Friday, May 08, 2009

Republican-Lite Health Care Policy

Kimberly Strassel over at the Wall Street Journal has a pretty good assessment of the Rebublican response to "Obamacare," as she calls it being proposed by Oklahoma Sen. Tom Coburn, MD, and North Carolina Sen. Richard Burr:
Their own bill overhauls the tax code, currently stacked in favor of corporate employees, to provide a tax credit to every American to purchase insurance. It expands health-savings accounts. It creates state health-insurance exchanges, where private insurers compete to cover Americans, including the uninsured. (This is partly modeled on the Medicare drug program, which has provided seniors with choice and held down costs.)

More broadly, it seeks to reorient financial incentives so that the system is no longer focused, as Mr. Coburn puts it, on "sick care," but on preventing the chronic diseases that eat 75% of health expenditures. These incentives would be used to lower costs and discourage insurers from cherry-picking patients. The bill also dives into Medicare and Medicaid reform.

Yet no small number of Senate Republicans are biding their time in Max Baucus land, waiting to see what the Democratic finance chairman produces as a "bipartisan" product. (Read: A bill the president wants.) This crowd has taken to heart Mr. Obama's accusation that they are the party of "no," and think it might be easier to be the party of Baucus, or the party of Baucus-lite, or the party of nothing whatsoever.
And we wonder why this response falls on deaf ears. While much of their soon-to-be-ignored proposal has some merit, using prevention as a means of lowering costs is a straw dog: doctors know it, patients know it, and responsible politicians know it. Until our conservative members of Congress quit fooling themselves that American's really give a damn about the "prevention" Kool-aid and understand that prevention has never lowered health care costs (except, perhaps, seat belt laws and anti-smoking legislation), their proposal is doomed to failure.

You gotta get a different angle, guys and unfortunately, time's running out.



Chris said...

I'm more cynical. I think many Republicans secretly want Obamacare. Republicans who didn't fight President Bush's spending increases obviously aren't driven by a commitment to keep spending down/reduce government. Plus, I wouldn't be surprised if there is a feeling that letting Obamacare go through will actually give Republicans a political advantage. If Republicans could get Health Care off the table as a campaign issue, they would substantially level the playing field in the next elections. Plus, if Obamacare backfires, it will be an enormous weight around the neck of the Democrats. Just getting an anemic proposal on the table let's them say "see, we had these better ideas, but you wouldn't listen."

DrWes said...


You're probably right. It was interesting to hear our hospital aministrators' stance at a recent "state of health care meeting" to our staff: they feel Obamacare is already here. With SCHIPS expansion and if a government insurance option comes to pass, they feel that large struggling employers like GM will be more than happy to offload the health care obligation on their balance sheet to the US government - hence, a mass exodus from the current private model. The only problem with Obamacare program "backfiring" after implementation, is that once people taste the nectar of more entitlement programs, it will be nearly impossible politically to end them. Just look at Medicare - fiscally dying faster than ever, yet the model upon which our current political majority hold dear as the best way to save costs. *sigh*