Not A Helpful Argument

I’ve frequently noted that it is counterproductive for advocates of health care reform to use the VA as a model. Their arguments in support of the VA system is based upon faulty data, many who have experienced care through the VA would not see it as a good model for health care reform, and a government run program of this nature is not even on the table. If using the VA as an example is counterproductive, Matthew Yglesias comes up with one that is even worse. You will never win an argument which tires to use the U.S.S.R.  as in any way a positive example.

Not Only Women Are Subjected To Unfair Attacks

Peter Daou compares Palin-bashing to Hillary-bashing at Huffington Post. His message seems to be that both Palin and Hillary Clinton were treated unfairly as they were women. Both were subjected to some unfair criticism, and some of this was related to their gender, but both were also subjects of attack for reasons independent of this. While it is strange to lump both Sarah Palin and Hillary Clinton together because their views are so different, both of them have views which I (and many others) find objectionable, both have demonstrated a lack of integrity when pushing their agendas, and both tend to display poor judgment in matters of public policy.

If Peter simply wants to separate such differences of opinion on public policy from personal attacks I totally agree with this. While I would be reluctant to vote for a ticket containing either a Palin or a Clinton, there are many grounds to criticize them without resorting to many of the attacks which they have been subjected to. I not only agree with Peter in criticizing the comments claiming Hillary Clinton was pimping her daughter, I wrote a post defending Clinton on this while opposing her candidacy. When posting about the many lies of Sarah Palin I noted regret that personal issues were mixed in.

What bugs me about the way that Peter lumps together the attacks on both Palin and Clinton in such a manner is that it implies that only female politicians are treated this way. Gender differences do make it inevitable that there will be some differences in the nature of the attacks, but plenty of male politicians have also been treated quite unfairly. One example from each party in a presidential campaign quickly comes to mind–the attacks of the Swift Boat Liars on the honor of a war hero in their false claims about John Kerry in 2004 and the Daisy Ad used by Lyndon Johnson against Barry Goldwater in 1964.

Unfair treatment is a fact of life in politics. It would be great if it could be eliminated but it cannot. Most politicians take their lumps and continue. They do not run away and hide like Sarah Palin.

Misleading News Report On Deal With Physicians

The New York Times has a misleading item in an article today which claims that deals made by Obama could add hidden costs to health care reform:

The deal with doctors could come at a steep price: a $250 billion fix to a 12-year-old provision in federal law intended to limit the growth of Medicare reimbursements. The American Medical Association and other doctors’ groups have sought to change or repeal the provision, and they are likely to try to extract that as their price for boarding the Obama train, people tracking the negotiations said.

This is not actually a new cost as the provision was so badly written that it is overturned every year. The idea was to tie physician reimbursement to overall health care costs under the assumption that this would give physicians an incentive to keep health care costs down. A formula was written to determine physician reimbursement under Medicare which would pay more if health care costs were kept down but pay less if costs rose.

While in theory this might make sense the formula has not worked. Individual doctors have very limited control with regards to overall health care costs which have increased with increasing technology and an aging population. The price of injectable drugs, primarily administered by Oncologists, has been responsible for much of the increases which would have triggered pay cuts to all doctors. In recent years the formula would have cut physician reimbursement by double digits every year. Realizing that this would cause physicians to be unable to afford to see Medicare patients, every year Congress has acted to block the cuts which the formula would enact.

The formula is highly flawed and pretty much everyone recognizes this. The formula is thrown out every year and has not brought about any cost savings. The formula should be thrown out once and for all rather than having to wait for Congress to act every year. Claiming there is a $250 billion cost to this is misleading as Congress has already been overturning the cuts which the formula would have brought about every year.

The Danger of Killing Health Care Reform From The Left

Matthew Yglesias has made an important point about the strategy of the “progressive block” to attempt to block any form of health care reform which does not meet their ideological goals. This now includes blocking plans which might serve the goals of health care reform if they do not include  a public option. An example of this was seen yesterday when they attacked an extremely sensible statement from Rahm Emanuel who argued that “The goal is non-negotiable; the path is.” I have used the Clinton’s as an example in criticizing the strategy of opposing any reform plan which the left does not consider to be perfect. Hillary convinced Bill to veto any bill which differed from the ideas of HillaryCare. As a result nothing was able to pass and the number of uninsured and under-insured has grown tremendously. Yglesias notes an even earlier parallel.

Yglesias points to a report on a plan proposed by Richard Nixon back in 1974 which is similar to what the Democrats are proposing today:

“It was an extremely extensive plan, as I remember, that would have given universal coverage” for health care, recalled Rudolph Penner, a former director of the Congressional Budget Office and economic official in the Ford administration.

Nixon introduced his Comprehensive Health Insurance Act on Feb. 6, 1974, days after he used what would be his final State of the Union address to call for universal access to health insurance.

“I shall propose a sweeping new program that will assure comprehensive health-insurance protection to millions of Americans who cannot now obtain it or afford it, with vastly improved protection against catastrophic illnesses,” he told America.

Nixon said his plan would build on existing employer-sponsored insurance plans and would provide government subsidies to the self-employed and small businesses to ensure universal access to health insurance. He said it wouldn’t create a new federal bureaucracy.

The Nixon plan won support from a Time magazine editorial on Feb. 18, 1974, which noted that “more and more Americans have been insisting that national health insurance is an idea whose tune (sic) has come.”

Considering his support for HMO’s I would have reservations about a plan advocated by Richard Nixon without seeing further details, but it is remarkable that we are still struggling this many years later over a way to do what every other industrialized country manages to do and enable all citizens to have access to affordable health care. The plan was not killed by conservatives but by those on the left who hoped for something better:

Despite the heated politics of Watergate, national health-care legislation was proceeding in Congress thanks to a compromise brokered by a young Democratic senator from Massachusetts, Edward Kennedy, a Nixon nemesis.

But then, according to a 1974 political almanac published by Congressional Quarterly, the AFL-CIO and the United Auto Workers lobbied successfully to kill the plan. Unions hoped to get a better deal after the next elections.

Yglesias concludes by saying essentially the same thing I have said on this topic in previous posts:

In retrospect, that particular iteration of the progressive block strategy doesn’t look so smart. And it’s possible that this time around, too, it’ll turn out that the votes aren’t there for a bill with a strong public option and the votes aren’t there for a bill without one either.

In retrospect, Emanuel was right and the liberal bloggers attacking him were wrong when Emanuel stated his concentration on the goals of health care reform as opposed to any specific path. For the past eight years we criticized George Bush and the Republicans for governing from the extreme right without compromise. Similar demands from the extreme left are no more rational.