THCB

Categories

Tag: 2012 Election

Romney vs Romney

• 9

By ROBERT LASZEWSKI

Republican presidential frontrunner Mitt Romney has pledged to end “Obamacare.” Upon taking office, he would immediately begin the process by granting the states waivers from having to implement it:

“I’ll grant a waiver on Day One to get repeal started. On Day One, granting a waiver for all 50 states doesn’t stop it in its tracks entirely. That’s why I also say we have to repeal Obamacare, and I will do that on Day Two, with a reconciliation bill [requiring only 51 votes in the Senate] because as you know, it was passed by reconciliation with 51 votes.”

Romney appears to be on thin ground in making his waiver promise and his promise to use reconciliation to stop “Obamacare” could lead to chaos in the market and among consumers.

The waiver promised is based on a provision in the law authored by Senator Ron Wyden (D-OR). Wyden’s provision was designed to allow states to petition the feds to opt out of the new health care law by taking the federal money that was going to be spent in their state under the Affordable Care Act and draft a comprehensive plan of their own that covered at least as many people as well as the Affordable Care Act would have.Continue reading…

Obama-ney Care

• 3

By SENATOR DAVID DURENBERGER

Tim Pawlenty used a recent appearance on Fox News Sunday to show a tougher demeanor and to prove he will not make health care cost containment and access a priority.   As Governor of Massachusetts Mitt Romney worked with the Democratic legislature and the health care industry to expand access to all residents of the state and to commit to cost containing behavior change. The coverage reforms came right out of conservative health policy playbooks at Wharton (in the 1980s) and the Heritage Foundation (in the 1990s) and the cost containment was to be accomplished by voluntary action of Massachusetts health systems and health plans. On which they have since foundered, leaving Romney to take the heat.

When President Obama made his commitment to reform of national coverage, access, insurance, payment, and delivery system policy, national Republicans refused to cooperate. The legislative policy approach he advocated came mostly from a bipartisan Senate Finance Committee report from 2008. Elements of it came from the bipartisan approach Romney took in Massachusetts. Congressional Republicans unanimously refused to participate in the process. Today every elected Republican has committed to repealing Obamacare (and now Obama-ney care).

What changed? The definition of Republican.  The election power of Sarah Palin, Michele Bachmann, Jim DeMint and the Rupert Murdoch/WSJ/Fox version of facts to bring out the “just vote No on government and on Obama” in a substantial enough minority of Americans turned the trick. While Pawlenty and Bachmann represent a state which has been committed to universal coverage and healthcare cost containment for decades, neither has done much to make it a reality in our state. Assuming “repeal and replace” implies state action is preferable to national, they’ve nothing to show for their efforts so far.

Senator David Durenberger, Minnesota, served in the US Senate from 1978 – 1995.

The Unbridgeable Gap between Left and Right on Health Reform

• 57

By JEFF GOLDSMITH

Though thoroughly smothered under 2900 pages of well meaning but poorly focused, expert-driven “good works”, the core of the Affordable Care Act was providing 30 million people subsidized health insurance coverage. As the country continues to decide how it feels about this monumental legislation, a major ideological divide persists over whether the aggressive coverage expansion in health reform was really needed or not.

Far from “selling itself,” as a overconfident White House aide suggested it would back on March 23, 2010,  health reform remains strikingly unpopular. Only 37% of the public thinks the country will be better off as a result of health reform, and only 28% think their families will be better off, according to the May Kaiser Family Foundation tracking poll.  There is a stark partisan divide over health reform.  While 72% of Democrats have a favorable opinion of health reform, a substantial minority believes the bill could have done more (covered more people, provided a public option or path to single payer).  Alternatively, 74% of Republicans have an unfavorable opinion of health reform; the same percentage favors repeal.  Independents tend to break toward the Republican view of the bill (49% unfavorable vs. 35% favorable).  Those opposed feel more intensely about health reform than those in favor.

The Ryan House Budget for 2012 zeroes out all new spending for health reform (while keeping ACA’s Medicare cuts, devoting them to deficit reduction!).  The conservative narrative is that the problem of the uninsured was liberal mythology, not meriting major new spending.  In the blogosphere, an analysis surfaced suggesting that the real uninsured problem is only about 4 million people. This apparently originated in a Heritage Foundation blog posting from late August, 2009.  Other conservative analysts charitably suggest there may be as many as ten to twelve million uninsured worthy of federal help.   To take care of this smaller number, you do not need a major coverage expansion, but merely to apply the familiar market oriented remedies: selling insurance across state lines, high deductible health plans, malpractice reform, high risk pools, etc.

Continue reading…

Inconvenient Facts (For Both Republicans and Democrats)

• 6

By ROBERT LASZEWSKI

I call your attention to Ezra Klein’s column in the Washington Post this morning.

In it he cites data that has been out there for a long time but Ezra puts some perspective on it that never occurred to me before.

Examining the Kaiser Family Foundation brief, “Health Care Spending in the United States and Selected OECD Countries” he points out, “Our government spends more [as a percentage of GDP] on health care than the governments of Japan, Australia, Norway, the United Kingdom, Spain, Italy, Canada, or Switzerland.”

The data would seem to indicate that even our single payer government-run American health care programs, Medicare and Medicaid, cost way more than similar health plans in these nations.

The argument is often made that we should adopt a single payer—or perhaps a “public option”—health plan in the United States in order to control costs and cover everyone. But it would appear that even those programs in America are way too expensive when compared to similar programs in other industrialized nations.

As for the Republican market-based approach, Klein also points out that those programs have been ineffective at cost control. House Republican Paul Ryan often cites the Medicare Part D drug benefit as proof his proposals to privatize Medicare would work better than what we have. But as Klein points out, Part D premiums have risen 57% since 2006 and the program is on track to see nearly 10% growth in annual costs over the next decade.Continue reading…

An Obama-Gingrich-Ryan Ticket on Health Policy Reform

• 2

By SENATOR DAVID DURENBERGER

Newt Gingrich has to be one of the most interesting figures in recent political history.  His soul lives at the intersection of public policy, politics and history.  Because he has been on so many sides of history and policy, political insiders greet his entry into the presidential primary campaign as “Harold Stassen-ish.” I am among them, having entered the Senate the same time Newt entered the House 30-plus years ago.  I don’t know Republican House Budget Committee chair Paul Ryan, but I admire his leadership talent and regret his decision not to run for the Senate from Wisconsin.  It would raise the level of health policy discourse substantially in that “august body.”

Barack Obama is undoubtedly making presidential history.  Given the many policy challenges he has had to take on since January 20, 2009, plus the one he chose to take on – health policy reform, aka PPACA, there’s no question he is in a unique place in history today.  But, it is the Republicans – the “Party of No” on Obamacare – that are carrying the day on bringing health policy in line with health reform on the ground in the U.S. today. Obama’s PPACA sets historic national policy goals.  Ryan and Gingrich articulate the policy means to the ends of the new law.

Public health insurance programs like Medicare and Medicaid should begin now to reward success in meeting access, quality, and value goals where they exist in communities and systems across the country.  On their way to converting to private insurance and “premium support” subsidies when, and only if, genuine competition comes to the insurance marketplace. Along with the information consumers of insurance and healthcare need to make value judgments to purchase.

Obama could encourage this now because he has the new law on his side.  He has a budget/debt ceiling impasse which could make it possible. Unfortunately, he doesn’t know it; and it appears those in his administration charged with implementing PPACA, haven’t figured out how to do it. Bogging down in waivers and new rules and regulations which set the new law up for “socialistic” ridicule, and the president for a messy political campaign which will not, as Gingrich suggests, “lead to a national discourse” on the future of health care policy and politics.Continue reading…

Paul Ryan Still Doesn’t Get It

• 99

By ROBERT REICH

Republican House Budget chief Paul Ryan still doesn’t get it. He blames Tuesday’s upset victory of Democrat Kathy Hochul over Republican Jane Corwin to represent New York’s 26th congressional district on Democratic scare tactics.

Hochul had focused like a laser on the Republican plan to turn Medicare into vouchers that would funnel the money to private health insurers. Republicans didn’t exactly take it lying down. The National Republican Congressional Committee poured over $400,000 into the race, and Karl Rove’s American Crossroads provided Corwin an additional $700,000 of support. But the money didn’t work. Even in this traditionally Republican district – represented in the past by such GOP notables as Jack Kemp and William Miller, both of whom would become vice presidential candidates – Hochul’s message hit home.

Ryan calls it “demagoguery,” accusing Hochul and her fellow Democrats of trying to “scare seniors into thinking that their current benefits are being affected.”

Scare tactics? Seniors have every right to be scared. His plan would eviscerate Medicare by privatizing it with vouchers that would fall further and further behind the rising cost of health insurance. And Ryan and the Republicans offer no means of slowing rising health-care costs. To the contrary, they want to repeal every cost-containment measure enacted in last year’s health-reform legislation. The inevitable result: More and more seniors would be priced out of the market for health care.Continue reading…

Earth to Republicans: You Are In Big Political Trouble Over the Ryan Medicare Plan

• 6

By ROBERT LASZEWSKI

It should now be clear to Republicans they are in trouble over the Ryan Medicare plan.

Yesterday, they lost a seat in a solid Republican New York House district. Their candidate had benefited from lots of money and House leadership attention. The big issue was the Ryan Medicare plan.

All month, Republican Presidential candidates have been walking a tightrope over the Ryan plan–don’t embrace it but don’t criticize it either for fear of offending the base who will drive the primary outcomes next year. You only had to watch the Gingrich implosion to see what happens if you fall off that tightrope.

Next the Senate will take up the Ryan budget. Senate Democrats can’t wait for a vote on it and are making the Ryan Medicare plan the central issue. Already, at least three Senate Republicans have said they will not vote for the House budget over the Medicare issue. Leader McConnell, sensitive to its political vulnerability, has told Senators they are free to vote their conscience on this one.Continue reading…

It’s All Going According to Plan

• 75

By JONATHAN HALVORSON

Most people regard health care reform in America as thoroughly bungled. The proverbial train left the station weak and wheezing, was pushed off the rails by hooligans and is about to crumple in an inglorious heap in the ditch. Only about 20% say the reform hits the sweet spot, with the rest convinced it went too far or didn’t go far enough.

To review the most recent pilings-on: in a time of huge Federal deficits, we get depressing predictions that the PPACA will do little or nothing to slow the growth of health care costs. Only a year after passage of what was supposed to be comprehensive reform, Democrats acknowledge that Medicare and Medicaid spending remain out of control and propose new cuts in the hundreds of billions. In the span of four months, Republicans switched from posing as aggrieved defenders of Medicare spending, to proposing to slash it and leave seniors to absorb the spillover. Medicaid funding is probably even more precarious, since fewer Medicaid recipients vote.

To add injury to injury, the Supreme court may rule to invalidate the entire law, or perhaps just the mandate to purchase insurance, thereby removing the most hated part of the law, but eliminating the “universal” part of universal coverage and inviting an actuarial death spiral. Oh, and the few reforms that look like they might bring costs down, like the IPAB board in Medicare and the minimum medical expense ratio for insurers, are under threat of being watered down. A year after legislation has been passed that will transform nearly a fifth of the American economy, to the casual observer it looks like nothing much has happened and nothing in the future is secure, especially anything that the big industry players don’t like.

In light of this and more, pessimism is understandable, but what we are witnessing in these turns of events is not mere politically-driven chaos. There is good reason to think that events are unfolding more or less in line with a staged strategy for deep reform that emerged out of the experience in Massachusetts. The strategy is essentially this: enact universal coverage first to precipitate a sense of crisis. This will lead to deep reform on the problem that exacerbates all other problems: the cost of health care. Readers of this blog need little reminding that these costs are twice as high as in any other nation.Continue reading…

Newt And The Health Wonks: A Tale of Lust And Power

• 3

By MICHAEL MILLENSON

When former House Speaker Newt Gingrich announced his bid for the GOP presidential nomination, I found myself singing a few bars from Night Moves, Bob Seger’s hard-driving tribute to teenage hormones: “I used her, she used me/But neither one cared./We were gettin’ our share.”

No, this isn’t one more commentary on the Georgia Republican’s checkered marital past. I’m referring to a different relationship, the one between Gingrich and the health policy community. A critical component of the climb back to prominence for a man who inspired nearly as much distrust in his own party as in the opposition was proving he could work harmoniously with those holding differing views on an important policy issue — how to reform U.S. health care.

Gingrich succeeded so well that some of the policy recommendations he was touting just a few years ago bear a close resemblance to Obama administration actions that Gingrich now denounces as leading us to “a centralized health care dictatorship.”

The romance between Gingrich and the health wonks, and Gingrich’s makeover as a leader with ideas as much substantive as political, began after the appearance of his 2003 book, Saving Lives & Saving Money. The book gave credibility and visibility to a set of ideas being talked about in the health policy world about using information technology to improve medical care.Continue reading…

Does Mitt Romney Deserve the Abuse He’s Getting on Health Care? Yes, He Does.

• 10

By DAVID E. WILLIAMS

Mitt Romney took a big beating on the Wall Street Journal‘s editorial page last week, the same day he laid out his health care plan in the USA Today and defended his position on the topic in a speech in Michigan. I’m not a big Romney fan but had been feeling sympathetic enough toward him on this issue to defend him. After reading what he has to say, though, I’m not prepared to offer a defense. On the other hand, Massachusetts health reform remains defensible, if incomplete.

Here’s what Mitt Romney should have said:

  • Health reform in Massachusetts has achieved its main goal: more than 98% of residents now have health insurance including 99.8% of children
  • The Massachusetts reform was achieved by bringing together all major stakeholders in the state from both parties, and focusing on addressing a serious problem rather than scoring political points against one another at the expense of the public good
  • Gaining consensus enabled health reform not just to get passed, but actually implemented more or less as envisioned, in contrast to earlier failed attempts at universal coverage
  • Massachusetts’ long history of substantial public sector investments made this kind of reform feasible. Good schools translate into an educated workforce that attracts high-wage employers who can afford to offer health insurance. That made it possible for the state to offer a safety net that was more generous than other states’ (e.g., in its eligibility criteria for Medicaid) even before the enactment of so-called Romney Care
  • Massachusetts, like other states, still has a cost problem. It’s no surprise that Massachusetts health reform didn’t bring costs down. First, that wasn’t its goal. Second, cost problems can’t be addressed in a serious manner without changes in the health care delivery system and reform of Medicare. Tackling the delivery system is very difficult, and states have no power to reform Medicare. That’s why health reform can’t be left purely to the states; it has to be tackled at the national level
  • Even a cold-blooded capitalist like me realizes that pure free-market approaches aren’t effective or fair in health careContinue reading…
assetto corsa mods