Motley Moose – Archive

Since 2008 – Progress Through Politics

Republicans and Health Care

Obama is right, as usual. Bi-partisanship is worth pursuing. Universal Health Care (UHC) will never be passed unless we get some help from the Republicans. I, for one, really, really want this country to get a health plan that covers everyone. I imagine most of the people reading this diary want the same thing. If we want help from the Republicans then we must make UHC seem the right choice.

(Each of the following subjects deserves its own diary.)

Most of the arguments from the Right can be rightly called fears. The biggest fear is the fear of Socialism. We need to show that UHC is not socialism. In the first place, it is an insurance plan not nationalization of the health care system. Doctors will still be private employees, except at public facilities and the VA. Hospitals that are private businesses now will remain private. We will hopefully have more publicly-owned clinics, but that’s a different program.

(Harry Truman looks on as President Lyndon Johnson signs the Medicare Bill)

This is not socialism in any way. We aren’t even proposing nationalizing the health insurance industry. Everyone will have the option of choosing a private plan or adding a supplemental one if they want to pay for it. The insurance companies will shrink, but they won’t go away.

One way we can make UHC more attractive is by pushing the positive economic benefits. The main benefit to businesses is obvious. Republicans are always pushing tax cuts for business. I understand the argument, I just don’t agree with it. UHC, however, will serve

as a huge tax cut for business. True, that cut will be partly offset by taxes for the same purpose, but it will still be lower than private insurance. This move alone would level the playing field for US-based businesses.

Another area of concern for many Republicans is the libertarian attitude that people should do for themselves. We I tend to view that as cold-heartedness, but it is a legitimate argument. That is the Reagan legacy at work. We need to treat that as an honest belief from their side and find an answer for it. Simple human compassion should be a good enough counter. It’s also the religiously correct position for almost all religions.

One of the chief fears common on the Right is the cost of such a program. This, too, is an honest concern. This is going to cost a bunch of money. We need to get the numbers in an easy to digest format and accompany them with charts.

We need to know the current cost to the country broken down into business costs, taxes, personal payments for insurance, personal payments for care, bankruptcies (this is a big one for me), lost exports and balance of trade. These, and other cost factors, are the total cost today. We then need the projections for those costs with a UHC in place. We also need to break down the +/- on an individual family basis. These numbers are critical if we want to educate the public and convince Republicans this is the right thing to do.

While I’m on fears, one big fear of many people is that covering everyone will result in rationed care. We must show that this is no more likely under a system where everyone is covered than it is with a system with so many uninsured who either suffer and/or die for lack of care or burden the system with non-collectible bills. The rationing issue must be addressed to calm those fears.

The Bush administration used fear as a political tool to get support for their policies. There is a reason they did that. Fear is a great motvator. I’ve mentioned some of the fears on the Right. It’s time we introduced another one.

The latest figure I saw for the total numbered of uninsured in this country was 47 million, including 10’s of millions of children. That number has gone up steadily over the last 8 years and is rocketing up today. People have to be shown that they may be next.

The cost of a sickness could easily bankrupt a family with insurance. Imagine what it would do to a family without insurance. Most parents would gladly spend their retirement savings if it would save their child. One serious illness and a family with or without insurance could be completely bankrupt, savings and all. Bankruptcies in this nation were already on the rise before the bubble burst. The majority of bankruptcies in this country are due to medical bills. This will only get worse. We must do something or pretty soon we won’t have a middle-class left. This must change.

One last fear on the Right can also be traced to Reaganism. How can we trust the government to handle this when they can’t do anything right. The private sector is always better than the government.

It seems an honest fear. Luckily for us, we have arguments in our favor.

The cost comparison between Medicare and private plans needs to be touted far and wide. Another comparison is between a disinterested bureaucrat making a decision and a corporate employee whose bonus depends on how many claims they deny. I know which one I would choose. An advantage a government run program would have is purchasing power. They would have far more control of pricing for drugs and other treatments. All in all, I’d say the government could very possibly do a better job in this area than private enterprise. Call it the Health Defense Department. The goobermint does a pretty good job with defense.

As long as we are wooing Republicans and opponents of UHC, we should add some to our side. We need to search out reasonable Republicans who favor UHC. There are some. Colin Powell, for one. He would make an excellent representative for veterans on any planning committee for UHC. There are others out there. Decent people who differ with their party on this one. There are also business executives who are more willing to come out in favor of this cause. We need to get those people out there front and center.

I was born less than 2 years after Harry Truman tried to get national health care in this country. I am 61 now. I’ll be eligible for Medicare soon. Most of you have far longer to wait. Yet, I am more passionate about this political issue than I am any other. It is time we finished what Truman started so long ago.

As I said in the beginning, we will never get this passed without Republican support. We must address the fears of opponents to UHC. Those answers must be honest and effective. In no other way will we be able to win this cause.

[UPDATE 1]

David S. Broder agrees with me in his latest column.

But the real reason Obama should ignore this advice is that he will need Republican votes to pass the remaining parts of his program. When it comes to energy, regional and commodity interests will inevitably divide the Democrats. They always do. Oil, coal, natural gas and consumer groups will exert their will. If Obama writes off the Republicans in advance, he will end up with a watered-down bill — or nothing.

This is even more true when it comes to health care. We saw what happened when the Clintons rebuffed John Chafee and other potential Republican allies; without their help, the Clintons could not even bring a bill to the floor. It will be exquisitely difficult to negotiate changes to a system of vital importance to every family, considering that hospitals, doctors and other providers, and insurers all have huge economic stakes. One of the few breaks Obama can count on is that Sens. Ron Wyden (D-Ore.) and Bob Bennett (R-Utah) have collected a growing number of Democrats and Republicans as co-sponsors of an innovative bill. Obama would be foolish to ignore them.


12 comments

  1. creamer

    I’ve only a minute, and I have a couple of comments.

     I’m not sure I consider insurance companys nessasary. Their drive for profits is a big part of why we have such an expensive system. Insurance companys have been reporting record profits on an annual basis for the last decade. Even now as the economy tanks they are raiseing rates on premium renewals for small business.

    Reagan was wrong. His economic policy have been shown to be a sham. The continual banging away at government by conservatives have much to do with Katrina, a crumbling infrastructure and a regulatory system in shambles.

     It will have to be done incrementaly, but I believe the most cost efficient and effective way to deliver health care is single payer. I suspect insurance companys will play a role, but over time I would like to see them turn into a quasi government agency, or at the very least have a stong regulator.

    Health should not be subject to the whims of a corporate board looking for dividends.  

  2. Have to comment at length tonight, but I agree 100%.

    Fear is not always misplaced, and Republicans (and everyone afraid of fucking this up) are not evil idiots (I am one of these folks, as you know).  We will either address these fears with solid arguments or we can whine our way to righteous failure again.

  3. muttsy

    I like the HCFA plan because I think it’s a good transition to public healthcare.  The plan is called Health Care for America, it’s a proposal put together by the political scientist Jacob Hacker with the support of the Economic Policy Institute. I’d suggest reading Thinking Big to get a better idea of the plan, but the basic idea is that employers pay money into a public fund, enough to cover their workers.  The public fund should have quality coverage for all, including preventive care.  Workers get to choose – keep your insurance, choose a different private plan, or join a public health insurance plan without a private insurer middleman, pick your healthcare providers and doctors.  Employers choose too. Those who prefer not to shoulder the burden of providing coverage as good as the law requires can decide to enroll their workers in the public plan at a modest cost.  HCFA and Medicare would function as a single nationwide insurance pool covering close to half the population. So basically either the public plan attracts most Americans, and our system gradually evolves into single-payer or because the floor prevents a race to the bottom, the public-private competition raises the bar on care and efficiency, improving quality and cutting costs, even in the private insurance plans.  The standards would be kept by a strong government watchdog.  

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