Bloomberg on the GOP’s Obamacare Alternative: Thank You but Try Again

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Bloomberg’s editors have a good op-ed responding to the Republican Study Committee (sort of the GOP’s in-house policy think tank) and its proposed alternative to Obamacare, which is more or less a combination of long-advocated GOP health care solutions — stuff like selling insurance across state lines, pumping money into high-risk pools, offering tax deductions for individuals and families, and so on.

If the only point of Obamacare was to lower costs, the RSC plan would be a valid, if rightwing, alternative. But as Bloomberg points out, Obamacare was intended to do two things: lower costs and create near-universal coverage. On the latter point — which is the element of the bill that’s achieved by expanding Medicaid and which most appeals to liberals — the RSC plan doesn’t just fall short. It doesn’t even try:

[A]ny plan billed as an alternative has to meet one definitional threshold, and only one: covering a similar number of Americans as Obamacare. To go a step further and be a better alternative, a proposal should cover a similar number of Americans at a lower cost or with fewer unwanted consequences. The documents Republicans released today are conspicuously silent on how many additional Americans would be covered.

Until now, the Republican “repeal and replace” strategy on Obamacare has been to pretend that an alternative to Obamacare exists without saying what it is. Today’s proposal is the logical culmination of that cynical strategy: calling something an alternative, and hoping nobody notices that it’s not.

Republicans are within their rights, of course, to oppose the goal of publicly funded universal health care. They are also free to ask how much money the U.S. should spend to reach that goal and whether the country can afford it. But these are essentially political questions.

This is the weird position the Republican Party finds itself in when it comes to health care reform. For obvious political reasons, you can’t just come out and say you think some people deserve to be bankrupt (or worse) by an illness or injury.

Yet the idea that Obamacare will destroy the country by handing health care over to a government interested in rewarding the Takers at the expense of the Makers — that’s the animating spirit behind the base’s feverish opposition to Obamacare. That’s the reality. And any attempt to side-step it is going to lead, at best, to the kind of policy non sequitur the folks at Bloomberg so rightly criticize.

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22 thoughts on “Bloomberg on the GOP’s Obamacare Alternative: Thank You but Try Again

  1. A long time ago probably during the initial fights over the law, Kevin Drum pointed out that the conservative/Republican position on healthcare was probably “do nothing”. They advocated the individual mandate during the Clinton years because Clinton tried to go further to the left than Obamacare. Now that Obamacare advocated their initial response, they moved further to the right. Drum’s conclusion was that the GOP never wanted to reform healthcare but needed to offer something during the Clinton years.

    Meanwhile a lot of commentors on the left are now starting to think that the constant cries of defunding Obamacare are not really about the law but more about constantly easy fundraising:

    http://plainblogaboutpolitics.blogspot.com/2013/09/those-obamacare-rape-ads-are-scam-on.html

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    • Meanwhile a lot of commentors on the left are now starting to think that the constant cries of defunding Obamacare are not really about the law but more about constantly easy fundraising

      A lot of commentors on the left are only just now figuring that out? You damn them with faint praise, ND — I suspect this has been well-known, or at least broadly assumed to be true, across the political spectrum for quite some time now.

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      • Okay it has been known for a while but there seem to be plenty of people who fall
        for the con over and over again. The word choice was poor on my part. Damning with faint praise was not my intent and I apologize for it happening.

        So I know it, you know it, a lot of people know it.

        What do we do about the people who constantly send checks to these organizations? Do they know they are being conned? Do they sincerely think that Obamacare is the worst piece of legislation in the history of mankind or are they just ultra-partisan warriors who want to gum up stuff whenever the Democratic Party controls the Presidency and/or at least one part of Congress?

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  2. Personally, I think most of the objection is that there will be a rush to the doctor’s office by the uninsured, followed by a shortage of doctors. This shortage will create a sort of rationing; and I’ve heard conservatives use that word to describe the thing they’re worrying about.

    As if not having insurance, either due to poverty of pre-existing condition, isn’t a sort of rationing.

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    • I live in Massachusetts where RomneyCare has been in effect since 2006. To my untrained eye, it hasn’t introduced a doctor shortage into the state. We haven’t seen any noticeable increase in wait times. Curious, I did a bit of Googling to see if there was any hard data to back up my sense. What I found were a lot *claims* about RomneyCare causing a doc shortage but not much in the way of concrete data to support those claims.

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    • Personally, I think most of the objection is that there will be a rush to the doctor’s office by the uninsured, followed by a shortage of doctors. This shortage will create a sort of rationing; and I’ve heard conservatives use that word to describe the thing they’re worrying about.

      And yet they, _at exactly the same time_, argue that the poor can currently use ERs. Because going to an ER for a something that started as a trivial medical problem but is now life-threatening uses less resources than just going to the doctor.

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  3. There can’t be a GOP alternative to the ACA because the Republican Party does not see universal healthcare as a right or as something that is desirable for pragmatic reasons. In order to ensure universal healthcare, you need strong government action of some sort. If you do not believe that government could be a force of good or that you really do not see universal coverage as a right or desirable than you can’t really support the ACA or provide an alternative.

    In all probability, the GOP simply does not seem to understand why universal healthcare is considered desirable by many people or the problems with the current health insurance system from the point of an insurance holder. To them the current system seems just because of their preference for the market and that it can only be improved by increasing the market like features in the system.

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    • Many GOP folks like charity. Not just the market. Perhaps they just want the gov’t
      out of their charity? (yes, it’s unrealistic. but republicans tend to live in “waldo’s world”
      where it’s better to give all this money to try and save a kid’s life– and fail, rather than
      give the kid insurance and save the kid’s life)

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  4. Isn’t it the case that the coverage problem is caused by the rising costs of healthcare? So, shouldn’t solving the latter problem also solve the former?

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    • No, there are still problems that wouldn’t be solved by curbing the rising cost: People who can’t afford care at most any price and people who have conditions that make them uninsurable.

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    • Murali, this is actually an interesting question from a global perspective. I am led to believe (McArdle, for instance, truth in sourcing and all that) that we here in America get the ‘best health care’ in the world because we get dibs; we’re the most profitable market, so we get the cutting edge stuff. And we get it first because we’re willing to pay a premium for it; and that’s one of the drivers of our high cost. McArdle’s argument was that lowering our prices, negotiating them down, would crash the r&d incentives.

      But another potential is that it would more broadly distribute those costs; that US costs would come down slightly, but global costs might go up, too.

      Don’t know if this would happen, should happen, or could happen; but I thought I’d throw the notion into the mix for appraisal by better minds than mine.

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      • Actually, it is debatable about the extent to which America gets the best healthcare in the world. For example the average survival under dialysis in the US is only 3.5 years, while in Singapore, it is twice that.* You guys may get the latest technology and drugs, but there are management issues that are often mediated by bad incentives.

        *Figures as reported by my mom who is a professional at the top of the field. My googlefu is not good enough to find any source that you would be able to verify on your own.

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      • , yes, I agree that it’s debatable, and perhaps I shouldn’t have said that, I was being somewhat sarcastic; but it is a relatively common thing to hear, too.

        What is true is that we pay more for prescriptions, for instance, than people in many other countries do. Because we pay more, there’s a powerful incentive to release them here first, and earn as much as possible on the drug while it’s still under patent; and that supposedly helps fund drug discovery. I’ve repeatedly heard (McArdle, but also others) that negotiating or limiting prices would decrease discovery, that the profits from those patent years in the US are critical for recouping that cost and earning profit before generics compete.

        So I’m pondering another potential: that instead of limiting discovery, some sort of price negotiating/controls to bring down costs in the US would potentially drive up costs in other countries; say Canada, the EU, etc.

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    • Isn’t it the case that the coverage problem is caused by the rising costs of healthcare?

      If it is the case, then there was never a time when health care costs weren’t too high ‘n rising.

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  5. I’m wondering if this is it. The breaking point. The nonsensical issue that breaks the camel’s back. For the first time in years, I can’t figure out what exactly is going to happen, politically.

    When the ACA goes into effect, is the GOP going to :
    a) start insisting it’s actually destroyed everything. Sadly for the GOP, about the only people the ACA will ‘hurt’ are young people who see their rates slightly increase and young idiots who think they don’t need insurance.

    Good thing the GOP has never done a bunch of stupid shit to piss off young people, like decades of racism and sexism and moralizing about teh gay. So all those young people will be flocking to *holds hand to ear* Sorry, a correction. I’m told the GOP has, in fact, been doing all that, and a large percentage of young people loath the GOP with the intensity of a thousand suns. Whoops.

    Everyone else with insurance will just look around, confused, and saying ‘Hey, I thought the government was supposed to take this over or something? Also, my rates appear to have stop rising, or at least are rising less than before.’

    b) forget the ACA ever exists. Yeah, good luck with convincing the base about that.

    c) pretend it’s not actually gone into effect and they can still stop it. This seems completely insane, but then, we’re talking about the Republicans.

    Seriously, we need to start a betting pool or something about this. The GOP has no actual solution, at all. They are broken.

    Assuming the entire government doesn’t crumple at the debt ceiling or continuing resolution because the GOP figures out their problem and takes it down for spite…what happens mid-October when people start realizing this entire thing has started, and actually bought insurance? What happens in January, when the insurance starts?

    What position does the GOP take?

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