Health Wars (10/8/09)

Continuing to arrange the legislative corpses of BarryCare so as to make them look like they perished more heroically, we bring you to fresh, complimentary, but ultimately non-starter stories.

First, a national public option with a state opt-out clause, a notion that I find as bafflingly futile as AP does:

But instead of starting with no national public option and giving state governments the right to develop their own, the newest compromise approaches the issue from the opposite direction: beginning with a national public option and giving state governments the right not to have one…

For conservative Democrats — especially those from states with major private health insurance industry interests — this concession could be key, allowing them to punt a vote on a public plan to local governments. For progressives, it would not be the hardest pill to swallow.

“It is clearly much better than triggers and [Carper's] opt-ins,” said Richard Kirsch, executive director of the group Health Care For Americans Now. “A trigger option is a way to kill the public option and these opt ins are not effective because it leaves it up to state legislatures to set it up…”

Another Democrat working on reform legislation added, “If everyone gets a plan, and states have to affirmatively vote, preferably by referendum, to opt out. I really don’t see a lot of states opting out, for one. And, for two, you get your national [public plan] available everywhere. If a few holes start appearing, it’s not nearly as fatal as if you went with the Carper plan, which after a few years might mean ten or twenty [state-based] public options. If you go the other way, you’ll probably have like forty-seven states. It’s a big difference.”

Personally, I don't see much difference between opt-ins and opt-outs. Either way the individual mandate and requirement to cover pre-existing conditions and Baucus's pile of ruinious new taxes skyrockets private insurance premiums out of sight, destroys the private health insurance market, and leaves most Americans without any health insurance coverage whatsoever. That's what they're designed to do. Opt-ins would simply take a bit longer to carry out to get to the theoretical unholy grail of "universal" (i.e. single-payer) coverage than an opt-out approach, which would, indeed, never happen because We, The People, would have no place else to go. Think of it as the Democrats' idea of "public sector efficiency".

This is what makes Stephen Spruiell's game attempt to apply lipstick to an enacted BarryCare pig so bittersweetly naive - or at the very least, beset by a very narrow opportunity window:

In the early 1990s, eight state governments imposed “guaranteed issue” and “community rating” regulations on health-insurance companies operating in their states. Guaranteed issue means that insurance companies cannot deny coverage except in rare cases, such as those involving fraud. Community rating means that insurance companies are restricted in their ability to charge higher rates based on things like gender, age, or medical history. All the versions of Obamacare being debated in Congress would impose guaranteed issue and community rating on the nation.

The effect of these reforms at the state level is no longer a matter for debate: In each case, insurance premiums skyrocketed; healthy people stopped buying insurance; and insurance companies exited the market in droves. Each state government was forced to take corrective action. Yet, while three state governments possessed the good sense to repeal or weaken their guaranteed-issue and community-rating requirements, the other five papered over their failures with inadequate, short-term fixes.

What accounts for the difference? In Kentucky, New Hampshire, and Washington state, conservative Republicans were able to find footholds at key moments and repeal or weaken the requirements. In New York, New Jersey, Vermont, Maine, and Massachusetts, the political culture proved inhospitable to calls for market-based solutions.

How is BarryCare different than these previous state-level attempts? It doesn't take effect until 2013. Consequently, the private health insurance market would have several years to prepare for the coming lethal tempest. How would carriers do that? By....jacking premiums faster than they would have otherwise, presumably, on the parallel of "stocking up emergency supplies" in advance of a major storm or disaster without the cover of the new system's destructive interventions. A - for them - necessary action that would nevertheless bulldoze them into a public relations trap, eyes wide-open, wherein the Democrats could further demonize private insurers and preach the virtues of the single-payer system that they'd have already "generously (with our money)" and "compassionately (death panels and all)" "given" the American people. We, The People, get distracted, little or no public pressure for repeal manifests itself, time passes, we get used to the idea of government-controlled health care, and when it lands - in a second Obama term, natch - the anesthesia will have long since taken effect.

This, of course, is why the push to kill BarryCare in its incubator is so overarchingly imperative. And the chances of such a happy ending of this episode of the never-ending health care putsch campaign are very promising indeed:

In a meeting [Wednesday] between House leaders and rank and file Dems in the capital, Nancy Pelosi frustrated many liberals by suggesting that they consider a watered-down public option as a way of getting health care through the House, a top House liberal says.

Pelosi’s suggestion prompted some aggressive pushback from some liberals, who demanded to know why the House leadership wasn’t throwing its weight behind the most robust form of the public option — one that reimburses providers at Medicare rates plus five percent — when a large majority of House Dems backs it.

But not 218 Democrats, apparently.

Chris Bowers explains the larger impact:

Every step of the process is important in this campaign. If the House passes a weaker public option with negotiated rates, then it is less likely that any public option will end up in the final bill. If the Senate does not include a public option in the merged Finance and HELP committee bill that is sent to the floor of the Senate, then it is less likely that a public option of any sort will be included in the final bill.

FDL’s David Dayen focuses on the Senate side of the question:

I’m hearing from sources about a letter to Harry Reid from a collection of liberal Senators, led by Senators Jay Rockefeller and Sherrod Brown, insisting that Reid publicly commit to putting a public option in any health care bill that reaches the Senate floor.

There’s a big difference between having a public option in the bill before the fact or trying to get it in by amendment. It’s likely that amendments to the bill will require a sixty-vote threshold, therefore it would take sixty votes to get a public option into the bill if it’s absent, or sixty to get one out of the bill if it’s present. Nobody has said that there are those numbers of votes to do either of those actions, so, whether the bill comes to the Senate floor with a public option or not is a crucial decision. The four people in that room making that decision are Max Baucus of the Finance Committee, Tom Harkin of the HELP Committee, Harry Reid and someone from the White House. A lot of this will depend on the White House’s inclination, and they certainly floated their support over the weekend. But Reid’s public statements have been noncommittal.

It's the same old question again: will the extreme Left really scuttle the entire BarryCare ship if it doesn't have the public option mounted on its prow? Or will they rediscover the virtues of incremental patience that their Donk forebears used to built the already-existing welfare state superstructure that serves as their platform for further expanding it? Because, if the former, they'll be lucky to hold on to what they've got.

But as we discussed yesterday, the public option isn't the only poison pill with which the Democrats are wrestling. With all the focus on health care "reform" right now, I think the inevitable citations of the Clintonoids' attempt at this windmill-tilting lose sight of an additional factor in what cost the Democrats control of Congress in 1994: the 1993 Clinton tax increase. Recall that Bill Clinton ran for president in 1992 with a "middle-class tax cut" as his "Putting People First" manifesto's crown jewel. Then, within two weeks of his election, he blew it out the nearest airlock, and using the usual "deficit-reduction" dodge, spent his first months in office trying to jack individual tax rates as high as he could, in addition to letting Al Gore run wild with what we would know today as "cap & trade" energy taxes. That Donk SuperCongress did water it down somewhat, but ultimately did enact what was a brazen replay of the same dynamic that got George H.W. Bush bounced from office.

This time around, ruinous new energy taxes are pretty much dead for this Congress, and it's health care "reform" itself that is the vehicle for Max Baucus's "deficit-reducing" tax hikes on private comprehensive health insurance plans and medical devices that put bullseyes on every Democrat voter demographic, including, remember, Big Labor.

And, behold, that mistress of moderation and discretion has belched out another one:

House Democrats are floating the idea of a windfall-profits tax on the private health insurance industry as a way to finance their healthcare overhaul, and to drum up support among members of a divided caucus.

House Speaker Nancy Pelosi (D-Calif.) called the windfall profits tax idea “very preliminary,” saying she’s asked House Ways and Means Chairman Charles Rangel (D-N.Y.) to look at how much the tax could raise.

“I have asked Chairman Rangel to see what is in it for us,” Pelosi said. “There’s more that the insurance companies could contribute to this health care reform. They’re going to get fifty million new consumers, many of them subsidized by the taxpayer. They can put more on the table.”

Gosh, madame Shrieker, what a bald way of putting it. A "windfall" of 3.3%. And that's BEFORE all of Max Baucus's taxes land on private insurance carriers' bottom line with both feet. Though it would be passed on to those "fifty million new consumers," who would become YOUR "consumers," wouldn't they?

Oh, and did we mention, Baucus's taxes would land on private insurance carriers' bottom line starting next year?:

Baucus has also included a little sleight-of-hand in this scenario. While the program itself would not start until 2013, the taxes start in 2010. That means the CBO compared seven years of expenses to ten years of revenue, which hardly makes for an apples-to-apples comparison, and will likely mean that the real analysis — which will contain a projection for the second decade as well as the first — will look much less positive for Baucus.

Which invokes the third poison bill in BarryCare: its ruinous cost, which all the taxes in the world couldn't offset even if static tax scoring wasn't bovine scatology.

As the August recess ferociously demonstrated, the American electorate is playing CLOSE attention to EVERYTHING these people are doing. If that were not so, a "cram-down" could already have been effected, no? Perhaps that's why yet another garbage poll that skews left by only sampling "adults" rather than "likely voters" and risibly oversamples Democrats shows only a third of its respondents supporting BarryCare and nearly half against it.

More and more, the bona fide chance for Dems to inflict this atrocity on the country seems to have been when Barack Obama originally wanted it - before the August recess.

But as the parting vid below shows, some leftwingnuts will never lose the faith, no matter how blind their guides get....