Posts
Feinstein to Introduce Gun Legislation, Boehner Proposes Tax Hike, and More
Newtown: An American Tragedy
Countdown to Doomsday
Egypt’s New PharaohBy Chris Hedges
By E.J. Dionne, Jr.
Why Is Washington Obsessing About the Deficit and Not Jobs and Wages?By Robert Reich
The Future of Gun Control in the Aftermath of Sandy HookBy Bill Blum
Feinstein to Introduce Gun Legislation, Boehner Proposes Tax Hike, and More How Republicans Would Benefit From John Kerry Secretary of State Nomination Red States Surrender Health Care Oversight to Federal Government Insurance Industry Is Taking Climate Change Seriously Weaker Social Networks a Cause of Black Unemployment, Study Finds Dream of a Global Climate Deal Is Over, Experts Say
Watch: ‘SNL’ Honors Connecticut School Shooting Victims GOP Lawmaker’s Solution to Preventing Mass Shootings: More Guns ‘Left, Right & Center:’ School Shooting, Susan Rice Withdraws, and More Mike Huckabee Blames Connecticut Shooting on Separation of Church and State
Hollywood’s Raid on ConventionBy Richard Schickel Understanding Economics in Plain English
By Thomas Hedges, Center for Study of Responsive Law Regulate Dissent in Hong Kong, Jackie Chan Says
Fighting Manifest Destiny
By Jonathan Yardley
The Questions Education Reformers Aren’t AskingDig led by Mike Rose Gore Vidal: His Life and Legacy
Dig led by Truthdig Staff
advertisement-->
Concentration Camps on the Home FrontBy John Howard
$19.14
advertisement
-->
Messenger Bag$38
advertisement
-->
White T-Shirt$18
Email 
Print 
ShareTweet
Posted on Dec 16, 2012 By E.J. Dionne, Jr.
WASHINGTON—The human capacity to put passion and intense feeling over cool rationality does not surprise us when it comes to love, sex, family, friendship, certain kinds of religious commitment and even devotion to sports teams.
But emotional approaches can be quite dangerous in public policy, and on no subject is irrationality as pronounced as it is in health care.
Here’s the difficulty: Conservatives who were once genuinely interested in finding market-based alternatives to government-provided health insurance have, since the rise of Obamacare, continued to make choices that are dysfunctional, even from their own point of view.
Start with the decision of the vast majority of Republican governors to refuse to set up the state insurance exchanges required under the law. The mechanisms would allow more than 20 million Americans to buy coverage. They were originally a conservative idea for large, trustworthy marketplaces where individuals and families could buy plans of their choice.
Many liberals preferred a national exchange in which the federal government could institute strong rules to protect consumers and offer broader options. This was the path the House took, but the final Senate-passed law went with state-level exchanges in deference to Republican sensibilities.
To ensure that governors could not just prevent their citizens from having access to the new marketplaces, the bill required the federal government to run them if states defaulted. So, irony of ironies, in declining to set up state exchanges, conservative governors are undermining states’ rights and giving liberals something far closer to the national system they hoped for. As Robert Laszewski, an industry critic of Obamacare, told The Washington Post’s N.C. Aizenman, conservative governors are engaging in “cut-off-your-nose-to-spite-your-face” behavior.
This is one of many forms of conservative health care unreason. The fiscal cliff debate has been distorted because the problems confronting federal finances are consistently misdescribed. We do not have “an entitlement problem.” We have a giant health care cost problem.
Our major non-military fiscal challenges lie in Medicare and Medicaid. In principle, conservatives should seek to find ways of holding down health care inflation in both the private and public sectors. In practice, they see most efforts to take on this issue system-wide as examples of big government run wild. They seem to have a vague idea that markets can yet solve a problem that markets have not been very good at solving.
The result is that conservatives would either let government get bigger, or they’d save money by throwing ever more risk onto individuals by undercutting core government guarantees.
Their most outrageous move was the big lie that the original health care bill included “death panels.” This would have been laughable if it had not been so pernicious. The provision in question would simply have paid for consultations by terminally ill patients—(BEG ITAL)if they wanted them(END ITAL)—with their physicians on their best options for their care. Few things are more important to the future of health care than thinking straight about the costs and benefits (to patients and not just the system) of end-of-life treatments. For those of us who oppose physician-assisted suicide, it’s urgent to promote rather than block serious, moral and compassionate discussions of the difficult issues raised by high-tech medicine.
Or take the health care law’s creation of the Independent Payment Advisory Board, known as IPAB. It’s a 15-member body charged with finding ways of cutting the costs of treatment under Medicare. Congress would have the final say, but through a fast-track process. Yet the ink was barely dry on Obama’s signature of the Affordable Care Act when a group of Republican senators introduced what they called the Health Care Bureaucrats Elimination Act, to get rid of IPAB. Thus did an innovative effort to save money meet with a slap in the face. And, conservatives barely acknowledge other cost-saving experiments in the ACA.
Is it any wonder that our fiscal politics are so dysfunctional? Yes, we liberals are very reluctant to cut access to various government health insurance programs. With so many Americans still uninsured, we are wary of depriving more people of coverage. But we fully accept the need to contain government health spending.
Yet given the conservatives’ habit of walking away even from their own ideas (the exchanges, for example) and of rejecting progressive efforts to save money, is it any wonder that liberals suspect them of greater interest in dismantling programs than in making them more efficient? We won’t find genuine common ground on deficits until we resolve this dilemma.
E.J. Dionne’s e-mail address is ejdionne(at)washpost.com.
© 2012, Washington Post Writers Group
Advertisement
TAGS: affordable care act conservatives democrats health care liberals obamacare republicans
Related Entries
Red States Surrender Health Care Oversight to Federal Government
Obamacare Begins
Which Path for the Right? The Peril of a Sentient GOP 
Email to a friend Get truth delivered to
your inbox every week.
Next item: Egypt’s New Pharaoh
New and Improved Comments
If you have trouble leaving a comment, review this help page. Still having problems? Let us know. If you find yourself moderated, take a moment to review our comment policy.
Please enable JavaScript to view the comments powered by Disqus.
Get Truthdig in your inbox
Newsletter
Become a Fan
Follow Us
Subscribe
CloseGive the gift of independent journalism.
Support Truthdig by making a donation of at least $25 in someone's name, and we'll send him or her a signed letter of appreciation from our publisher.
With your support, we've been able to pay writers such as Chris Hedges, Col. Ann Wright, Mr. Fish and Nomi Prins.
We've sent reporters around the world, from Afghanistan to Cairo to Cuba.
Thanks to you, our mission to find and publish a range of insightful opinion and analysis from a progressive point of view continues.
Support Truthdig
HOME|Digs|Reports|Arts & Culture|Uncovered|Ear to the Ground|A/V Booth|CartoonsTags|Bazaar|Podcast|About Us|Contact Us|User Agreement|Privacy Policy|FAQ: Comments and Moderation | Google+ Google+
A Progressive Journal of News and Opinion. Editor, Robert Scheer. Publisher, Zuade Kaufman.© 2012 Truthdig, LLC. All rights reserved. Web site development by Hop Studios
View the Original article
0 comments:
Post a Comment