Squeeze Play
There’s definitely something nice about being out of power. I feel like all day every day for the past week, I’ve been watching conservatives on television ranting and raving about how Democratic efforts to control health care costs and reform the system will lead to rationing and your grandma being turned into soylent green. In part precisely in order to avoid those accusations, the bills on the table probably don’t actually do enough to really throttle health cost inflation. So now for their trouble David Brooks treats Democratic legislators to a vicious lashing for not doing enough to control costs, during which time he somehow manages not to mention the scorched earth anti-rationing campaign being waged by the opposition party.
Here’s GOP Senate Leader Mitch McConnell:
Senate Minority Leader Mitch McConnell (R-Ky.) says President Barack Obama wants to ration health care for Americans and involve the government in decisions on what treatments individual citizens can receive.
During an appearance Sunday on CBS’s “Face the Nation,” McConnell said Obama supports “a national rationing board, to determine what kind of treatments would be available for American citizens. Typically, those in single payer countries like Canada and Britain involve delays in treatment, denial of care, those kind of things.”
Now McConnell is just lying here. Straight-out lying. And by doing so he’s making it extremely difficult for the Senate to take anything other than fairly modest steps toward cost control. It’s fine—welcome, even—for conservative pundits to criticize current legislation for not going far enough in this regard. But if you want to make that argument you owe it to the world to get real about the context here and spare a lash or two for the folks who’ve been pushing legislation in this direction. But the right is, as Jon Chait points out, very conveniently having it both ways on the health spending issue, simultaneously whining about expense of giving health insurance to the currently uninsured while positioning themselves as the defenders of unlimited services.
27 Responses to “Squeeze Play”
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July 10th, 2009 at 1:00 pm
A little web search yields the following:
“The president plans to cut $313 billion over the next decade from the two federal health programs by limiting the growth of Medicare reimbursements to hospitals and health care providers. He also said he was open to expanding the role of the Medicare Payment Advisory Commission—a body set up by the Newt Gingrich-led Republican Congress in 1997—to save another $200 billion.”
From the World Socialist Website.
July 10th, 2009 at 1:07 pm
The democrats don’t have to modify their positions to accomodate republicans. To the degree they are less than progressive it is due to lobbyist influence on democrats. The republicans are just convenient cover.
July 10th, 2009 at 1:13 pm
Mitch McConnell and the Republicans have been lying for YEARS about progressive proposals — but if you LET them get away with it, they will be lying for years more.
WHY do DEMOCRATS NEVER go on the attack? Point out that the Republicans had control of the US Congress for 14 years and did NOT DO A SINGLE DAMM THING to provide healthcare coverage to the millions who do not have insurance. After they sabotaged Hillary Clinton’s effort to address the issue.
Why is it that the Right has Bill O’Reilly, Rush Limbaugh, Glenn Beck and a whole slew of propagandists spewing out invective day after day — while not a single fucking Democrat so much as raises his voice.
Is that the sign of opponents? Or the sign of collaborators/enablers?
July 10th, 2009 at 1:16 pm
Democrats have 60 votes. What Mitch McConnell says or thinks is completely irrelevant.
July 10th, 2009 at 1:17 pm
When are the Dems going to rebut this “rationing” argument by pointing out that no one will be required to buy the public plan? Even if one passes, and even if it contains procedure-based cost controls, private insurance companies will have no obligation to adopt that approach. And you’re free to purchase/retain private insurance!
Not to mention that HMOs, which insure a large percentage of Americans, already literally ration care. My mother had colon cancer, and yet my 43-year old sister had to wait 3 years for a colonoscopy – thanks to her HMO. She can’t leave that plan, because it’s all her employer offers. With a public plan, she could actually consider getting out of the HMO. It could very well be an improvement over her private insurance.
Why do the Dems keep letting this BS argument go without reponse? It’s maddening.
July 10th, 2009 at 1:21 pm
Now McConnell is just lying here. Straight-out lying. And by doing so he’s making it extremely difficult for the Senate to take anything other than fairly modest steps toward cost control.
Wrong. What’s “making it extremely difficult for the Senate to take anything other than fairly modest steps toward cost control” is the inability of Senate Democrats to hold their caucus together, and their bizarre insistence on bipartisanship. A Democratic caucus willing to use its numbers is a Democratic caucus immune to the “lies” of this or that right wing troglodyte.
Good heavens, Republicans are lying. Pass the smelling salts!
July 10th, 2009 at 1:22 pm
I see Al @#4 beat me to the punch.
July 10th, 2009 at 1:26 pm
The right wing and their lies are so tiresome…
July 10th, 2009 at 1:28 pm
“Not to mention that HMOs, which insure a large percentage of Americans, already literally ration care. My mother had colon cancer, and yet my 43-year old sister had to wait 3 years for a colonoscopy – thanks to her HMO.”
Well, that was probably the right call, though. Unless there is significantly more of a family history, then I don’t believe you or your sister is at increased risk of getting colon cancer. Particularly in your 40s. Unless you’re having concerning symptoms, you’re good to go until age 50. Evidence based medicine in action.
July 10th, 2009 at 1:36 pm
I hate it when Al is right.
Of course, it’s a bit disingenuous after all the whining and mewling from the Right about how mean ol’ Obama isn’t bipartisan enough, for them to turn around and claim they have no responsibility for anything that comes out of the legislative process.
But it’s the first half of that act that’s dishonest, not the second half. Any bill can now become law without a single Republican vote. Any legislation that fails to pass, from here on out, is entirely the fault of the Democrats. Period.
July 10th, 2009 at 2:15 pm
“In part precisely in order to avoid those accusations, the bills on the table probably don’t actually do enough to really throttle health cost inflation. ”
Wow. It’s Stimulus Fight, the Sequel.
July 10th, 2009 at 2:23 pm
No he isn’t. From Chait’s article…
That is to say, determine what the insurance will pay for and what it won’t. Rationing. It seems that you BigY are the liar. Why not be forthright and defend rationing if you believe in it, rather than weasel around it?
July 10th, 2009 at 2:24 pm
Democrats have 60 votes. What Mitch McConnell says or thinks is completely irrelevant.
Well, it’s relevant only in that the Democratic caucus includes people like Nelson, Landrieu, and Lincoln who would probably be Republicans in other states and vote like it. And Kennedy and Byrd who there are logistical difficulties in getting to the actual chamber to vote. And the absurdity of the modern filibuster which has turned every piece of legislation into a supermajority requirement that never previously existed.
But it shouldn’t matter.
July 10th, 2009 at 2:26 pm
“That is to say” is not, in fact, a magical device that allows you to change the meaning of words, Shooter.
July 10th, 2009 at 2:32 pm
That is to say, determine what the insurance will pay for and what it won’t. Rationing. It seems that you BigY are the liar. Why not be forthright and defend rationing if you believe in it, rather than weasel around it?
Wow, you’re right! Kind of like, oh, say, the insurance executives determining what it will pay for and what it won’t. Rationing. It seems that you BigShooter are the liar. Why not be forthright and defend rationing if you believe iin it, rather than weasel around it?
July 10th, 2009 at 2:33 pm
“That is to say, determine what the insurance will pay for and what it won’t. Rationing.”
It’s true. Those socialists at CMS refuse to pay me for doing those appendectomies on my patients with headaches. Who are they to tell me what works?
The point of comparative effectiveness is getting better treatments.
July 10th, 2009 at 2:40 pm
it’s a bit disingenuous after all the whining and mewling from the Right about how mean ol’ Obama isn’t bipartisan enough
Now, now, we were told repeatedly during the campaign that Barack Obama is post-partisan, and that all of this partisanship will be put behind us if only we’d cometogether and elect Barack Obama.
July 10th, 2009 at 2:54 pm
I, too, am disappointed that Barack Obama overestimated the decency, patriotism, honor, and honesty of D.C. Republicans.
But whattyagunnado?
July 10th, 2009 at 2:54 pm
Now, now, we were told repeatedly during the campaign that Barack Obama is post-partisan, and that all of this partisanship will be put behind us if only we’d cometogether and elect Barack Obama.
I have a favorite quote that I think is relevant here, Al:
“I really don’t understand how bipartisanship is ever going to work when one of the parties is insane. Imagine trying to negotiate an agreement on dinner plans with your date, and you suggest Italian and she states her preference would be a meal of tire rims and anthrax. If you can figure out a way to split the difference there and find a meal you will both enjoy, you can probably figure out how bipartisanship is going to work the next few years.”
July 10th, 2009 at 2:58 pm
Rationing is the process of limiting the amount of a good, service, or resource made available to someone. For example, “Sorry, we won’t fund a cast for your leg, because that would cost more than we want to spend on you.”
Comparative effectiveness decisions are about determining the most effective ways to spend resources. For example, “Sorry, we won’t fund a shaman to sprinkle chicken blood over your broken leg, because that treatment is useless. We’re going to pay for a cast instead.”
July 10th, 2009 at 3:46 pm
The oceans are dying! Soylent Green is people !!!!
July 10th, 2009 at 4:32 pm
Comparative effectiveness decisions are about determining the most effective ways to spend resources. For example, “Sorry, we won’t fund a shaman to sprinkle chicken blood over your broken leg, because that treatment is useless. We’re going to pay for a cast instead.”
===========================================================
More than $1 billion of the stimulus is dedicated to government-sponsored research into the “comparative effectiveness” of various medical treatments. In theory, such research could provide doctors with important information. But because the research is government-funded, it will likely be used to justify cuts in government health spending.
That’s what’s done in Britain. The British comparative-effectiveness agency routinely denies cutting-edge medicine because of cost. And the Obama administration has begun creating comparative-effectiveness institutions that parallel those across the Atlantic.
On March 19, the Obama administration announced the establishment of a 15-member “Federal Coordinating Council for Comparative Effectiveness Research” to oversee the research. Terrifyingly, there are no practicing physicians, patient advocates, or nongovernment healthcare economists among the council’s members. Instead, all hail from the Washington, D.C. area—and all are likely to see comparative effectiveness as a way to drive down costs by limiting the availability of drugs and medical treatments and rationing care.
http://www.usnews.com/articles/opinion/2009/05/13/under-obama-healthcare-scheme-big-government-rations-care-for-sick-patients.html
What penalties will deter your doctor from going beyond the electronically delivered protocols when your condition is atypical or you need an experimental treatment? The vagueness is intentional. In his book, Daschle proposed an appointed body with vast powers to make the “tough” decisions elected politicians won’t make.
The stimulus bill does that, and calls it the Federal Coordinating Council for Comparative Effectiveness Research (190-192). The goal, Daschle’s book explained, is to slow the development and use of new medications and technologies because they are driving up costs. He praises Europeans for being more willing to accept “hopeless diagnoses” and “forgo experimental treatments,” and he chastises Americans for expecting too much from the health-care system.
Elderly Hardest Hit
Daschle says health-care reform “will not be pain free.” Seniors should be more accepting of the conditions that come with age instead of treating them. That means the elderly will bear the brunt.
Medicare now pays for treatments deemed safe and effective. The stimulus bill would change that and apply a cost- effectiveness standard set by the Federal Council (464).
The Federal Council is modeled after a U.K. board discussed in Daschle’s book. This board approves or rejects treatments using a formula that divides the cost of the treatment by the number of years the patient is likely to benefit. Treatments for younger patients are more often approved than treatments for diseases that affect the elderly, such as osteoporosis.
In 2006, a U.K. health board decreed that elderly patients with macular degeneration had to wait until they went blind in one eye before they could get a costly new drug to save the other eye. It took almost three years of public protests before the board reversed its decision.
http://www.bloomberg.com/apps/news?pid=20601039&sid=aLzfDxfbwhzs
July 10th, 2009 at 4:52 pm
In his book, Mr. Daschle proposes a National Health Board to regulate the way health care is provided. This board would have vast powers in regulating the massive federal health-care system — a system that includes Medicare, Medicaid, and other programs. Under Mr. Obama, it is likely that that system will be expanded and that new government insurance for the nonelderly, nonpoor will be created.
This is WJS quoting one of Obama’s major health care providers.
How many quotes about rationing health care from the Obama camp, quotes taken from both the right and the left, do we need before we are convinced that Obama means exactly that?
Maybe Obama is specifically mis-informing Yglesias, but the other 300 million American citizens can continue all day finding rationing quotes from the Obama medical camp.
July 10th, 2009 at 5:32 pm
“I really don’t understand how bipartisanship is ever going to work when one of the parties is insane. Imagine trying to negotiate an agreement on dinner plans with your date, and you suggest Italian and she states her preference would be a meal of tire rims and anthrax. If you can figure out a way to split the difference there and find a meal you will both enjoy, you can probably figure out how bipartisanship is going to work the next few years.”
That would be a good point except that the Republican Party didn’t change between the time Obama made those pretty-sounding promises and now.
July 10th, 2009 at 8:11 pm
So now for their trouble David Brooks treats Democratic legislators to a vicious lashing for not doing enough to control costs, during which time he somehow manages not to mention the scorched earth anti-rationing campaign being waged by the opposition party.
In subsequent TV appearances, Brooks offered a more bipartisan, if no less puzzling, formulation: Republicans are against rationing & Democrats are against competition.
July 11th, 2009 at 12:29 am
I don’t get this post. Didn’t they lie when they were in power?
July 11th, 2009 at 12:24 pm
The sum total of actual evidence – as opposed to speculation and opinion – that the Comparative Effectiveness Board would be used to ration treatment is found is this sentence:
The vagueness is intentional.
That’s it. The only thing they can point to to suggest that rationing would be used is “the vagueness is intentional.
Pathetic.