David Frum: Health insurance bill builds on ideas developed at the conservative Heritage Foundation

[Nikki Stone1]

"Could a deal have been reached? Who knows? But we do know that the gap between this plan and traditional Republican ideas is not very big. The Obama plan has a broad family resemblance to Mitt Romney's Massachusetts plan. It builds on ideas developed at the conservative Heritage Foundation in the early 1990s that formed the basis for Republican counter-proposals to Clintoncare in 1993-1994."

http://www.aei.org/article/101820

The quote comes from a conservative website where Frum is castigating the Republicans for not compromising on the bill since it had so much in common with the way conservatives already think.

Whatever today's bill was, it was not a victory for progressivism...or the financially challenged.

[FiveGoodMen]

1. K&R

[FrenchieCat]

2. Have you actually looked into all of the similarities vs. the differences of these bills?

or do you just choose to have Frum be 100% accurate on everything he says to this extent,
from now on? :eyes:

[Unvanguard]

3. Be that as it may, it's likely it was the best that could have been passed.

And while obviously there were better policy alternatives in abstract, one advantage of having it end up this way is precisely the fact that this kind of commentary is in the mainstream: every time someone reminds the country how fundamentally moderate this bill is, the worse the Republicans look, and the harder it will be for them to derail it.

As so many commentators have stressed, it is fairly unprecedented for a bill of this magnitude to pass without bipartisan support. The best outcome for us at this point is for the Republican opponents to be blamed for this fact rather than the Democratic supporters, such that health care reform will acquire the same kind of place in American social legislation as previous large domestic reforms have.

Medicare for All, or a strong public option, would still have been better, but at this point, one takes what one can get...

[Nikki Stone1]

4. So, you really don't sound too overjoyed about this bill either.

Why?

[Skittles]

9. you know why

because it sucks

[Nikki Stone1]

14. You know there's a photo thread called "Beautiful Decay"?

I think of our party that way. Such a pretty surface.

[Unvanguard]

15. I'm simultaneously overjoyed and disappointed.

The disappointment is a general thing; I am perpetually disappointed with the limitations of our public policy debate, such that there was no real shot at single-payer (among so many other things related and not related to health care reform), and even a strong public option had little chance of passing muster.

I am overjoyed now that it finally passed, and that the politics of it seem to have worked out nicely: I think it is a good thing for the American public on its own policy merits, and that it will get better with time, and I think further that anything that helps the Democrats in 2010 is also a good thing for the country and the people.

I don't really object to where people fall on this spectrum. I think people should have a clear-eyed view of what the bill actually does and doesn't do, and a realistic view of the political alternatives, and I think that should lead nearly all progressives to support it, but I respect both Noam Chomsky's stance of a "hold my nose yes" and the sort of euphoria that one expects the Obama Administration officials are feeling right now.

[Nikki Stone1]

17. So mandates are ok with you?

And the loopholes?

*Insurance companies can't have a lifetime cap, but they can have a yearly one. You can get your coverage stopped in mid-chemo

*Insurance companies can still practice rescission for "fraud", even though alleged fraud was the reason they gave for dropping sick people off their policies.

*Insurance companies can still charge high rates with no actual cost controls.

*We citizens now HAVE to buy this, under penalty of law, a financial penalty (which is impossible to pay for many people) or a criminal penalty if (1) the financial penalty isn't paid in a "timely" fashion or (2) if you provide false information:

______________________________________________________

(b) CRIMINAL PENALTIES.—Section 501 of the Em-ployee Retirement Income Security Act of 1974 (29 U.S.C. 14
1131) is amended— 15
(1) by inserting ‘‘(a)’’ before ‘‘Any person’’; and 16
(2) by adding at the end the following: 17
‘‘(b) Any person that violates section 519 shall upon 18
conviction be imprisoned not more than 10 years or fined 19
under title 18, United States Code, or both.’’. 20


They cannot be imprisoned (yet) for failure to pay their penalty IN A TIMELY FASHION

‘(1) INGENERAL.—The penalty provided by this section shall be paid upon notice and demand by the 5
Secretary, and except as provided in paragraph (2), 6
shall be assessed and collected in the same manner as 7
an assessable penalty under subchapter B of chapter 8
68. 9
‘‘(2) SPECIAL RULES.—Notwithstanding any 10
other provision of law— 11
‘‘(A) WAIVEROFCRIMINALPENALTIES.—In 12
the case of any failure by a taxpayer to timely 13
pay any penalty imposed by this section, such 14
taxpayer shall not be subject to any criminal 15
prosecution or penalty with respect to such fail-16
ure. 17
_____________________________________________

I have to say, I think the model, from the skeleton up, is regressive and punitive. I can understand how it came from the Heritage Foundation.

[Unvanguard]

19. Mandates are fine with me, because they're entirely necessary.

Cost controls are going to come with time; thanks to this bill, they are a political necessity, not simply something that can be shelved and forgotten about. The government has made a commitment that will not go away, and it will be called upon to fulfill its terms. The "fraud" issue is only a loophole if the rule is poorly-enforced; we'll have to wait and see on that one, but for sure it is better than nothing. The cap compromise is unfortunate but alterable later, and, still, "not goes far enough" is a far cry from "should be opposed."

The structure of the purchase of nearly all services is highly regressive; this is how it works in a market capitalist economy, rich and poor pay the same amount for services. Even a public option, weak or strong or whatever, would have had this basic structure. (Single-payer might not have, but probably would have entailed a fairly regressive payroll tax system, like Social Security.) The subsidies do alleviate some of this; in an ideal world, they would do a whole lot more, but that kind of redistributive project is not something this Congress, or any likely future Congress within the foreseeable future, is likely to embark on, especially not in the middle of a recession. It remains true that things have not gotten worse; they have actually gotten somewhat better.

[Nikki Stone1]

23. "Cost controls will come in time"? Really?

You don't sound like an ignorant person, not in the least. But you do sound very uninformed. Maybe at some point you'll see that getting cost controls, or fraud abuse controls, or the the yearly cap lifted are all gargantuan tasks. Considering the deals that Obama made with the insurance industry and Big Pharma to get this thing through, you can bet he's not going to take chances upsetting the applecart, and the GOP sure as hell won't interfere. Congress has been bought off with election donations.

So who is going to change this?

This bill is not the best they could do for America: it was the best they could do for the insurance industry. All of the fault falls on the individual.

[Unvanguard]

26. I don't mean they will come tomorrow.

The political pressure will not get intense until the bill's main provisions are much closer to coming into effect than they are now. And you're right that these are likely to be political fights, but because they are narrow issues, they avoid many of the difficulties that plagued the Democrats during this reform effort. Republicans can campaign against a government takeover of health care; they will have a much harder time campaigning directly in defense of abusive insurance companies. Those are among the least popular players in this mess; the Democrats are on their strongest political ground when they challenge them. The difficulty with this bill is that, thanks to the structure of the insurance market, it had to do so much more at the same time.

If this bill were aimed at pleasing insurance companies, it would have expanded rather than reduced the privatization of Medicare, it would have deregulated rather than more tightly regulated the insurance market, and it would have dispensed with the "exchanges." As it stands now, the insurance companies stand to gain from some aspects and to lose from others; they got a reasonable deal, but not a great one, which is perfectly acceptable for a bill whose main aim is to expand coverage and security.

[Nikki Stone1]

28. And I never said or implied "tomorrow"

I'm assuming an Obama win in 2012 but the GOP could just as easily do so.

I don't know what your income level is, but I know this bill is going to be hellish for those under $25K. The people I find are the most blase about this bill have employer-based insurance coverage and they think they will be immune. They're wrong. There will be a "race to the bronze" as employers realize that they only have to provide what is legally necessary. In fact, this bill will be good for the large employers who will be able to pay a lot less for insurance, as long as they provide the legal minimum, and greatly reduce their labor costs.

[Grand Taurean]

5. Frum is trying to tie the GOP to the bill since their are many popular

provisions in it. We all knew the GOP would try to take credit for this bill once it was made into law and had popular support among the electorate.
This bill is NOT perfect, but it offers something for those lower on the economic scale.

[Nikki Stone1]

8. That's very funny.

Thanks for the laugh. :D

[sabrina 1]

16. Frum is being honest. He is agreeing with President Obama

and Nancy Pelosi who said at the Health care Summit that they had 'included Republican ideas in the bill' and asked why they still were against it.

So Frum is simply saying what Obama and Pelosi said.

But no one needed their verification, although it's nice to have. From the start it was clear that this was just a much larger version of Romneycare. It expands the role of Corporate America in our most personal lives, and gives access to private corporations to more public funds, (Medicaid and Medicare = Subsidies) than they already have.

Bush's faith based initiatives were vehemently opposed by the 'left', placing public funds in private hands was seen as anti-progressive, yet this expansion of privatization is being touted as some kind of progress by the same left.

I am wondering if those supporting this transfer of public funds, now support Bush's successes in doing the same thing. It would be pretty hypocritical to remain opposed to Bush on this issue if you support Obama who has now outdone him on privatizing what should be public programs as they are being paid for with tax dollars.

The reality is that both parties are doing the job of turning over our government and our public funds to private corporations.

How will you apologize for the privatization of SS if it is done by a Democratic Majority? Bush couldn't get it done because he had used up his political capital by them. But Obama, with help from the so-called 'left' is very likely to be asked to take care of that next.

Look how easily he got the support for this expansion of privatization from so-called progressives. If anyone can hand over the SS fund, he can do it and the same people who opposed it under Bush, will be cheering him along.

[Grand Taurean]

18. There are GOP amendments in the bill.

True. But Heritage Foundation should not be taking credit for this.

[sabrina 1]

22. Why shouldn't they? Why ARE there

those awful Republican ideas in a Democratic Bill to begin with. We rejected them when they proposed them. I expected this to be the fall back position of Republicans in the long run. For once it is the truth.

Ezra Klein and others on the so-called left, who supported passing this bill, were USING the fact that it was filled with Republican ideas to attack the refusal of Republicans to go along with what was in effect, a bill they could love. Nancy Pelosi and Obama also.

So, to say they have no right to claim credit for the ideas is just silly. Especially when for once they are correct. It's sad to see progressives cheering on these ideas though.

Be prepared for Romney to take credit also. If he runs in 2012, which I believe he will, he will definitely point out that the Democratic Bill was based on his for profit model. Of course he will criticize aspects of the bill and claim Democrats should have stuck closer than they did to his ideas.

Didn't you expect this? I think a lot of people predicted it as it was pretty inevitable. And that's what is so wrong about the bill. The fact that the Heritage Foundation and Romney can truthfully take some credit for the whole idea of Mandated Insurance with a huge transfer of public money to private business.

It's done now so there's no use rehashing it all over again. We were kept out of the debate, liberal amendments were killed as soon as they appeared while Republican ideas were accepted and included. And people right here supported every rejection of progressive ideas and every inclusion of Republican ideas because it was a Democratic administration ~

[Nikki Stone1]

29. +1

Excellent post

[Nikki Stone1]

24. It's not the amendments: it's the entire structure of the bill.

That's the point. If you could get beyond " winning" and "losing"...

Or maybe your employer pays for your insurance and you haven't had a serious operation or illness.

[Nikki Stone1]

30. +10,000

.

[Nikki Stone1]

35. Actually, Frum is right. From the Heritage Website, 2007:

http://www.heritage.org/Research/Reports/2007/12/The-Crisis-in-Americas-Emergency-Rooms-and-What-Can-Be-Done

Here's more:

http://www.heritage.org/Research/Reports/2007/12/The-Crisis-in-Americas-Emergency-Rooms-and-What-Can-Be-Done

Step #1: Rapidly expand private health coverage to include the uninsured.

The first step in reforming the emergency medical system is to reduce its inappropriate use by patients who could safely be seen elsewhere. For example, growing numbers of uninsured Americans frequently lack regular primary care, and the ED often fills the gap. Covering the uninsured for non-emergent care-if done correctly-is an essential element of emergency medical reform and would certainly help to reduce the strain on the system. Patients would then be more likely to receive regular care (including preventive services), have less need for the ED, and avoid costly hospital admissions.

The data indicate that simply moving the uninsured into public programs such as Medicaid and SCHIP might not solve the ED demand crisis and could even exacerbate the problem. According to a recent National Hospital Ambulatory Medical Care Survey, patients with Medicaid as the expected source of payment used hospital emergency departments in 2004 at nearly twice the rate of the uninsured and at four times the rate of the privately insured. Moreover, more ED visits by Medicaid and SCHIP patients (35.7 percent) were classified as non-urgent or semi-urgent than were visits by self-paying patients (23.7 percent).<39>

The number of Medicaid-eligible patients who initially present to the emergency department as uninsured and are eventually converted to Medicaid is unknown, but it is not likely to be large enough to have any significant effect on the data reported in the NHAMCS study.<40> However, a major cause of these disparities is probably the lack of a sufficient number of primary care doctors available to Medicaid patients. This is likely a natural response to Medicaid's very low physician reimbursement rates in many states.

Thus, the most effective way to reduce inappropriate ED utilization is to institute sound "premium support" programs that would enable Medicaid patients to purchase quality private health insurance coverage with better access to care. The right policy is to integrate the working uninsured population and non-disabled Medicaid and SCHIP beneficiaries into a reformed private health insurance market.

At the state level, legislators could also create premium support programs for private health insurance for low-income individuals and families and combine this with a new statewide market in which employers could make defined contributions to their employees' health insurance through a health insurance exchange, securing portability and personal ownership of health coverage.<41> This would not only eliminate gaps in health care coverage, but also ensure continuity of care.

Beyond Medicaid changes and state market reforms, Congress could enact a universal tax deduction for health insurance, as recommended by President George W. Bush, which would allow individuals and families to purchase personal and portable health insurance.*<[/i>42] For lower-income persons, Congress could also enact a generous individual health care tax credit program, particularly for those who do not and cannot get health insurance through the workplace. Such a program, with a family tax credit of up to $4,000 annually, is embodied in the Tax Equity and Affordability Act (S. 397 and H.R. 914), sponsored by Senator Mel Martinez (R-FL) and Representative Paul Ryan (R-WI).<43>

Private health plans possess the right set of economic incentives to coordinate patient care in ways that reduce costs and improve outcomes, including limiting patient ED use to true emergency situations.

* Hey, I want that universal tax deduction.

[Skittles]

6. no shit

no surprise here

[Nikki Stone1]

10. All you had to do was follow the money: where it was going and who got it

and that was the insurance industry and big pharma, and Americans are being required to pay them under penalty of law, financial, or in some cases, imprisonment. Congress might has well have put on black masks and held guns to our heads.

[nightrain]

7. knr. Thanks for posting this. For all those folks who claim how "progessive" this bill

is, here's info to the contrary. My how the New Dems and Repubs have similarities!

[Name removed]

12. Deleted message

Message removed by moderator. Click here to review the message board rules.

[Nikki Stone1]

20. You're welcome.

:)

[amborin]

11. ny times David Brooks had praised it last week; he's from the Weekly Standard n/t

[Nikki Stone1]

13. Do you get the feeling that TPTB really wanted this to pass, and the Dem vs GOP was just

political theater? Sort of like Jon Stewart's skit about political fights being like the pro wrestling.

[leftstreet]

31. +1

It was so obvious

K&R

[Nikki Stone1]

32. Yup

:(

[Mari333]

21. knr slowly the truth seeps out

[Nikki Stone1]

25. Isn't that the truth.

But we've known for a long time that this bill was far from progressive.

[FrenchieCat]

27. Say those who not only haven't read the bill just passed,

but also haven't really bothered reading these other bills mentioned.

This is kind of frumny! :rofl:

[followthemoney]

33. So, if only we could have all voted for Republicans years ago...

this bill could have been passed long ago.

The biggest mistake Democrats make is resisting 'good' Republican ideas just to win elections and then passing them, belatedly, into law.

Look how long it has taken to do what 'needs' to be done in Afghanistan and Pakistan; and Obama is pushing for war against Iran and may get it soon.

Without the resistance from Democrats the war in Iran could have been started and been 'over' by now, just like in Iraq.

Democrats seem to do nothing but delay enactment of 'good' Republican laws so they can take credit for them. This health care bill proves this point.

[Echo In Light]

34. k/r