Matthew Holt

Ezra says pusillanimousity has won

Now he’s no longer a young punk but an insider of the first order Ezra Klein has come up trumps and got an early copy of the latest Senate Finance committee legislation/trial balloon. It’s not going to make the left happy. In order to ratchet down from the $1.3 billion CBO said that their earlier version was going to cost, the Committee has basically taken out the public plan option, cut back the amount of subsidies, and are relying on what looks like an increasingly unenforceable individual mandate.

Now admittedly this is where I said Obama would end up more than 18 months ago. But, given that with the recession we really had a chance to do something here, this is very very weak.

I got a call from Organizing for America (Obama’s grass roots organization) asking me to support the reform bill the other day. This one is barely worth passing. We might be better off leaving the system and having a proper collapse before we start again in the next recession (which at the rate we’re going might be this one).

It’s looking increasingly like the Democrats on the Committee got rolled, and didn’t even care about that. Perhaps they felt that the risk of passage of something significant was greater than the risk of a quick loss of legislation that no one could get behind anyway.

I’m not allowed to call the Democrats a certain word beginning with P any more (even if John Stewart uses it all the time). But I can call them pusillanimous. And in your treat for the evening, here’s Marina from HotForWords to explain what that means.

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16 replies »

  1. Sorry, Matthew, but I was writing and speaking and posting on CompuServe every day about ClintonCare in 1993 and 1994. McCaughey’s very accurate article played a big role in defeating the Clintons.

  2. Dr. Lippin,
    The “restless citizenry” is at the beach n
    this weekend, not gining a second thought about this debate.
    Matthew, are you off a decade on your dates?

  3. Don. I dont know what you’re smoking this week but even John Goodman’s never claimed that we’re cheaper here than Europe! I would LOVE even a shred of proof that 25 years of health services research is wrong.
    And you need to get a calendar. Clinton’s reform plan was already on life support by late summer 2003 after he lost the unions on NAFTA and had to scrape the budget through Congress died effectively between Sept 2003 and Dec 31 2003 when he lost industry support (especiually the AMA’s) after proposing big cuts in Medicare to pay for it. The major problem was the loss of public support as the economy picked up in late 2002 onwards
    Betsy McCracker’s untrue article came out in Jan 2004 & the fuss made about it by her and fellow loonies ever since way overstates its influence. There’s no reason to suspect her analytical skills have gotten any better

  4. While representatives from all stakeholder groups claim to want reform, or at least think the status quo is not sustainable, in the end, they all wind up paraphrasing the former Senator, Russell Long, with a cry of whatever you do, don’t cut you, don’t cut me, cut that fella behind the tree.
    We should be asking every stakeholder group, what’s your (CBO scorable) contribution? Put up or shut up.

  5. Matthew,
    You still want to imprison all of us in a 1990s style Medicaid HMO with powerful gate keepers denying care and angry physicians and providers making patients feel like pieces of meat.
    Reality shock hit Washington this week. Ted Kennedy’s killer bill not only would kill patients by denying care until many died but also by showing consumers how Obamacare would limit access to care.
    Most important, Kennedy has produced a bill that kills the chances of Obamacare being enacted because he not only shows how care would be rationed, but also how it would cost many times the $1.6 trillion projected by analysts.
    Sticker shock, rationing shock and political reality have sent Congressmen back to the drawing board where they don’t know up from down.
    If you account for the hidden costs of European health care, you’ll see that it costs Europeans a much greater share of their disposable income than U.S. care costs most Americans. And if you compare apples to apples, catastrophically expensive critical care to the same in both countries, you’ll see that we not only get better care but more cost effective care.
    But reality never has been in the minds of advocates of single-payer scams. They prefer woulda shoulda to the realities of economics, human nature and medicine, not to mention American politics and culture.

  6. Matthew–
    Only time will tell if Pres. Obama has the “gonads” of Lyndon Johnson in his fight for Medicare (Medicaid).
    There isn’t any blood on the floor of committee chambers and the oval office yet.
    You obviously have never actually witnessed sausage being made.
    We have just completed batting practice with the teams trash talking before the first inning. Give it some more time. Reforming 1/6th of the economy isn’t easy and it won’t be cheap. But you are right to be worried watching the courage of our Congressional “leadership.”

  7. Matt-
    Just because the Congress is wimping out(not unexpected)you are underestimating the power that-
    – A popular President can bring to the issue
    – A restless US citizenry can bring to this central domestic issue
    Ezra Klein and you are premature in your pronouncements of expected outcomes.
    Dr.Rick Lippin

  8. I am not sure if “pusilanimousity” has won. Because the alternative is far more expensive.
    The loss is due to proper plan. I for one truly believe that we out to have some sort of tax funded plan – at least the wellness care part. And rest can be private insurance driven or by the system as it is.
    Here is a portion of that thought…
    Open community care clinics and make primary care responsible for that. Primary care will not only be a care giver but your health manager. They will decide and manage your wellness. Their incentive would be driven by wellness index and that would be mean less need for specialists. You reduce the cost due to admin cost, as well as due to too much emergency and specialist care.
    Not just that, you also created healthier population. What that does is increase your national productivity and hence global competitiveness.
    Another benefit, employers do not have the burden to waste their time on health issue which is not their core competency.
    This whole thing can be funded by progressive tax on individuals…the money employers are giving now to employees in health benefits should be given to them in salary raises.
    Then people can buy additional insurance for emergencies.
    Those who do not like, they can buy a complete insurance package from insurance company…still they got to pay the taxes.
    Is it that difficult…NO.
    But we got lots of pundits and boston brahmins screwing things up….
    Well take it from a real pundit and a real brahmin…the solution is far simpler and far cheaper…The politics is bad.
    Both – republican and democrats – are out of their minds and just want waste or not do anything.

  9. Healthcare “reform” will not work beause our country is about individual rights and freedom. There is nothing either free or individual about a federal system where the words “required” or “mandate” are involved. The Dems will have to cut Medicare and Social Security cost all by themselves without raiding the private healthcare cookie jar. Political hell. Love it.

  10. I’ve repeatedly called Democrats spineless, not as eligant as pusillanimous, but no reason to reach for the dictionary. Just another example here. If anybody sinks Obama it will be his own party.

  11. I come back to what I was saying when I first started reading this blog last year. The government’s role should be to bring the stakeholder groups within the system to the table. It must ensure that the discussion stays on track, and that each group gives something up in the name of a lower cost, higher quality system. No one can leave until all cost drivers are addressed and dealt with. That is the only conceivable way this can work.
    Our current government and political system is not conducive to making difficult decisions and devising effective solutions. It is nothing more than a perpetual campaign for most elected officials and the lobbysists certainly know that well.

  12. Cowardice among politicians even before push comes to shove? Nothing new there.
    Better than the video however is perusal of my favorite reference – the Indo-European roots section of the American Heritage Dictionary: pusill- from pou- cognate of current English “few”, pusus “child” in Latin, -ill (probably same as -ile in puerile) adjectival ending -animus root ane- to breathe.
    “To breath like a child” That sounds like a description of talk from national politicians.

  13. Don. As usual logic isn’t your strong suit.
    a) we spend 17% of GDP–Europeans spend 10%. Yet somehow those Europeans have doctors for their seniors–even though it’s a greater share of their population. Somehow we should be able to cut spending and cover everybody, but we wont because of the P word
    b) We dont count people who are unemployed longer than 6 months and whole lot more–yet we’re at 8.5% unemployed, they’re at 8.6%–counting it properly.
    Your touching faith in the free market seems untroubled by recent events 🙂

  14. Matthew,
    It appears that the Dems have a death wish for Obama care. They’re talking about cutting Medicare expenditures/costs 1.5% a year. Go figure. That would make it impossible for baby boomers to find docs once they became eligible for Medicare.
    And they’re talking about taxing employers that don’t offer health insurance. That’s a sure fired way to ensure that the uninsured will be permanently unemployed.
    Can you say 15% unemployment. That’s the European way, for sure.