James Pethokoukis

Politics and policy from inside Washington

Why ObamaCare is morphing into RomneyCare

July 30, 2009

Time for a political reality check. Government-run public health insurance that competes with private plans — a Democratic dream since President Truman suggested it in 1945 — may not be dead for now on Capitol Hill, but its vital signs are awfully faint.

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Of course, many proponents are hoping to use the congressional August recess to rally the grassroots and the netroots for one final push come September. And maybe that will work.

But it’s more likely that Democratic leaders in Washington will use the break to tell the outside-the-Beltway crowd the cold truth: If they want something that can be legitimately called “healthcare reform” to pass in 2009, they need to quit wasting time, energy and money on the fading dream of a public plan and instead work to get other key elements passed.

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And what might those elements be?

Analyst Daniel Clifton of Strategas Research makes an educated guess. He thinks President Obama may get the chance to sign an $800 billion (over 10 years) bill that would contain features such an individual mandate to buy health insurance, subsidies up to 300 percent of the poverty limit to purchase a regulated plan through a health insurance “exchange”, and an expansion of Medicaid.

Obama might even get his commission that would try to determine what Medicare pays doctors and hospitals — now that the Congressional Budget Office has determined it would pretty much be powerless.

As one lobbyist put it: “I would see this as mostly a symbolic victory (for Republicans), as the Dems can get most of what they want without calling it a public option. Frankly. it’s pretty close to the Massachusetts model.”

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Ah yes, the Massachusetts model. The state passed sweeping reform in 2006 under Governor Mitt Romney. What would a similar approach mean for America?

Well, there would be a lot fewer uninsured people. Massachusetts has halved the number of people without health insurance, with just 2.6 percent not currently covered.

But the reform has been far less successful bringing down costs. For starters, original cost estimates for Commonwealth Care projected the program would cost $400 million in 2008 and $725 million in 2009. The actual numbers were $628 million in 2008 and $869 billion for this year (with some costs estimates of $1 billion or more).

Moreover, health insurance premium costs continue to rise at a rapid clip of 9.4 percent a year, compared with 7.7 percent for the United States on average. As the Urban Institute found: “Health spending in Massachusetts is higher than the United States on average and is growing at a faster rate. Furthermore, health insurance premiums are growing even faster than health care costs in the state.”

So America might find itself in 2012 with lots more people covered, but in an ever more expensive system. And President Obama might find himself doing what Romney’s Democratic successor, Governor Deval Patrick, is doing: cutting back the subsidies that allow poorer residents to buy insurance.

The state is also considering moving away from fee-for-service medicine, where doctors are incentives to perform lots of pricey procedures rather than focusing on results.

But Obama and Democrats might also make this argument: We expanded coverage and now it’s time to finish the job by getting costs under control. And the only way of doing that is … a public insurance option!

Indeed, the Urban Institute makes the same argument that Team Obama surely would: that the presence of a national plan would force insurers to compete with a plan with strong bargaining power and, as an arm of government, a powerful financial interest in containing costs.

What’s happening in Washington isn’t the end of healthcare reform, it’s merely the end of the beginning.

Comments

I just have a comment about President Obama’s healthcare plan. I am definitely for it. The polls say support for healthcare reform is waning, but who are the pollsters asking? Everyone I know is in agreement on this issue. We need health care reform! The United States is the leader of the world and 40 + million citizens don’t have health insurance. These people are the ones that fall between the cracks because they are not poor enough but don’t make enough to buy insurance at the going rates. or if they do, it’s with incredible high deductibles that they can’t afford!

Posted by Beatriz Krinsky | Report as abusive
 

I can’t say I am the most educated on the subject of health-care, but I do know that I don’t like Obama’s plan. I also know that there are many people on both sides of the spectrum and if you don’t know someone with a different view than yourself you need to get out more. I also think that those of us who know that this Obama-care plan is not going to help the financial sector, we need to speak up to our Congressmen and let them know how we feel! An active citizen is a good one.

Posted by Spacious Skies | Report as abusive
 

It’s easy to say “I am definitely for” healthcare reform — but I have to question how many of the people who unquestioningly believe what Obama tells them REALLY KNOW the details in the Congressional plans.

I’d like to see a pollster pose some questions along that line to the ObamaCare supporters. Let’s see how informed they really are.

Posted by Paul in NJ | Report as abusive
 

Its about grabbing taxes. Not instituting a functional system. Put state health care in the dysfunctional state operations like medicare, social sec, and the mortgage debacle. All run into the ground by political meddling. Really, you give the disaster masters the keys to the rest of the estate after they burned down several of the buildings? The jig was up as the details of the health care “reform” started to leak out.
Its more taxes, period.

Posted by frankg | Report as abusive
 

If you want the government running your life, you’ll love Obamacare. If you think the government can do a better job than the private free markets, you are…a newborn. Get real!

Posted by JeffT | Report as abusive
 

JeffT, you’re the one who needs to get real. The American “free market” health care model is a travesty. I don’t want my health care needs being mediated by someone who receives bonuses to deny treatments among other bad-faith style practices.

Posted by zyz | Report as abusive
 

The US government spends about 20% more per capita on health care than the Canadian government, even though the US govt only covers those on Medicare or Medicaid, whereas the Canadian government covers EVERYONE. On top of that, most Americans pay health insurance either directly or through their job. This means if we cut the insurance companies and HMOs out of the equation, the US government could provide universal health care without raising taxes. No paperwork required when visiting the doctor, no one between you and your doctor, deciding what treatments you can and can’t have. Why would assume giant corporations are less corrupt than the government?

Posted by Diego Hausfather | Report as abusive
 

Responding to Diego Hausfather:

Why would you assume that government officials would be less corrupt than a large corporation?

Posted by F. Sumter | Report as abusive
 

Diego Hausfather:
people like you who go around comparing the US costs to Canada or British healthcare costs, without ever mentioning how much of the higher costs have to do with lawsuits and liability insurance, it is much harder to sue and the settlements are more standardised and smaller in both Canada and Britain then the US, democrats wouldn’t touch tort reform because trial lawyers own them. Your let’s do away with insurance companies and HMO’s, as though it would be possible to just destroy in a day almost 18% of the American economy, for dummies that’s hundreds of billions of dollars and millions of jobs going puff, ah not going to happen. Every country has private insurance and public healthcare just like the US which has medicare and medicaid for the old and poor except Canada and Cuba, since Cuba’s not worth really mentioning and Canada whole economy is about 1.2 trillion to compare it to US is ridiculous, and even in Canada in a decade they will have to have public/private insurance because their Healthcare costs are unfunded , and the wait lines have been struck down by the Supreme Court as against Canadian human rights, so let’s not copy a system that itself will be no more in less than a decade.

Posted by sam | Report as abusive
 

Let me get this straight from you room temp IQ libs…
You want the government who just brought you Cash For Clunkers that was recently suspended for lack of oversight to NOW administer your health risks and care.
It should be painful to be stupid !

Posted by The Right Side | Report as abusive
 

On the same page as your article an actress complains she cannot receive a CAT scan. That’s the problem with the costs of medical care. an x-ray would do.,

 

As a healthcare worker I firmly believe healthcare sould be provided to all. It basically is, with hospitals picking up the charity care and passing it on to all. With politics envolved you can’t even get medicare reimbursement paid out the same from state to state. How wrong is that? What politition will touch tort reform? When are the elected officials going to quit following party lines and sit their butts down and do their jobs!! What ever the politicians come up with they too should be covered by it! We already have a healthcare plan,its called medicare. Let everyone be eligable.

Posted by Mikel Oklock | Report as abusive
 

For those of you saying you want health care for all, please tell me who you think is going to have to pay for it? Where will the money come from? Oh, yeah, you want to steal it from the top 1% who pay most of the taxes in theis country. Why is it 1% of the country pays more than 95% of the country and 40% pay no taxes at all. Why is it a crime to be smart, get an education, work hard and get a JOB. Why should we have to pay for everyone else, most of those too lazy to apply themselves and work hard for a living. Oh, and if you can’t afford health care, STOP HAVING CHILDREN!

Posted by Kate99 | Report as abusive
 

It’s absolutely fascinating how quickly big pharma and Fox News can whip up a frenzy-fest of people who fight against their own best interests:

How providing cost reducing OPTIONS can be twisted into —> “a government take-over of health care”.

How providing free LIVING WILL CONSULTATIONS, can be twisted into —> “Obama’s death panels”.

How providing PREVENTATIVE CARE INCENTIVE for doctors, can be twisted into “government coming in between you and your health care provider”.

HOW FINALLY PROVIDING ADEQUATE CARE FOR AMERICANS WHO CAN LEAST AFFORD IT, IS TWISTED INTO —> “SOCIALIZED MEDICINE”

I have one simple request for anyone reading this:
Think for one moment what will occur if the insurance lobby wins and real reform is NOT passed:

Carefully think about this and ask yourself if you are happy with your health insurance cost going up by 200% the rate of inflation year, after year, after year.

Ask yourself if you are happy with millions of jobs being shipped overseas due to high health costs in the U.S.

Ask yourself if you will be happy as the U.S. health system continues to spend a higher portion of its gross domestic product than any other country, but also continues to rank WORST in preventable deaths among industrialized nations. WORST!!!

If this really is a Christian nation, as most would claim, I am seeing fewer and fewer signs of it every day. What ever happened to, ‘Amen, I say to you, whatever you did for one of these least brothers of mine, you did for me.’?

I can’t help but to wonder why those angry mobs at the town hall meetings are not fighting FOR the PUBLIC OPTION rather than against it? Why they are not picketing the insurance industry that is financially incentivized to DENY your coverage (based on pre-existing conditions, etc. etc. etc.). Why medical payments are STOPPED, after a fixed period of time EVEN THOUGH YOU HAVE MADE INSURANCE PAYMENTS LIKE CLOCKWORK YOUR ENTIRE ADULT LIFE.

You want to see a REAL death panel at work? Just look into the current practices of even the most popular health insurance providers.

Get the facts, and then get real folks. If you assist in blowing THIS CHANCE for high quality health care that EVERYONE can afford, then there may never be another opportunity to once-and-for-all get this one right.

References:
http://www.nchc.org/facts/cost.shtml
http://www.americashealthrankings.org/20 08/index.html
http://www.who.int/whr/2000/media_centre  /press_release/en/index.html
http://www.reuters.com/article/healthNew s/idUSN0765165020080108
Matthew 25:40

Posted by Iam-ru Awake | Report as abusive
 

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