My spies tell me that this WSJ article by Bush adviser Allan Hubbard is packed with more half-truths per inch than even stuff emanating from AHIP. But I’ve lost my WSJ access,
as as I won’t pay money to Mr Murdoch on principle –after what he did to NSW Rugby League–I can’t get only get the the first part unless I subscribe. Can someone send me the rest of the text?
As it turns out, the whole thing is a defense of the upcoming Veto for SCHIP renewal.
Here’s the whole piece with my comments
There aren’t many issues in Washington that everyone can
agree on these days. But here’s one: Our health-care system needs serious
Not a lie
Deciphering the forms you get when you take your child to
the doctor is very difficult. Small business owners who provide health insurance
for their employees struggle to afford skyrocketing costs. Many communities
don’t have a single practicing ob-gyn because the risk of lawsuits has run them
out of town.
Mostly, not a lie (let’s save the malpractice arguments for another day…)
The problems are clear, yet there is great disagreement
about what to do about them. What we need is an honest look at what’s right with
our health-care system, what’s wrong with it and what we can do to improve
Not much of a lie (although the "honest" part is a little troubling).
Let’s start with what’s right. America’s private system of
medicine is the world’s finest. It taps into the efficiency and flexibility of
competition and markets. It puts doctors and patients in charge — not
government. It gives us the world’s most talented doctors and nurses, the most
advanced hospitals and the most promising medical research. Americans with
access to this system receive outstanding care — and people from around the
world come here to benefit from it.
Good. Now we’re talking. "The world’s finest".
Funny because in many studies the underfunded VA–not private
medicine–does better than private medicine. Let alone private medicine
or even public medicine in other countries. So this is a lie. And the "taps into efficiency and flexiblity of markets" line. That’s what causes the "forms you get when you take your child to the doctor".
Of course, there’s also a big problem. Access to high quality
private health care is getting so expensive that many can’t afford it. Growing
numbers of Americans depend on the government for coverage. That creates a
bureaucratic maze for them, and weakens the system of private medicine for all.
As President Bush summed it up recently: "America’s health care is too costly,
it’s too confusing, it leaves too many people uninsured."
If private health care is too expensive, shouldn’t the wonders of
the market have made it ripe for someone to come in and provide it more
cheaply? But let’s not worry about that. After all even the President–a
busy man with much on his plate–has noticed that there are problems
with health care. He does though think that people poorer than him should get it in the emergency room.
So how do we fix the system? The president agrees with the many
members of Congress — Democratic and Republican — who believe we have an
obligation to ensure that poor kids have health insurance. The State Children’s
Health Insurance Program (Schip) has been covering poor kids for 10 years and
now is up for reauthorization. The president supports reauthorization, his
budget boosts funding for poor children in Schip, and he is prepared to sign a
bill with appropriate funding increases.
This is a lie hiding behind some dishonest proposals. Put it this way. If there were no SCHIP would Bush support its creation in any form?
The president differs from some in Congress on how to cover
children in middle-class families and other Americans. For example, one bill,
sponsored by Sens. Max Baucus (D., Mont.) and Charles Grassley (R., Iowa), would
expand Schip dramatically beyond what it is intended to do. And it would be a
dangerous step down the path of government-run health care, ultimately resulting
in fewer options and lower quality care for American families.The Baucus-Grassley proposal would expand Schip to cover
many children who are not actually poor. A family of four making $82,600 would
be eligible for taxpayer-funded health insurance.
Unless I’m mistaking the inner workings of the bill, that’s a lie, or at least is economical with the truth. "A family of four making $82,600 would
be eligible for taxpayer-funded health insurance" for their children, and given that SCHIP is usually not implemented fully, it’s a "might" not a "will" in terms of getting it.
It would also cause many people to drop their good private
coverage and move to taxpayer-funded, government-run health care. In fact, the
Congressional Budget Office has estimated that for every two people who would
join Schip under this bill, one would drop his/her private health insurance — a
striking example of "crowd-out" that is contrary to the purpose of the
The crowd-out effect is probably true. But lHubbard’s leaving unsaid that the private health insurance market that some kids would leave is a disaster in its ability to save costs or waives pages of forms at the doctor’s office. Oh, wait. he did say it a few paragraphs ago!
Finally, this bill would run up a huge tab — $71 billion over 10 years
— and would impose new tobacco taxes to pay for it. But even a large
tax hike won’t pay for this bill’s vast expansion of the Schip program.
Instead, the bill resorts to a massive budget gimmick to hide its true
costs. This trick makes it appear that Schip’s costs under this
legislation will steadily increase from $5 billion this year to $16
billion in 2012 and will then suddenly drop to $3.5 billion a year — a
steep fall that won’t happen of course because millions of kids would
Not a lie but very funny. First that amount is 1/10th the increase in health care spending from the taxpayer that Bush rammed through the Congress in 2003 in the MMA. Where was the White house’s rhetoric on saving money then?
Second, the trick of making money disappear in the "out" years was invented by this Administration in its heinous 2001 Act of "borrowing from tomorrows workers for tax-cuts for today’s wealthy". Those cuts are all expiring soon too. But not until after this Administration is gone.
In short, the Baucus-Grassley bill would weaken the part of
American health care that is working well — our private system of medicine —
while doing little to address the real problem for most Americans, which is the
cost of care.
Another lie. It would probably improve the profits of the private insurance
industry as it would provide a way for them to further skim the risk pool, and
dump the remainder onto the taxpayer. But let’s be real, if the private market
works so well, why are costs "the real problem for most
Americans".Well of course, it’s because the private market isn’t being
allowed to work by those dastardly government people.
If Congress really wants to talk about reforming American
health care and getting more people covered, there is a smarter way — a way to
build on the strengths of our private system while addressing its shortcomings.
And it starts with addressing one of the root causes of the problems in health
care — the federal tax code.
The problem is straightforward: Under today’s tax code, people
who are fortunate enough to get health insurance through their jobs get a big
tax break — but those who have to buy coverage on their own get no tax break at
all. That is not fair, and it is not wise. It makes it impossible for millions
of Americans who work for small businesses or who are self-employed to afford
health insurance. And it drives up the cost of coverage for us
Two lies, one big one small, and one truth. First the small lie.
Self-employed people can deduct their insurance on their taxes. I have done
every year since 2003. It’s employed people who don’t get health insurance
through work who cannot make that deduction. But given that the vast majority of
those are on very low wages and pay very little income tax, giving them a tax
deduction won’t make much difference to their ability to buy health insurance.
The truth is that making health insurance tax deductible does
drive up the cost of health care.
So what’s the genius solution from Hubbard? Do more of
So President Bush has proposed to level the playing field for
health insurance. Under his plan, every family with private health coverage
would receive a standard tax deduction of $15,000 — no matter where they get
their health insurance. This deduction would encourage more people to buy their
own health insurance, just like the mortgage interest deduction encourages more
people to buy their own homes. Some have suggested that a flat tax credit could
also achieve the president’s goal of leveling the playing field, and he has
signaled that he would be open to that option.
These tax reforms are
simple, but their effect would be revolutionary. More than 100 million people
who are now covered by employer-provided insurance would see lower tax bills
right away. Those who now purchase health insurance on their own would get a tax
benefit for the first time. And millions of others who have no health insurance
would be able to purchase private coverage
Not a lie–just dumb. Notwithstanding the business practices of many of our
leading health plans, the reason that health insurance is expensive is because
health care is expensive. Only some 6% of Americans buy their insurance in the
individual market. So using that as the fulcrum to reform health care and reduce
its costs is a non-starter.But what giving everyone a huge tax-break
might do is break the "solidarity" of what’s left of the insurance pool in the
employer market. If younger and healthier employers left to buy their own
coverage in the individual market, it’s likely that more employers will find
their risk profiles starting to look more like GM’s than say Google’s. Which
will help hasten the end of that market while the Administration has done
nothing to reform the gong-show of the individual market (even along Romney-care
lines) that these people will go into.
To reduce the ranks of the uninsured even more, President Bush
has also proposed to make federal help available to states that ensure all their
citizens have access to basic private health insurance.
No point even pointing out the level of that lie. "All their citizens"? C’mon
There are sharp contrasts between the president’s plan to
reform the tax code and the Baucus-Grassley proposal. Reforming the tax code
would bring more affordable health insurance to 100 million Americans, while
Baucus-Grassley will not change the cost of coverage for most people. Reforming
the tax code would reduce the ranks of the uninsured by as many as 20 million,
while Baucus-Grassley would cut the uninsured by fewer than four million. And
reforming the tax code would achieve these goals without increasing taxes, while
Baucus-Grassley would mean more taxes, more spending and more control for
federal bureaucrats in Washington.
For taxpayers, families, patients and businesses, the choice
is clear. Therefore President Bush will continue to work with members of both
parties for reforms that make health care more affordable and more available for
all Americans while continuing to support Schip for poor
Actually, I’m not sure he’s lying here. SCHIP is a dog-meat "separate but equal"
program for the poor. Any advocate of SCHIP would trade it in a heart-beat for a proper
inclusive universal insurance program, and we all know that programs for the poor are treated poorly. Ten years after SCHIP we still have lots of uninsured
children, and it’s clear that the Administration and perhaps much of the country
just doesn’t care. Apparently Baucus and Grassley — two conservative moderates — do.Of course the concept of moving 190m Americans to a tax-credit based
system with no concurrent reform of the individual market is a level of
insanity that even Republicans in Congress knew was a non-starter when they ran
the place–no matter how much looney Rooney and his buddies wanted it. Now that the Republicans don’t run the Congress, the best advocates for change can hope for while
Bush is still around is incremental moves like SCHIP expansion. In the end it doesn’t mean too much–the increase in health care costs that our current system churns out will put more people into the public sector or the uninsured population than SCHIP will fix.
But in the meanwhile there are some kids who’ll get health care because of SCHIP that won’t if it’s not around. And the
upcoming SCHIP veto is just petty vindictiveness on behalf of a totally
discredited White House.
Hubbard’s central thesis is that insuring more kids through SCHIP will unleash a domino effect ultimately resulting in single payer, government run healthcare.
It worked for fearmongering about communism. Why not healthcare?
So why didn’t past expansions of SCHIP lead to such a slippery slope? And what about other massive expansions of federal healthcare programs (i.e. MMA)?
“which is a Canadian single-payer system writ large. The plan calls for massive new payroll taxes and a government board charged with care and reimbursement decisions.”
Ever see all those bus loads of Canadians fleeing to the U.S. for cheaper, better healthcare? If you’re impling that government boards in Canada determine patient care that’s certainly not the case. Doctors and patients determine care, the ELECTED government covers the costs (taxpayers) and determines the macro budget. No it’s not free. But what would they be paying if they had the U.S. system? Less?
As for reimbursements to doctors that’s done through NEGOTIATION with the provinces, a very communist idea (Fidel?). Nursing salaries etc. are determined by the marketplace, COLA, unions, budgets, etc. just like every other reinbursement. Ah yes comrade, we will all unite with our other comrades in France, Britian, Australia, Germany, Canada, to provide better healthcare access at about 1/2 the cost. Come on quit red-baiting.
I don’t see that you’ve discussed the “Healthy Wisconsin” plan, which is a Canadian single-payer system writ large. The plan calls for massive new payroll taxes and a government board charged with care and reimbursement decisions. I can guarantee you many of Wisconsin’s best doctors, and there are really good ones there, will be headed to Florida, Texas, and Arizona (this I know for a fact). Many of Wisconsin’s exceptional small businesses (many high-paying manufacturers) will be going to Iowa, South Carolina, and parts further afield.
It would be a complete disaster, but the Wisconsin Dems, with visions of Fidel and Michael Moore dancing in their collective heads (and I mean that in the Soviet sense), don’t care.
I can guess the typical lefty response: we can’t do single-payor on a state-by-state basis. We have to nationalize the whole American system. This we may get in 2009. I can guarantee you one outcome should this come to pass. America will never, ever forgive the Democrats.
The VA is fine, unless of course you’re a patient there. When I was doing my cardiac surgery rotation at UW Madison nine years ago, we had a doc with rather poor infection control practices. His CABG patients kept getting nasty infections. Many stayed in the hospital for days or weeks longer than usual. Some died.
Problem was, this wasn’t good for the hospital, which has a fairly stellar rep. They quietly let him go. You know where he went. Yes, that’s right, to the Madison VA, where he continued to lay waste to unsuspecting veterans. Of course, everyone knew about this guy. Madison is a small town. The VA was always the subject of goulish jokes among the students and residents, and absolutely nobody wanted to work there.
I find it amusing, this attempt to pretend that the VA provides quality care. Nothing could be further from the truth.
Yeah well. It’s efficient at “enhancing stockholder value” and supporting pasty-faced lifestyles on, say, the yachts I see down at Camden Harbor in the summer. Oh yeah. That’s efficient and competitive and OH so flexible.
So long as you define those things as being efficient, competitive and flexible at funneling cash.
Come on, everyone. Let’s stop lying to ourselves. Pretending that the market is “free” is like pretending Spam is “meat.” As soon as you start worrying about marketshare and stock value, you’ve forgotten WHAT BUSINESS YOU’RE IN.
I guess if leave no child behind only works for education. I can see all those kids with their high deductible HSAs now ….
Then, I didn’t get my colonoscopy done as a vacation home house call either, so much for government provided healthcare.
I like the part about tapping, “into the efficiency and flexibility of competition and markets.”
That’s why healthcare costs here are about double what other government run systems around the world cost.
As for the lies, well this administration has always been about lies. Follow the money that leads to the incompetence.