find some way of spinning things around.. you need to just come to terms with the fact that no matter how you slice it, dice it, stir it, or spin it.. you end up with the same crap sandwich that you started with.. You need to stop being so acute and find a different angel..
ChanRobt
John Batchelor thinks the White House is the gang that can't shoot straight.
Yglesias thinks Obama is Lyndon Johnson.
I'm really curious to find out which theory is right.
Benager
While I like the wishful thinking Yglesias is demonstrating, I think he's being far too naive about American politics and how politicians work.
If the GOP and the special interests manage to defeat health care reform this time around, then the lesson Democrats take away from it will not be to try tougher reforms, but to run screaming away from this for another 15 years.
Dems will do what they've been doing since Reagan, which is to abandon their principles and concede the entire premise of the debate to the GOP, in the hopes that voters don't see them as too LIBERAL (perish the thought!) and instead elect them for being a good centrists.
There are way too few Democrats with the fortitude to take the Republicans head on and actually call them out for refusing to help save America from this increasingly out-of-control health care system.
Sadly, I can't even include the current White House occupant among those with a spine. He's too busy chasing a handful of Republican lawmakers to exhibit any backbone.
Obama doesn't seem to get that the GOP will never see him as a nice guy and come around to working with him. They want to see him crash and burn, no matter what.
So is this the best deal on health care reform opponents can hope for?
No way! They can kill this bill and force the US to slide even further into its medical morass. And that's exactly what they want.
estcruzer
The other lesson will be that the Republican leadership, and the Health Insurance Industry really don't care about the Health of Americans.
AlanD2
Benager: Reform cannot be delayed much longer, even if it is defeated this year.
Health insurance premiums are projected to double in the next 10 years, as they have in the last 10. Small businesses, which employ most Americans, will not be able to afford to pay for insurance for their workers. Individuals and families will not be able to afford $25,000 to $50,000 a year for their own health insurance.
We will wind up with 200 million uninsured Americans, which will be catastrophic for health care and for many, many Americans.
ChanRobt
How much do you make, Matt? And how much are you going to be left with if ObamaCare passes?
It would be interesting to know how all the various pundits who are pushing for this are going to make out if they get their wishes.
estcruzer
A whole lot more than I have now -after paying $100,000 bill to a hospital for Pneumonia care for my wife - after which I lost my home and had to file for bankruptcy. All because I couldn't afford the $12,000/year premiums the health Insurance industry demand.
WestVillager
This bill sounds awful. No, i haven't read it (who cares) but it seems like a political compromise not legislation for, you know, people.
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n--Y--grumpyguyneverlate
This Bill is a massive tax bill that will kill jobs.
estcruzer
Please explain?
Mariafrania
Hopefully it'll kill a few jobs within the health insurance companies.
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n--Y--grumpyguyAlanD2
neverlate: Remember France, which has better and cheaper health care.
We can do it too, don't you think?
winston1
AlanD STOP IT WITH FRANCE.
AlanD2
Winnie: You might as well start puking, because you're going to hear a lot more about France from me.
I hope you have good health insurance, as constant puking is bad for you.
crngndmhm
I'm sure you belive in trickle down economics too.
johnstafford
>so, let's see if i've got this right: those of us who voted for the president should be excited about the "obamacare" proposal that just got out of the senate finance commitee because:
=it requires people to buy health insurance from private, for-profit insurance companies;
=to make sure that the private health insurance industry maintains its obscene profits [up 428% in the past decade], subsidies, paid for by taxpayers, will be provided to those who can't afford private health insurance premiums;
=even though pres. obama said this summer that the "public option" was a "must" as part of his health insurance reform plan--to "keep the private insurance companies honest," in his words--he will not insist on it;
=there will be no price controls or "cap" on premiums, so private, for-profit health insurance companies can charge pretty much whatever they want--indeed, the guarantee of taxpayer-funded "subsidies" will provide an incentive for them to raise their "prices".
>have i got it right? what's not to like?!?
willybill
Here's another reason why the public option is, well, no longer "optional"--- it's absolutely mandatory. Perhaps contrary to popular belief, the federal government actually does quite well in operating such massive and popular systems as MediCare and the V. A. Each of these systems manages to attract dedicated professionals and staff to their ranks and are deemed essential to the quality of life to those eligible to enjoy their services. If history tells us ANYTHING it's that one thing the government CANNOT do is regulate private for-profit industry and/or ensure that these gargantuan "financials" operate in the public interest. [Vis, the bailout and today's news regarding the payment by federal $$$ recipients of record bonuses--- yet again.] WillyBill, San Diego CA
Grimmace
I'm 100% against any form of Government controlled healthcare, but this "modest reform" that Yglesias touts as the best that Republicans can hope for seems like a worse deal to me than some version of Swedish healthcare. The Baucus bill seems like the worst of both the Socialized World and the World According to the U.S. Constitution.
I still can't get past this point...What does the Baucus Bill offer to the average citizen that already has some kind of health insurance? The only thing that I can see is higher taxes and higher premiums as the additional costs are passed down to the consumers.
In my dream world the Government has no part in the delivery of healthcare and we remain faithful to the Constitution. However, if the Baucus bill is supposed to represent the best deal that I as a Libertarian minded Republican can ever hope to achieve, then give me Swedish healthcare. As with most things and people that try to please everyone, it or they end up pleasing no one.
estcruzer
So in your dream, virtually all retired citizens lose their medicare benefits and get to pay insurance premiums that are jacked up ($428% in the last decade) while living (not for long) on a fixed income - they get to pick insurance, or food, not a good choice. Remember, this is going to be you some day, your parents and grandparents and eventually your children will get to suffer at the hands of an industry that is NOT focused on your HEALTH, but on your Pocketbook.
Doesn't sound very healthy to me - but then you might be a masochist with a death wish - or just plain sociopathic.
cbeenthere
Really, what Grimmace is, is terribly uninformed, but it makes no difference to him, just so he thinks he will have his. And they say they don't depend on the government..baloney.
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n--Y--grumpyguyAlanD2
Grimmace: I'm 100% for government-run, single-payer health care.
The average citizen only thinks he or she has good health insurance. Only when becoming really sick will one find out the truth. For example:
An average of 22% of health care claims in California are rejected by insurance companies. PacifiCare, the worst, rejects 40% of its claims.
"An investigation by the House Subcommittee on Oversight and Investigations showed that health insurers WellPoint Inc., UnitedHealth Group and Assurant Inc. canceled the coverage of more than 20,000 people, allowing the companies to avoid paying more than $300 million in medical claims over a five-year period."
"The South Carolina Supreme Court has ordered an insurance company to pay $10 million for wrongly revoking the insurance policy of a 17-year-old college student after he tested positive for HIV. The court called the 2002 decision by the insurance company 'reprehensible.'"
"Humana was recently featured in a HuffPost story for denying health care due to lack of an enema. In 2005, it settled a racketeering suit for $40 million. It settled a fraud lawsuit in 2000 for $14.5 million. Since 2000, its profits have soared from $90 million to $834 million."
You may trust your insurance company, but I certainly don't! They care only about profits and engage in criminal behavior.
Reason
You are absolutely correct.
To add another example of the reprehensible behavior of these for-profit insurance companies, there is the recent case of Rocky Mountain Health Plans denying care to 4-month-old Alex Lange, who measures 25-inches long and weighs 17 pounds, for being too fat!
Even Fox News reported this one...
http://www.foxnews.com/story/0,2933,564501,00.html
Reason
Have you even read the Constitution?
Providing for the safety and security of the citizens is the primary role of government. The health of our citizens should be on par with national security. If anything other than the US military is more clearly a role for the government, I don't know what it is.
I don't like high taxes any more than anyone else, but if given a choice between paying $20,000 per year to a for-profit health insurance company whose primary goal is to increase their profits (as any corporation should do) and paying $5,000 more per year in taxes in order to have health care without the profit motive, I'm in.
eurydice9276
What does this article have to do with its title? The text is about special interest groups, but in the past few years they've been giving much more money to the Democrats than the Republicans. Also, if Swedish-style health care is not the principle under which we operate in the United States, or the principle under which Obama operates, then why the scare-mongering? Are you suggesting that Obama and the Democrats will do something that goes against their own principles? This article makes no sense.
As for the possibility that the GOP won't like Obama's next proposal, I imagine they're still waiting for his first proposal.
ThinkAgain
The GOP will benefit most as a party from what what will be the worst possible outcome for the country. That will take some of the sting off of that bitterness.
AlanD2
ThinkAgain: The GOP is going to spend the next 20 years in the wilderness.
Until they dump their Christian conservative extremist base, they will never become a major factor in American politics.
Americans like centrist parties, and the Republican party doesn't qualify.
Mariafrania
I'm curious how many critics have ever spent any time in Europe (a 2 week vacation doesn't count) and actually witnessed how those health care systems work and if people are happy with them, rather than throwing around empty speculations and spilling words. Of course, every country may have its share of problems, nothing is perfect, but in comparison, America is the third world in terms of health care.
I haven't read the bill, I've only heard lots of discussion on it from both sides. I'm sure it's got its drawbacks- but for now it's the only thing we've got. We have to finally start somewhere, start making some changes, and then make modifications where needed along the way. The right-wing side seems to have a plethora of "good" ideas, but no republican president has put into effect anything that would really turn things around. Nixon ruined health care and his party successors kept it that way. So, instead of bickering like children about who has the best idea, let's finally actually do something.
ThinkAgain
I worked in London for 8 months. They complain about their healthcare system all the time. Take a gander at their online papers and you'll see that the escalating costs are something that's constantly debated in Parliament.
America is not remotely a third world country when it comes to healthcare. What we are is fat. Just by reducing our obesity down to the levels in Europe alone would wipe out the differences in cost.
Why should we all have to pay because someone ate too many hamburgers and now can't afford their diabetes drugs or heart bypass surgery? This is another example of government enabling bad behavior by some at the expense of others.
cbeenthere
Didn't you post that you have a dependent with a health problem? Do you feel the same way toward them? Do you begrudge them the additional care required when there are others that are healthy and do not require extra care?
AlanD2
ThinkAgain: I know some Americans who would love British health care - the 45,000 uninsured Americans who died last year because they couldn't afford to pay for medical treatment that would have saved their lives.
Had they been in England, they might still be alive today.
America: The Real "Death Panel".
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