James Pethokoukis

Politics and policy from inside Washington

Did the Blue Dogs just rollover on healthcare?

Jul 22, 2009 17:38 UTC

Pelosi seems upbeat, but Arkansas Democrat Mike Ross less so:

The Blue Dogs share the President’s goal of providing the American people with quality, affordable health care reform that’s deficit neutral, and we have put forth a number of substantive policy proposals over the past several months aimed at achieving this goal.

We are making progress; however, we have a long way to go. The Blue Dogs will continue to work constructively with the administration, Chairman Waxman and members of the House and Senate to produce a bill that we can ultimately support.

Why you should or should not bet against healthcare reform

Jul 22, 2009 10:14 UTC

jamespethokoukiscropThe chances of sweeping healthcare reform have dropped dramatically over the past month or so.  (I still think the president will have something to sign by year end.) Mark Halperin of The Page gives his reasons why healthcare reform still has a good chance of happening, though what “healthcare reform” means is left undefined — and that is kinda important:

1. Reid, Pelosi, and the applicable committee chairs all are still on board (no one has taken their marbles and left, in part because the White House congressional affairs office has a great ear and many eyes).

2. Senators Grassley and Snowe haven’t given up.

3. Rahm Emanuel knows what’s possible.

4. If he can get a bill to conference committee, the press will start implicitly cheering more for success, and stop obsessing over every setback.

5. The health care industry and business community are still largely supportive.

6. Labor unions are likely to give in (maybe) at one or two critical moments.

7. Obama is not rattled.

And this article from The Hill makes some counterpoints:

If Democrats in the lower chamber do not pass a healthcare reform bill before the recess, it would be seen as a major step backward from the legislative timetable President Obama initially outlined. As recently as last week, leading Democrats were predicting they would pass bills through the House and Senate before adjourning for the summer. … In another blow to the Democrats’ healthcare reform efforts, the U.S. Chamber of Commerce on Tuesday launched an advertising campaign targeting a key aspect of Obama’s healthcare plan — a government-run “public option.” Another powerful industry group, America’s Health Insurance Plans, stated on Tuesday that a “government-run plan is a roadblock to reform.” … Hoyer on Tuesday confirmed that opposition was not limited to the Blue Dogs. … “It’s the spending and the cost. The [Congressional Budget Office score] last week was really a hit across the bow,” said Rep. Baron Hill (D-Ind.), a Blue Dog leader and member of the Energy and Commerce Committee. … Some members want to wait to see what the more conservative Senate will do so that members don’t have to make tough votes on issues, like raising taxes, that are difficult to get through the upper chamber. Complicating the healthcare reform effort is the fact that the Senate Finance Committee still hasn’t released its bill or indicated how it will be offset.


You hear how much different healthcare plans will cost but,nothing about “how much more it will cost if we do nothing.”

Posted by Jim V | Report as abusive

Jindal’s GOP healthcare reform alternative

Jul 22, 2009 09:59 UTC

Bobby Jindal takes a shot at a Republican alternative for healthcare reform in the WSJ today: 1) IT-driven consumer choice; 2) health savings accounts; 3) medical lawsuit reform; 4) insurance reform; 5) pools for small business; 6) pay for performance rather than procedures; and 7) tax credits to help low-income working Americans buy health insurance. Fine, fine, I guess. But wouldn’t it better to describe how a real plan would work in people’s day to day lives and what it might cost or how it might reduce costs? Does this really change the debate at all, or merely show Jindal as wonky potential presidential contender?


Instead of a 1,018 page bill that nobody has read, can we not “reform” the qualifications for Medicare and Medicaid to include all less fortunate “AMERICANS” ?
This way, instead of creating another huge governmental waste program, we can use these already existing programs.
I cannot see any reason that any “AMERICAN” cannot qualify for these programs.
Just let your state and federal elected officials know that you are tired of supporting foreigners in our nation illegally !

Posted by JOHN F. KOSTRUBAL | Report as abusive

What healthcare reform might actually look like …

Jul 21, 2009 12:39 UTC

One Capitol Hill watcher sends me this on what a Democratic fallback position on healthcare might look like:

I think that a “compromise” plan looks something like an individual insurance mandate and some further coverage mandates/restrictions (like not allowing denial of coverage based on pre-existing conditions).  If they didn’t want to “fall quite that far back,” so to speak, they could couple such a plan with substantial subsidies for people up to 400-500% of the federal poverty level.  This would mean no “public option,” but it would still represent something the Democrats could call health care reform.

That kind of a plan would probably have some legs, assuming the cost/pay-fors weren’t an enormous problem.  … Many Republicans seem to have already conceded that an individual insurance mandate is acceptable, so I think that’s the route Democrats could use to get closer to their preferred destination.


I really can not understand what is the matter with he fed. they seem to think that by keeping the interest rates low that they are helping people . This ladies and gentleman is the WORST thing that can be done for the building trades and large buys.

who in this country have the most disposal income? I hope you got i right and that is seniors. and what do they spend ?? NOT their capital!!! They spend and give away there interest. so with this in mind WHO is benefiting from low interest?? The people that put us in this situation.
Please do not make us a Third Class Country . We now because of past policies now a Second Class Country.
Please do what is right for the country not Goldman Sachs

Posted by Dan Behan | Report as abusive

Applying the Summers-Google metric to healthcare reform

Jul 20, 2009 19:26 UTC

So does more public interest in healthcare reform help or hurt?


Where cap-and-trade and healthcare are heading …

Jul 20, 2009 17:49 UTC

While both healthcare and cap-and-trade look to be in various degrees of trouble, some savvy Capitol Hill watchers make this point to me: Democrats look at failure to do something about healthcare as an Extinction Level Event, with a failure on cap-and-trade also incredibly damaging, particularly with the Dem base.  House Speaker Nancy Pelosi told wavering Dems that a cap-and-trade failure was a dagger in the Obama presidency. She pushed them to the wall. Healthcare even more so.  Expect a full-court press in the Senate on both. At the same, either of those issues slipping into 2010 is fatal to their chances. The next five months may make or break the Obama presidency.


I hope they are both headed for the shredding machine where they deserve to be. Plus, I want the money back that’s been wasted on all of this unconstitutional hogwash!

Posted by jason | Report as abusive

Another free-market fix for healthcare

Jul 20, 2009 14:21 UTC

I can tell you the pro-Obamacare Washington wonks I chat with are pretty down right now about the chance of “real reform” getting passed. And as the costs and inadequacies of Obamacare become more apparent, I expect to here more ideas like this one by economic analyst Ed Yardeni:

I think that the problem isn’t that health care costs too much. Rather, we provide it too cheaply. Insurance companies should probably charge higher copayments. Medicare simply gives health care services away to senior citizens without any limits on how many times a patient can go to see a doctor or go to the hospital for the same ailment. Some older folks jump from one doctor to another to get multiple opinions. Perhaps keeping electronic records might help to limit the over usage (and abuse) of our health care system. However, the government shouldn’t have access to our medical records.

We should consider a more radical solution to the Medicare problem. Privatize it! I propose that senior citizens should also be required to have coverage under private plans with the federal government reimbursing them for their premium payments. To insure competition, let them rather than the government select their health care insurance providers. It would be up to individuals to choose the best plan for themselves. The government shouldn’t set the premium fees, but let the market do so. The onus of rationing health care services for the elderly and the rest of us should fall on the insurance companies, which is where it belongs. The government shouldn’t be in the business of monitoring, approving, and allocating the health care needs of Americans.


I respectfully disagree with Rich G. AT&T didn’t decide to break the company into smaller parts, it was broken up for being a monopoly. It is monopolies that destroy free markets. Monopoly capitalism is marked by booms and busts.

I also disagree that free markets don’t keep costs down. They will do that–if the market is truly free. Right now, the health “care” business (more accurately the “health denial industry”) is controlled by two major groups: a handful of insurance companies that make fortunes by denying healthcare, and the AMA, a union that effectually limits the number of physicians available in the market. With limits on where you can get insurance and who provides actual care, there is no free market at all.

But “economic analyst” (I have other descriptions for him) Ed Yardeni provides a total non-solution. Making health care MORE expensive as he proposes and limiting access to health care will result in higher costs (as people put off getting care and end up in far more costly emergency rooms), more illness, less work productivity due to chronic and acute illnesses not receiving treatment, and both more deaths and shorter life spans. One wonders just how much Mr. Yardeni is getting paid by the health denial industry.

Posted by Don | Report as abusive

Centrists in Congress continue to trip up healthcare refrom

Jul 17, 2009 16:26 UTC

This is why the Al Franken/Supermajority Effect is overstated. Centrists in the Senate can toss a spanner into the works. The lot below (letter via HuffPost) want to slow things down for more debate.


Pelosi: If surtax passes, it’s staying, get used to it

Jul 16, 2009 19:40 UTC

Madam Speaker speaks (via The Hill) about the surtax and what it might be used for:

I hope we can change that percentage and get much more coming from savings,” Pelosi said. “In fact, I believe that all of the cost of the healthcare reform bill can come from squeezing more savings out of the system.”

Asked why Democrats were proposing more than $500 billion in new taxes if savings alone could fund their healthcare plan, Pelosi said: “We have to have a revenue stream to ensure that the bill will be paid for. If we don’t need that money we can use it to reduce the deficit. … There is going to be a revenue change at the high end. It will be directed to reduce the deficit or … to help reduce the cost of this initiative.

Me: So it really isn’t a surtax is it? It is just a plain-old tax increase — and a big one at that.

How ‘hedge fund’ Democrats are influencing tax bill

Jul 16, 2009 18:23 UTC

I just got this email on the markup of the House healthcare bill:

The healthcare surtax would apply before any tax deductions are allowed (charitable, mortgage, etc.), save one: margin loan interest. So if you want to take out a loan to buy stock, the interest on that will still be deductible against the surtax. But if you want to give to charity or pay your mortgage, you’re out of luck. Those aren’t deductible against the surtax.


Why do we continue to encourage indebtedness with the tax code? So many wonderful things would happen if we did away with mortgage interest deductibility!

Posted by Rolfe Winkler | Report as abusive