Comments on: Why a Slim Majority of the Public Opposes the New Health Care Bill

By: Dale Steinacker

Dale Steinacker — Sun, 11 Apr 2010 01:37:43 +0000

You wrote: If seniors perceive that the savings come through a reduction in Medicare services, opposition to this plan is likely to grow.
That is the key to the anger about the package. Many seniors realize they have been paying into two Ponzi schemes for most of their working lives: Social Security and Medicare. The Federal Government can keep its costs for both systems down by denying coverage.
The infuriating thing is being told that the anger has something to do with the President’s skin color. It has to do with the color green – as in money.

By: Matthew Dickinson

Matthew Dickinson — Mon, 05 Apr 2010 18:16:49 +0000

Arabella,

My initial reaction is that I’m not sure how Grayson’s bill does anything to contain Medicare costs, although I could very well be missing something. But, at first glance, its seems more like an exercise in position taking rather than a serious effort to expand insurance coverage. During the health care debate, there was serious consideration to expanding Medicare coverage to those below 65, but the problem is that for most people under age 65, the projected cost to enroll doesn’t seem worth the expected payout, particularly as eligibility drops. That means you need to provide subsidies (e.g., taxes) to keep premiums down – but that simply exacerbates the longterm funding problem Medicare is already facing. So, my initial (admittedly off the cuff) response is that – despite the bill’s simplicity and superficial political appeal – I don’t see this passing nor do I think it will help limit Medicare spending.

By: Arabella Holzapfel

Arabella Holzapfel — Mon, 05 Apr 2010 14:37:18 +0000

Matt,
Rep. Alan Grayson (D-FL) recently introduced the “Medicare you can buy into” act. (The press release can be found at http://grayson.house.gov/News/DocumentSingle.aspx?DocumentID=175363 and it has a link to the bill itself.)

Do you think this could possibly pass, and if so, could it help put limits on Medicare spending?

Also, thanks for your blog – it’s fascinating!

By: Matthew Dickinson

Matthew Dickinson — Sun, 04 Apr 2010 16:29:31 +0000

Marty – I said when the legislative first passed that it wouldn’t be repealed as long as Obama is president. Beyond that, I don’t know. I suspect it will be very hard to change the legislation in a way that will reduce the number of people who have health insurance coverage. I don’t think this will be a wedge issue along the lines of “welfare”, which proved controversial because of the sense that the “undeserving” were receiving government payments. Instead, if Republicans are to mount an effective attack on the program, it will likely center on the cost implications, and they will likely push solutions that focus more on cost containment. Whether they can do so in the context of retaining the existing legislation, in the spirit of “mending it, not ending it” remains to be seen.

By: Martin

Martin — Sat, 03 Apr 2010 23:02:59 +0000

Matt,

Is it fair to say there’s no turning back? For instance, “welfare reform” was as close as Republicans came to pushing a “repeal” of the original system. Are there any historical cases of successful entitlements repeal?

To the extent that unemployment stays high for the foreseeable future, and welfare cuts would tap poor white voter anger, “health care” is going to be the new “welfare.” Maybe the conservatives have already figured that out. Health care critics, like welfare critics, are going to be around a long time.

Your insight certainly held up on the distinction between health care reform and insurance reform. It’s plain that “health care costs going down” is impossible. The best we’ll do is throttling back the increases — “cost containment.” As you suggest, once the private sector begins to fail in its tougher social mandate, the next round of debate will heat up.

On the other hand, this isn’t as easy a win for conservatives. First, it’s not as easy to stigmatize the sick as it is to stigmatize the poor. And beyond that, the fiscal conservatives don’t yet have a sound argument. It was pretty clear this time that the usual revisionist spin that the solution will be further privatization or deregulation doesn’t sway many people. The conservatives ONLY gained ground when they talked about how dismal the Medicare system would be under the new law. I’m all for letting them propose co-ops and other Third Way solutions, though it’s pretty clear it’s not going to scale well enough to dig us out of the hole. Maybe some evil genius will invent a health care Laffer Curve, and the two sides will be off to the races again.

Do you also see this as a new, permanent issue divide?