Blue Dogs Object to House Bill’s Cost, Cost-Control Measures
The health reform debate would be a lot simpler if the kind of center-of-center politicians inclined to worry about spending too much money were also inclined to support the kind of government intervention into the health care system that’s likely to reduce health care costs. But instead, the left finds itself needing to argue both sides of the issue against forces of the status quo who both object to the cost of giving people health care and object to cost-saving measures like a robust public plan. And the House Blue Dog Caucus is no exception judging by their latest letter on health reform. As Igor Volsky explains “the letter contains an inherent contradiction”
[T]he Blue Dogs want to find more savings within the system — they’re asking for Delivery System Reforms and “maximizing the value of our health care dollar” — but they’re also asking the bill to spend more on rural health and physician reimbursement. And, they are reluctant to support any legislation that moves us towards that goal, causes providers to lose revenue or regulates the system to improve efficiency.
Consider their objection to a “Medicare-like” public option that reimburses providers 5 to 10 percent above Medicare rates. According to MedPAC, Medicare rates are adequate and consistent with the efficient delivery of services. In fact, over-payments by private insurers to health-care providers drives up overall costs. “Hospitals which didn’t rely on high payment rates from private insurers ‘are able, in fact, to control their costs and reduce their costs when they need to’ and ‘combine low costs with quality,’” Glenn Hackbarth, the chairman of MedPAC, said during recent testimony in front of the House Ways and Means Committee. Moreover, if the public plan pays bloated market rates, it will fail to offer lower premiums within the Exchange, and would cause the government to spend more money on subsidies.
You don’t save money by magic. You save money by spending less money. You can do that by just letting a large and growing number of people go without adequate health care. Or else you can do that by spending less money on overpayments, inefficient processes, and unnecessary treatments. But you can’t do that without taking a bite out of someone’s bottom line. The Blue Dogs seem to be looking for a free lunch, or else just grasping at straws for reasons to object to the bill.
To her credit, I saw Lorretta Sanchez (D-CA) talking about this on MSNBC earlier. She’s a Blue Dog but she explained that she didn’t sign the letter specifically because she sees the public option that the letter objects to as a big part of the solution to the cost issues. That’s a correct and coherent stance, the rest of the caucus might want to listen to her.
23 Responses to “Blue Dogs Object to House Bill’s Cost, Cost-Control Measures”
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July 10th, 2009 at 12:25 pm
It’s called “chasing your own tail” – most dogs do it, and “Blue [Cross Blue Shield Lap] Dogs are no exception.
July 10th, 2009 at 12:27 pm
If you consider that most Blue Dogs are not, in fact, ideological centrists who are earnestly committed to bipartisanship and fiscal responsibility, but rather are mostly center-right politicians who got elected to Congress in rural or exurban Republican-leaning districts by drawing support from conservative business interests to defeat the sort of raving creationist loons who scare the shit out of the capital class, then it all becomes clear.
July 10th, 2009 at 12:34 pm
Or else you can do that by spending less money on overpayments, inefficient processes, and unnecessary treatments. But you can’t do that without taking a bite out of someone’s bottom line.
Exactly. But of course the people whose bottom line might suffer are the pimps who buy off the whores in Congress.
July 10th, 2009 at 12:39 pm
OK, that all makes sense. But the health care reform struggle is not about cogent analysis. “Correct and coherent” really don’t have much to do with anything at this point. It is about political will.
What drives political will? Many things including data, analysis, sense of social responsibility. But we all know the big movers are money and votes.
Opponents of real reform have the money, the lobbyists, and some Congresspeople in their pocket. One result is that single-payer was off the table before the debate began. That’s pathetic both strategically and tactically, but it’s reality. The scare/smear/mislead campaign against the public option is well underway. We can still get a strong public option, if voters can be mobilized to convince their representatives and the administration to stand firm.
It is time for action. Please go to firedoglake.com if you need ideas about whom to contact and what say. You don’t have to be a public policy wonk to say, “We want a strong, immediate, federally administered public option.” Tell your friends.
July 10th, 2009 at 12:45 pm
I don’t believe that the Blue Dogs are necessarily more corrupt than other congresspeople. They (especially mine) just seem completely out of touch and self-absorbed.
July 10th, 2009 at 12:47 pm
It’s far beyond the point of complaining about this stuff anymore. The political system is brain dead and dysfunctional. This is the real cause of the economic disaster. At heart it is a political disaster. A political failure on a monumental scale. Rearranging the deck chairs on the Titanic or Nero fiddling while Rome burned barely touch the level of absurdity now going on.
The rest of the world looks on askance and in horror. America is now the last place most want to invest. At the same time we are still running huge current account deficits.
When you see arguments about if we are facing inflation or deflation just know this. Setting aside the issues of money, America is deflating.
July 10th, 2009 at 1:09 pm
They’re hoping for the ultimate in political win — to be able to vote against it, and be able to take credit for it.
July 10th, 2009 at 1:13 pm
she explained that she didn’t sign the letter specifically because she sees the public option that the letter objects to as a big part of the solution to the cost issues. That’s a correct and coherent stance
The CBO says that is false: “The new draft also includes provisions regarding a “public plan,” but those provisions did not have a substantial effect on the cost or enrollment projections…”
It doesn’t surprise me that Lorretta Sanchez is lying.
July 10th, 2009 at 1:15 pm
The fundamental problem for Democrats here is that they are not really a party. They function a lot more like a continental European coalition government, while Republicans approach the staunch level of party adherence that you’d expect from the British Parliament.
I think this dynamic has a lot to do with the fact that, over the past few elections, Democrats have increasingly been defined less as “Democrats” and more as “not Republicans”.
July 10th, 2009 at 1:18 pm
@ myself:
“…increasingly defined less…”
Sorry, bad writing. You know what I meant.
July 10th, 2009 at 2:41 pm
Things have become so absurd that if the Mexican drug cartels were to adopt a Robin Hood type crusade against the medical insurers, they would garner widespread support.
And if serious healthcare reform ain’t passed, then something like that’s in the cards, folks.
July 10th, 2009 at 3:07 pm
Yup, that’s exactly it. They can’t openly be against it, so they’re just going to frustrate it to death. But if it passes, they can still be on the Democratic bandwagon, yet still say to the conservatives in their districts at home, “I was on your side all along.”
July 10th, 2009 at 3:14 pm
Although that picture Yglesias posted is not actually the logo of the Blue Dog coalition (it is merely a picture of a dog who happens to be blue), it makes me realize that the Congressional Progressive Caucus needs a cute logo of its own so that it can pull its own leverage. That is how politics is won: cute animals.
July 10th, 2009 at 3:33 pm
Someone on another blog noted that this is the best argument why Blue Dogs should push for Single Payer. IF they’re serious about cost control, they should go for the program that best controls costs.
Otherwise… they should just shut their collective pie-holes and stop pretending.
July 10th, 2009 at 3:45 pm
THE AMERICAN EMPIRE THE PROBLEM NOT SOLUTION!
“There is no doubt that we have to update and refresh and renew the international institutions that were set up in a different time and place,” the Imperial Media Messiah President of the American Empire, said. “Some like the United Nations, date back to post World War II. Others, like the (G8) are (30) thirty years old. There is no sense that those institutions can adequately capture the enormous changes that have taken place.”
The fact of the matter is that the one institution that has no sense nor can adequately capture the enormous changes that have taken place is the Governmental Structure of the (17th) Seventeenth Century totally out of date American Empire Government. Even government on the face of the earth has evolved and upgraded with changing times, with the exception of the American Empire. The total mind set the family controlled structure, Sen. Kennedy has not been in Washington D. C. in (10) Ten Months and what does that say about the American Empires Government. Gerrymandered Districts you can not get individuals out of office only feet first and if they could have a dead person vote, it would not even be feet first, there are no Term Limits no (2) Two and out, or move from one position to another but (2) Two and out in any position in government, No you can’t take a lower position, it is either up or out into the Private Sector.
The one and biggest institution no doubt that we have to update and refresh and renew of (ALL!) the international institutions that were set up in a different time and place, is the American Empire, its dragging the entire Global Community down, and preventing a faster entry into a better future. The American Empire is NOT THE SOLUTION IT IS THE PROBLEM!
TRIATHLON
July 10th, 2009 at 3:50 pm
This is why the Progressive Caucus’ bright line was so important. Without that, the House leadership would only be responding to the Blue Dogs, and would bend in their direction to get a bill out. But now, they have to balance two opposing factions, and the Progressives are bigger, especially since I don’t think we’ve seen a count of how many Blue Dogs have actually signed onto this letter. That gives more political gravity to our side.
July 10th, 2009 at 3:52 pm
The CBO link you provided is for the Senate HELP bill, not the House bill. The HELP bill has a much weaker public option that isn’t even open to everyone.
Should I be surprised that you were lying?
July 10th, 2009 at 4:14 pm
Hey, look at the timing. The House bill public option will save $150 billion according to CBO preliminary estimates.
July 10th, 2009 at 4:21 pm
Having read their letter, I must conclude that they lead very insulated, privileged lives.
July 10th, 2009 at 4:40 pm
McGuff Says:
July 10th, 2009 at 2:41 pm
Things have become so absurd that if the Mexican drug cartels were to adopt a Robin Hood type crusade against the medical insurers, they would garner widespread support.
And if serious healthcare reform ain’t passed, then something like that’s in the cards, folks.
==========================================================
Oh, you bet. The torches and pitchforks are being stockpiled now
http://www.cnn.com/2009/POLITICS/03/19/health.care.poll/index.html
More than eight in 10 Americans questioned in a CNN/Opinion Research Corp. survey released Thursday said they’re satisfied with the quality of health care they receive.
And nearly three out of four said they’re happy with their overall health care coverage.
But satisfaction drops to 52 percent when it comes to the amount people pay for their health care, and more than three out of four are dissatisfied with the total cost of health care in the United States.
“When Americans say they support health care reform, that doesn’t mean they want to lose their own coverage or give up their own doctor,” said Keating Holland, CNN’s polling director. “That’s something that the Clinton White House didn’t realize in 1993.”
July 10th, 2009 at 5:55 pm
Actually, I think there is a free (or at least cheap) lunch to be had.
Suppose we stop paying all the doctors and hospitals and drug companies for unnecessary treatments to the now-insured, and instead pay them exactly the same amount of money to provide necessary treatments to the now-uninsured. The healthcare providers would suffer NO LOSS from their bottom lines. The uninsured would be treated. The already-insured would be just as healthy.
It would be too neat to be true, of course, for the amount of waste we can squeeze out of the system to equal exactly the amount of care needed by the uninsured. But there should be a large overlap.
July 10th, 2009 at 6:59 pm
when exactly can someone start politikin’ in indiana for
bayh’s seat. he just can’t get over the fact that Obama took indiana………….spose we will have to wait until there are no limpublicans left before he gets it.
July 11th, 2009 at 10:17 am
I don’t believe that the Blue Dogs are necessarily more corrupt than other congresspeople. They (especially mine) just seem completely out of touch and self-absorbed.
What constitutes “corrupt,” exactly? Arguably the Blue Dogs are less corrupt by running pretty explicitly under a caucus label that inarguably identifies them as shills for corporate interests, rather than running on a progressive-agenda ticket and then only sucking up to corporate interests once they’re elected.
More than eight in 10 Americans questioned in a CNN/Opinion Research Corp. survey released Thursday said they’re satisfied with the quality of health care they receive… But satisfaction drops to 52 percent when it comes to the amount people pay for their health care, and more than three out of four are dissatisfied with the total cost of health care in the United States.
Gee, if only our current health care reform effort was dedicated to lowering the overall cost of and access to health care while allowing individuals who have coverage to stay with their existing doctor!