Thursday, February 25, 2010

Republicans vs. Democrats on Health Insurance Coverage

A few final thoughts for this fourth and final segment:

  • In a January 2008 debate, Senator Obama asked what then-Senator Clinton what would happen if people cannot afford insurance: “What are you going to do about it?…Are you going to garnish people’s wages?”  Yet that is what the House and Senate bills would do—sic the IRS on people who do not buy “government-approved” insurance.  Many may argue these provisions violate the President’s campaign promise not to raise taxes on individuals with incomes under $250,000—“not your income tax, not your payroll tax, not your capital gains taxes, not any of your taxes.”
  • According to CBO, nearly half the total reduction in the number of uninsured comes from an expansion of Medicaid, which pays physicians 40 percent below private insurance plans.  As a result, doctors accepting Medicaid are so hard to find that a Consumers Union spokesman recently called a Medicaid card a “hunting license” to try and find a doctor that would see them.  How is giving 15 million low-income people a “hunting license” to try and find a doctor who will see them “reform?”
  • Governors in both parties that cannot afford their current Medicaid programs have already voiced significant concerns about what Tennessee Democratic Gov. Phil Bredesen termed “the mother of all unfunded mandates” being imposed upon states in the form of 15 million new Medicaid enrollees.   As a result of the added restrictions in Democrats’ proposals, the head of Washington state’s Medicaid program believes that states facing severe financial distress may say, “I have to get out of the Medicaid program altogether.”  How does encouraging states to drop out of Medicare constitute “reform?”
  • During his presidential campaign, Senator Obama promised that “you will not have to change plans” under his platform, and that “for those who have insurance now, nothing will change…except you will pay less.”  However, the Congressional Budget Office has stated that enrollment in Medicare Advantage will decline by millions under Democrats’ proposed more than $120 billion in cuts, and millions more will only be able to keep their current coverage by paying more in premiums and co-pays.  So in other words, seniors who like their current plan won’t be able to keep it—and those who are “permitted” by the Obama Administration to keep their current coverage will be forced to pay more.
  • Republicans have long argued that the key to expanding insurance coverage is reducing costs, which is why incremental measures like liability reform and insurance reforms allowing broader choice of plans will bring down the long-term trend of cost growth and have beneficial effects on coverage.  Independent experts at the Congressional Budget Office agree on both counts.
  • Republicans also believe in allowing portability and choice in insurance plans, which is why many believe in premium assistance options for programs like Medicaid that according to CBO would reduce the deficit by billions of dollars, even while giving more individuals a choice of private plan options rather than a one-size-fits-all government-run plan.
  • Even some leading Democrats have argued that the party’s fixation on expanded insurance coverage is potentially damaging.  In an interview last spring, former House Majority Leader Dick Gephardt (D-MO)—who led his party during the time of the last national health care debate—told the New York Times that “the way to get to [universal coverage] is to show that we can deal with some of these [cost] problems first.”  Republicans couldn’t agree more with those sentiments, which is why Republican efforts have focused like a laser beam on cutting costs, not creating trillion-dollar schemes creating massive dislocation within the health care system.