Thursday, June 11, 2009

Rove's Dissembling on Health Care


Karl rove shares this anecdote:
It was a sobering breakfast with one of the smartest Republicans on Capitol Hill. We can fix a lot of bad stuff President Barack Obama might do, he told me. But if Mr. Obama signs into law a "public option," government-run insurance program as part of health-care reform we won't be able to undo the damage.
Anonymous? I don't think Rove's making the story up, nor do I think he's such a pariah that the politician at issue doesn't want people to know he still breaks bread with Rove. So the most likely reasons for the anonymity are:
  • The politician at issue doesn't want to have to defend his comments on the merits; or

  • The politician at issue was speaking of "bad stuff" in a very different way than Rove suggests. That is, he's using the term to mean the implementation of policies, no matter how sound, that make it more difficult for the Republican Party to regain power.

If Rove were an honest man, beyond naming his breakfast guest he would admit the following: It would be easy to kill a public plan that people found unsatisfactory. What scares him is not that it will work or be ineffective, but that it will be better, cheaper and more efficient than private health insurance plans and decades of fear mongering about "socialized medicine" will have been for naught. (Not to mention, $millions in health insurance industry lobbying dollars would disappear from Republican coffers.)
I'd go the Republican member of Congress one further: If Democrats enact a public-option health-insurance program, America is on the way to becoming a European-style welfare state.
"European-style welfare state"? I guess that's the new term for "socialist", that particular epithet having lost its traction. Perhaps Mr. Rove will elucidate: Which European countries are not "welfare states"? And which nations in the world are clamoring to imitate the U.S. model? (I might quip, why does Rove have so little faith in America that he believes we can't create a national health care plan as good as those people in countries like France and Canada have absolutely no interest trade for a U.S.-style scheme of insurance.)

Rove offers a number of flimsy arguments against a public option. For example he claims that "Advocates say a government-run insurance program is needed to provide competition for private health insurance. But 1,300 companies sell health insurance plans. That's competition enough." Except as he fully knows, the market for health insurance is not a normal market. The principal buyers are employers who, in the absence of a CBA mandating a minimum level of benefits, seek to minimize their expenditures. They look for the cheapest plan they can successfully foist on their employees. Most employees don't have a choice of plans, or at best get to choose from a handful of plans within their employer's price bracket. If they're not employed, the market's a near failure - individual plans tend to offer a glorious mix of extremely high cost, high deductibles, and poor coverage.

Rove speaks of savings brought on by competition in the Medicare drug plan, using high projected costs to spin the illusion that competition has reduced cost to the government, but neglects to mention that the Republicans deliberately excluded Medicare from using its market position to negotiate discounted drug prices - that is, they knew full well that without their legislative hamstringing, Medicare would have outcompeted the private plans. You don't believe me? Ask him to put his money where his mouth is, remove all restrictions on the government's ability to negotiate drug discounts, and prove that private plans are cheaper. He'll no doubt stammer out an excuse about how it's not fair for a government plan to be able to negotiate for discounts even though private plans are free to do so, but it will be a smokescreen.

Rove all but admits his deceit, arguing, "government-run health insurance would crater the private insurance market, forcing most Americans onto the government plan." His reasoning is that employers would see the government plan as, you guessed it, the cheapest option. And despite his regurgitation of the standard parade of horribles, about how doctors and hospitals won't get adequate payment for services (yet apparently would still participate), government bureaucrats will choose your doctor, and the cost will be higher than that of private plans (ostensibly because any government plan would be subsidized, but he's barely trying for internal consistency), people will voluntarily sign up with the government plan. Uh, yeah....
Health care desperately needs far-reaching reforms that put patients and their doctors in charge, bring the benefits of competition and market forces to bear, and ensure access to affordable and portable health care for every American. Republicans have plans to achieve this, and they must make their case for reform in every available forum.
Great, Karl. How about sharing those plans right here and right now? Or naming a single country where a public plan, in competition with private plans, has led to the outcome you describe? Oh, out of space? Why does that always seem to happen right when the discussion might become substantive.

As Rove obviously understands, its easier to run for election while claiming to have a "secret plan" than it is to do so while admitting that you don't actually have an answer. And, of course, that a lie told often enough becomes the truth.

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