"We will not be able to recover the vision and understanding of God's grandeur until we recover an understanding of ourselves as creatures who have been made to know such grandeur. This must begin with the recovery of the idea that as beings made in God's image, we are fundamentally moral beings, not consumers, that the satisfaction of our psychological needs pales in significance when compared with the enduring value of doing what is right. Religious consumers want to have a spirituality for the same reason that they want to drive a stylish and expensive auto. Costly obedience is as foreign to them in matters spiritual as self-denial is in matters material. In a culture filled with such people, restoring weight to God is going to involve much more than simply getting some doctrine straight; it's going to entail a complete reconstruction of the modern self-absorbed pastiche personality."
- David Wells
Wednesday, March 17, 2010
We are now in the ending "end-game" of the year-long healthcare debate and legislative brou-ha-ha. I think this time we really are getting near the end.
So, it's prediction time. Do you think that house will vote on the Senate version of healthcare reform this week? If so, will it pass? Finally do you think this will be a good or a bad thing?
Leave your predictions and opinions in the comments.
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Comments on "Healthcare Predictions":
3. Bill
- 03/17/2010 6:08 pm CDT
An addendum to my comment: a few other questions that I thought of.
Will it help people? Yes, some. It will also hurt people, vis a vis creating an economic and business environment less conducive to giving people jobs.
Will it help the President? Absolutely. It will be seen as a stunning political achievement, especially since it will be, in all practical terms, unrepealable.
Will it help Republicans? In the short term, as in for the 2010 election. But in the long term it will greatly help Democrats, as all entrenched entitlement programs help the party of Government. Any Republican who thinks that the passage of this bill will, in the long term, push the Republicans to ascendancy is smoking something illegal.
Will it help people? I already answered this :-) - but will again. It will help some, it will hurt others, in many ways it will just transfer pain from one group to another, so in that way it will be a wash. But a very, very expensive wash.
I hope I'm wrong about that, though. Maybe a modern wonder will occur and the Government will really be able to have this much influence in the health-care industry without ending up with a bunch of unintended consequences and perverse incentives. I hope so.
8. Quaid
- 03/17/2010 10:39 pm CDT
Recognizing Andrew's comment as true, if the bill passes, this is going to have more ramifications that just what we will see on the health care and economical fronts. From a societal standpoint, I think this bill is disastrous, should it pass.
Firstly, to answer questions:
1& 2. Will they vote on the bill and will it pass?
I don't think so. No.
3. Is this a good thing?
If it doesn't pass, yes.
Assuming it doesn't pass, the fallout for the Democratic party will be pretty bad, but they'll recoup and the election in November won't be so bleak as people are saying. I think this bill is the main source for the citizenry's dissatisfaction right now. When it's gone, Obama's approval ratings will buoy back to their levels from a few months ago - just above 50% and a lot of the races that are supposed to be leaning left, but are currently in play for Republicans, will return to their proper place. Meanwhile, legislative concern can turn back to jobs, the economy and all the things the majority of Americans actually care about.
I have a theory, though, that I almost commented on in in Jared's post from Monday. I believe that the White House wants Congress to return to Republican control as a means of leveraging power and to develop a foil to gain reelection in 2012. If the Democrats retain control of both the House and Senate, I think Obama's in a horrible spot for re-election. To comment on someone else's post here, I'm not so certain that the White House is being entirely altruistic with their push for Health Care despite wild unpopularity. If it passes - especially if it passes by "deem and pass" or via reconciliation - the Republicans really will fry the Democrats in eight months (which is still a long time, politically).
All to say, that pushing health care will achieve a few things for the White House if it passes:
1. Obama is the first President who accomplishes his primary domestic agenda item in decades. - GOOD
2. People who aren't covered get covered gaining massive publicity and a positive return for the White House in 2012, when the practical impact of the bill starts to take effect (while the negative economic impact remains to be seen for another few years). - GOOD
3. The short-term political fallout returns Congress to Republican control (almost) and Obama has his foil. - GOOD
Should it pass, it will plunge our government further into the destructive, divisive, political mess than it already is. I really think that this lack of government will push society into a minor depression. Economically, we'll really be up a creek without a paddle. But at least all the counseling will be free . . .
That and abortions.
9. Bill
- 03/17/2010 11:14 pm CDT
Andrew, well said.
Quaid - regarding the "Republicans as foil" idea. I dunno. I always think winning is better than losing. My guess is Obama does too. Losing Congress seems like an awfully risky thing, and certainly not guaranteed to work in building the "foil". Obama isn't a Clinton-level skilled politician. He is a true believer (which is why he's ramming this through).
And, yes, we've had debates in this space about how good of a politician he is and how strong his beliefs are. After the past few weeks, I've come around to he's a slightly better politician than I thought (but still not a very good one - if he didn't have a supermajority he'd already be a lame duck) and he is a true believer, because he's making a frightfully risky play with healthcare - nearly as risky as Bush played with his Iraq strategy.
And Bush was (and is) a true believer too, about Iraq.
10. Evan
- 03/17/2010 11:46 pm CDT
I doubt it gets passed this week, but I still think there are pretty strong odds it gets passed eventually rather than gets defeated.
And I think it will be ultimately be just one more step, albeit a big one, that will likely cause an eventual major financial collapse of the US, probably within the next 20 years. I guess the 'good' news is that some European dominoes with even worse government spending and terrible demographics are likely to fall before us, and their collapse might shake us up enough to change our direction. But I still doubt it.
And if a major collapse comes, just like the near collapse caused by the housing bubble bursting in 2008, all the press and a large part of the citizenry will be asking "Why didn't someone warn us or stop this?" while conveniently forgetting or downplaying their support for the 'free lunch' policies that directly led to it.
As for the question 'is the CBO right?', all they can do is model the assumptions they are given. The problem is that the assumptions are ridiculous and manipulated to get to a result that will never be achieved. The assumptions being given to the CBO to score this bill are the equivalent of me taking a lavish vacation this year to be paid for by not buying any groceries for the next 3 years. Yes, I can mathematically balance my personal four year budget using those assumptions, but realistically there is no way the savings of not eating for 3 years will materialize.
11. Andrew
- 03/18/2010 7:50 am CDT
Obama isn't a Clinton-level skilled politician. He is a true believer (which is why he's ramming this through).
To be fair, he's pushing it through because he has gigantic majorities in Congress. He's pushing it through because he will probably win. Clinton didn't push his bill through because it never made it to the floor.
I've got a post coming one of these days on how Clinton wasn't as good as people like to think, just lucky. :-)
12. Bill
- 03/18/2010 9:06 am CDT
CBO scoring is in
Since they only needed about four votes to get this over the hump, the CBO scoring that rates this thing as a deficit-reducer over ten years will probably provide any wavering democrat the cover they need (not to mention get them out from under the barrage of inticements of federal cash for their district, threats of losing plumb committee positions and re-election funding, and all the other arm-twisting that's going on).
I'm sticking with my prediction: it passes this weekend.
13. jen
- 03/18/2010 11:36 am CDT
I'm wondering who they bought at CBO. All prior reports from CBO said this would be a deficit increaser.
This will be very bad for an already ailing US economy. Collapse in 20 years? I think it's closer to 10.
The Treasurer of Massachusetts spoke out today against the bill. MA is nearly bankrupt b/c of romneycare. He said the only thing keeping MA from economic collapse is help from the feds. Who will help the feds?
14. Jared
- 03/18/2010 12:26 pm CDT
I want to preface htis comment by saying I am not for government-run health care systems. I've seen how efficient and effective and excellent government-run entities are, which is to say, not very.
But:
Hey, how do we fix the system, if this isn't the way? Or is it not broken? Do we disagree that something is broken?
For the first time ever I am in the market for self-purchased health insurance for my family. I am scared. I have no idea how I'm going to afford it. I have looked into co-ops as alternatives but they are not "safe" enough (and don't cover checkups, prescriptions, etc).
But as I look at the options available, I am extremely nervous. I'm not exaggerating. I'm running the numbers in my head and I'm not even sure I'll be able to afford anything comprehensive.
And I'm not poor.
So if government provided or government-made-affordable health care isn't the answer, how do we get health care costs down? Feasibly.
I don't know how people who make less than I do but don't have employer-provided insurance do it. I'm sure most of them don't.
15. Jared
- 03/18/2010 12:47 pm CDT
All that to say, also, I wonder if a lot of people opposed to this plan -- probably for good reasons -- have not been self-reflective enough to wonder if they would be against it if they did not receive insurance through their employment. How different does one's perspective become when all insurance coverage is out of pocket?
I know for me it has not changed my mind about the government's quality/efficiency or the tax burden it creates, but it has made me more open, self-reflective, sympathetic, etc. I've also come around a bit on whether philosophically I think the government should be concerned at any level with health care or dealing with the impoverished.
I have noticed for instance how caring Christians can be when it comes to serving the poor through the church but how when things go through government we call them "entitlement programs" and suddenly become suspicious of the poor. The lens changes our attitudes about the recipients somehow. We are more likely to rail against welfare moochers in political discussions than missiological ones.
I've also been affected somewhat with a lot of what our community is trying to do for folks in my new ministry environment. I am in a depressed area, lots of unemployment, lots of older folks, lots of medically challenged people. The few churches here are ill equipped for all the need. For instance, we have a lady who needs pretty much round the clock in-home care. Nobody from our church can do this themselves. We do all kinds of things for this family, from helping with bills, housing her teenage daughter, cleaning her home, visiting her in the hospital, liaising with her legal representation, etc.
But the social services can provide "free" (it's not free of course, b/c it's taxpayer-funded) in-home care. So are we suddenly communists or liberals or just bad Christians if we figure out how to acquire this sort of care for her? A trained professional in her home to care for her for "free"? Should we not avail ourselves of that outlet b/c it's governmental and not "church" doing it?
Thinking through this stuff has colored my views. I have been broken on a lot of things I was once sure of back when I lived in a relatively safe suburban area and had a mostly well-off church and circle of contacts and never worried about how I was gonna pay for the doctor.
I think I see less "us" and "them" now. Not sure how to explain it.
And yes we could say -- and I do say -- we wouldn't need all this stuff if the church had been doing it's job, but the church didn't and still isn't. What are the alternatives? The need is too great and the number of churches and Christians ready and willing to do whatever it takes to meet it is too small. So do we sacrifice people on the altar of our conservative political principles?
I don't know. But I feel like that's how many in my political and even church tribes think.
16. tcl
- 03/18/2010 3:35 pm CDT
My prediction is the Dems will squeak it through this weekend. They are going down in flames this midterm election (and that would've happened anway historically-- it just would have been an issue of how much). Good luck repealing it. The early momentum against it will be stifled by the veto power.
Jared, I don't presume to know anything about your situation or those you speak of. But here are my comments anyway. We have an already artificial cost and availability structure, with a plan to ratchet up the artificiality, but hide it with subsidies.
We have problems created by the people who are now telling us they need to intervene to fix our problems, and their solution is more of the same disease.
When federal law privileged employer-provided policies, it became easy for people in mid to large companies to get insurance. Thus reducing the pool of non-covered, financially able, low risk families. So most regularly employed people are covered, and most who are independent are vastly more likely to seek out coverage for a reason (i.e. they know they are about to NEED insurance). People who aren't employed by a company providing the health insurance are both less likely to pay on time and more likely to really use their coverage.
The federal move privileging employer plans also ended up making insurance the norm, rather than the exception, to healthcare payment. This has: 1) raised the cost-- when more of something is paid for by somebody else, the price to you is lowered, and you demand more 2) raised the friction on the insurance side-- when people are demanding more, you scrutinize claims more 3) raised the friction on the docs' side-- when insurance scrutinizes claims more, you have to spend more money to get your claims paid.
Put in simple terms, one of my doctor friends says he'd be happy to charge $50 instead of $150 for an office visit if he didn't have to employ an army of coders, billers, and clerks to make sure he got paid. And it's no talk. He actually does that from time to time because people come to him with no insurance. And he'd provide more free care if the potential liability were less. Not necessarily agape in action, but rational I think.
As for what we do in the current healthcare/economic situation. I say smoke 'em if you got 'em. If there are services out there, encourage people to use them. I do it. The good news is that you can exercise pastoral oversight (so to speak) over their use of government programs. You can tell the welfare momma she has a responsibility to eat healthy if she's going to accept food stamps and medicaid. You can tell the chainsmoker he has a responsibility to quit it if he's going to expect Uncle Sam to keep his emphysema at bay. Who out there is teaching entitlement recipients to act like stewards instead of slaves?
AND by your involvement in that way, you can encourage your members take charge. "Isn't it pathetic that this single mother has to go on welfare because Christians haven't stepped up to provide for her family?"
Because ultimately IMO all this is God's judgment on us for our failure to man up and accept our responsibility to the orphans and widows.
17. Bill
- 03/18/2010 4:53 pm CDT
Jared,
My hope and prayer is that you are able to get the insurance you need. Let me know if/how I can help.
I haven't had to buy insurance independently, and I can only imagine how horribly expensive it is. I think tcl hit on a lot of the reasons. Bottom line, there's no easy answer, because where we are (what Government is planning on "fixing") is largely due to what Government has done in the past. It's probably too late do roll back anything.
If passing Obamacare helps you in your situation, then I'm, well, not "for" it, but more for it than I was before, if you understand my meaning :-)
On the whole Christian/Conservative/etc. debate. I think the real answer is a complicated one. Here's what I mean: I honestly believe that most people, if they know that their taxes were being used wisely, spent on the right things, and not being used to incentivize all manner of unwise behavior, would be all for paying more. Many Christians are very generous with their money, but more so to private charities and their church, that they have more visibility into.
I feel kind of "dirty" thinking about how much tax money just gets . . . blown. Or just makes things worse. Surely liberals feel the same way about money spent on the wars? Just dirty.
It's not about not wanting people to be helped. I'm glad there are safety nets available. I don't want anyone to die or starve in the streets. But it's frustrating to see our government exhibit such hubris about its abilities to fix this problem. And I don't have confidence that this bill will fix the problem. I think it may even make it worse. In any event, it won't be good for the government's finances.
And there's the rub. I'm glad people who don't have insurance now might be able to afford some if this passes. But how much will my great-grandchildren have to pay for that? Will we break the bank? And why do liberals consider people like me "selfish and heartless" for asking these questions?
I've been thinking a lot about my own interaction with politics (based largely on some of your critiques and prophetic posts here and elsewhere). For me, what keeps me coming back to this subject of politics and current events, and what I believe makes it a moral topic for Christians to talk about, is truth. Regardless of party loyalty, we should be about truth. So, if Bush lied about WMDs, we should stand against that (I don't think he did, but I need to be open to that, regardless of party). If Obama and the Democrats are calling this bill a money saver because they start collecting taxes on it now but don't start actually delivering benefits for four years, thus making it a "positive" over the first ten years, well, figures don't lie but liars can figure. It puts an anger in the pit of my stomach. I felt the same way when I heard Obama promise in a rally (I was there in person) that if I didn't have health care his plan would give me a plan as good as Congress has, and if I did he would cut my family's premiums $2,500 a year. That's a lie (and not excused just because he was on the campaign trail and, you know, "politicians". Just like Congresspersons who were bribed with 100s of millions of dollars coming from the public treasury so that they would vote on this thing, saying they "can't be bought". It's a lie.
Both sides lie. If Christians should stand for anything, it should be for the truth. And that's where this Christian hopes to interface with politics from now on.
And not because of the politics. Because of truth.
Well, sorry for the digression. I was gonna write a post but maybe I just did :-).
And let me know how the health insurance search goes. I'm sorry you're having to deal with that.
18. Jared
- 03/18/2010 5:26 pm CDT
If passing Obamacare helps you in your situation, then I'm, well, not "for" it, but more for it than I was before, if you understand my meaning
I don't expect it will as I'm sure we're above the income line that would qualify.
I don't mean to make a stink of the situation. I'm nervous about it, but we'll be okay. God provides. Jesus is king. And whether I can afford "good" insurance or paltry insurance won't change that anyway.
I think I've just learned not to be so sure about some of the stuff I used to be really sure about, politically speaking, I mean. I understand the economic arguments in play here; I don't want to saddle my kids with a lousy financial future either, or their kids. And the government flat out stinks at running stuff like this. I've been to the DMV and the post office, and those places don't (usually) handle life or death situations!
And I know Christians are generous with their money, and usually their time too. I think the stereotype of the stingy conservative/Christian is a myth. Conservatives are more charitable than liberals, demonstrably so in the research. And Christians have been the ones feeding/clothing/healing in the farthest reaches of the world for decades upon decades, before any celebrity decided it was a good idea.
But there are limits, corporately speaking, that American evangelicalism has placed on itself. And I include myself in that. I cannot physically or financially live in another person's house and give her medical treatment. But I can go to a social services office and advocate for her and get her somebody who can. I cannot offer her legal representation, but I can go to legal aid and advocate for her and get someone who can.
I guess what I'm saying is, I don't think it's liberal or communistic for the church to avail itself of services provided for by taxpayers if there's no other recourse, and especially if it's in the best interest of the person in need.
I guess that's my beef. Do we really want to help people? Or do we just not want the government to take too much of "our" money? (And I didn't put "our" in scare quotes because I think it's the government's money. I put it in there b/c it's God's.)
I unfortunately know more Christians than I care to count who are adamantly against government-provided or subsidized health care but who are doing practically nothing in their own lives to practice "pure religion" aside from the occasional check to a charity (if that).
20. Bill
- 03/18/2010 6:44 pm CDT
"I guess what I'm saying is, I don't think it's liberal or communistic for the church to avail itself of services provided for by taxpayers if there's no other recourse, and especially if it's in the best interest of the person in need."
For what it's worth, I don't think it is either :-). I had a lot of experience in the last few years *trying* to help a chronically sick member of our young singles class. Sometimes it got overwhelming, and I was extremely thankful for the paid providers and home care help this person had. I also saw what appeared to be a ridiculously disfunctional medical services apparatus. The programmer in me was wondering why people's medical conditions, records, experiences can't follow them around somehow digitally. It was like this person was starting over every time they found themselves in another ER (it didn't help that there were some mental issues as well, possibly/probably due to the incredible prescription drug coctail ingested every day). I would be for a universal medical records thing (which may be part of the current proposal, I can't recall). But not administered by the Government. I'd be way more comfortable with Google doing it :-)
I mean, it's a mess. All of it.
I don't mean there aren't good doctors and medical professionals out there. There are. Probably most of them. But the system is really, really messed up, especially for those on assistance, w/o insurance, etc. It doesn't make sense.
I've learned something over my long time in the business world: Anytime things don't make logical, common sense, there's almost always a perverse incentive of nonsensical regulation that was put there by a Governmental authority.
Sorry for the rant. This is what I fear from Obamacare. And the frustrating thing is that I know there are many things that could be done with minimal governmental jiggery-pokery to make things better.
21. Evan
- 03/18/2010 10:16 pm CDT
My belief is that the problems of health care cannot be solved because the demand is virtually unlimited, and the supply is always finite. Our health care spending is already robbing a lot of other good and necessary things for society, and will continue to grow until younger and healthier people refuse or simply can't pay for any further expansion. Furthermore, just like there will always be a continuum of rich and poor people, there is always going to be a continuum of health care from excellent to poor.
For example, by definition, there can only be one 'best' heart surgeon in the country. How are we to decide who gets to have his services? By who can pay him the most? By who the government says he must treat? By who he freely decides he wants to treat? By random lottery? How are any of these methods more fair than any other? Any way you look at it, only a few people will get the best care and everyone else will get less.
I freely agree none of these methods is ideal, and it is terrible hard for people at the bottom of the health care continuum regardless of what method is used. But having government decide seems the worst solution of all to me. Not only will political power (and all the corruption with it) determine who gets the best care, but it will also reduce supply over time as forcing doctors and hospitals to treat who the government mandates and at what prices will inevitably make health care a much less attractive profession, and eventually we will have employees as motivated as those at the DMV and Post Office.
As for Obamacare, the people who are really going to get impacted are the 9% of people in the country that purchase their own health insurance already. I am in that 9%.
The 1/3 of the population already on Medicaid/Medicare/government health insurance theoretically will face some cuts, but no one honestly believes they will really happen.
The roughly half of the US population that gets their health insurance from their employer will be largely unaffected because most of the rule changes do not apply to them.
Which leaves the 10-15% of the population currently uninsured who are going to be forced to buy health insurance, but also given subsidies to pay for it. Those subsidies will be paid in part by new taxes on wealthier people, but also large increases in private insurance premiums for those 9% (including me) already buying private insurance as these new high cost people are initially forced into their plans with no denial or higher premium allowed for any preexisting condition.
Which means in a relatively short period of time, the private insurance plans will become incredible costly, no one will be able to afford the premiums, and they will largely go away. Government plans will absorb us private insurance buyers, leaving only big government and big business plans.
Personally, I expect my premiums to quadruple in the relatively short term, which will then likely force me to go to one of the government exchanges, where I will still probably pay double what I do today, with the government supposedly subsidizing the other half. And what really upsets me is that left alone, I could obviously pay far less and also not become a cost to other taxpayers.
22. jez
- 03/19/2010 7:44 am CDT
"I would be for a universal medical records thing (which may be part of the current proposal, I can't recall). But not administered by the Government. I'd be way more comfortable with Google doing it :-) "
It is incredible in this day and age, isn't it? I remember attending conferences in about 2001 where American delegates were talking up fancy systems they wanted to develop which could handle managing individuals' genome data, and I never thought it would happen in the short time-frame, because there are two barriers to good medical records management:
1) the personalities involved in frontline health care tend to be anti-IT, so there's a big cultural shift required to get any fancy infrastructure to be used properly. This is perhaps happening naturally as the younger generation is more accustomed to computers.
2) the requirement for privacy leads to most of the bureaucracy involved, which makes working in this area Not Fun. (They're not offering, but this would rule out google and their business model!)
23. Bill
- 03/19/2010 8:43 am CDT
Jez, on number 2 - there are a number of businesses and entities on the internet that handle private data. I think it could be done - I was kidding (a bit) about Google, but I think with some out of the box thinking we could find a non-Governmental entity that would do this. I'm really not comfortable with the government owning my medical records. Since they'll be "paying" for my healthcare it's only a short step until they decide they can run my entire life, and having my medical records . . . well, that's gonna be a huge temptation.
One of the greatest (and near-miraculous) blessings of the modern age, that we're enjoying right now, is the fact that the internet is not owned by the government. In fact, it's not owned by anybody. It's just an agreement.
That's why it works so well. I have to believe there's a paradigm we could imagine where health records are digitally portable, entirely secure, and not prone for analysis and tweaking by anyone beyond the doctor(s) and medical professionals we choose.
But, yes, every time I go into a doctor's office and fill out a paper form, I always think "Oh my gosh, I could fix this!". If I had my druthers, you'd be able to fill out the online information before heading to the doctor. And once that record was filled out you'd just add-to and modify as things changed, rather than starting over every time.
At some point I'm going to post my ideas about how to make the DMV run better. Seriously - it's so easily set right. My first step would be to privatize it . . .
Another post for another time.
24. jen
- 03/19/2010 9:28 am CDT
tcl - yes, yes, and yes.
Jared, I completely understand your anxiety - I've been uninsured, underinsured, and well-insured. I understand the fear of not having insurance and worrying about some catastrophic illness or an accident that requires a huge outlay of cash to pay for medical care, especially as a parent.
My concern about this bill is that it puts the government in charge of managing the system and to a large extent funding it. As a taxpayer, I'm concerned - we already have a huge deficit, the dollar is weakening by the minute, China is thisclose to owning the US, and this bill will only add to the burden. Yes, we should be concerned with the individuals struggling and the system needs overhaul, but this isn't the answer. I believe that this bill will do serious damage to the infrastructure of our country to the point of economic collapse, enslaving a large portion of our population, and giving our government control that is not Constitutional.
25. Jared
- 03/19/2010 10:00 am CDT
I understand this bill isn't the answer. I don't think it is either.
I think most of us are abundantly clear on what isn't the answer. Still unclear on what should be done.
So far a few answers seem to surface:
a) Nothing can be done, really.
b) "Google" should take it over.
c) The church/charity should take care of it.
Any others?
26. Bill
- 03/19/2010 10:13 am CDT
Heh - I wasn't really serious about google taking over healthcare. I was more talking about the digital health-records aspect of it.
A lot of very smart people have good ideas on healthcare. For me, I think there should be incremental change, biased toward more competition among insurance companies (allowing them to compete across state lines), with MAJOR attention paid to tort reform (how much of our healthcare costs are eaten up by perverse incentives and malpractice insurance costs due to ridiculous and overbearing legal pressure?).
I know it's not the same thing, but the way auto insurance works *may* be a model to at least look at. Making cheaper catastrophic insurance available, etc.
On the other two options: "Nothing can be done" isn't the answer, but it does feel like we're already too far gone and massive Government interference is the next logical step that we can't get out of. But I believe other things can be done (as I've mentioned above). The Republicans have a plan and I'd love to see a real, good-faith debate on the merits of their plan.
On the "Church/charity should take care of it". I think most here agree that the church should do more, but I don't think anyone has suggested that the church shoulder the entire burden. I certainly haven't suggested that.
There are sane, incremental improvements and reforms that can be done that won't break the bank or fundamentally screw up the good parts of the healthcare system that many Americans currently enjoy.
27. Quaid
- 03/19/2010 10:15 am CDT
I think a lot of solutions have been presented.
Primarily, we should focus on driving health-care costs down. And it doesn't have to be done in one, large, omnibus bill, necessarily. Why don't we just start with tort reform? Let's knock that out and then we can focus on other cost-cutting measures.
From what I understand, the current bill doesn't really do anything to promote cutting costs. I think cutting costs (or, at least, implementing cost-cutting measures) is the common sense first step before we introduce millions of new people into the system.
Peggy Noonan has a compelling column out today regarding this issue. Her final paragraph reads:
And so it ends, with a health-care vote expected this weekend. I wonder at what point the administration will realize it wasn't worth it—worth the discord, worth the diminution in popularity and prestige, worth the deepening of the great divide. What has been lost is so vivid, what has been gained so amorphous, blurry and likely illusory. Memo to future presidents: Never stake your entire survival on the painful passing of a bad bill.
I think this column speaks to my earlier comment that the harm this bill causes is more than just economic (as severe as that is).
29. Quaid
- 03/19/2010 10:33 am CDT
A column by Rep. Paul Ryan (R-Wisc.), who is (I think) the minority leader on the House Budget Committee penned this column in the Post early this week that also speaks to possible solutions. According to him, all of the expensive premiums that Jared is looking at for his family will go up as much as 15% if the bill is passed.
One idea that he pushes in the column is to throw the tax breaks currently afforded to businesses to the individual taxpayers which would help us all afford the insurance, regardless of whether we receive it through our employer or elsewhere.
31. jen
- 03/19/2010 11:02 am CDT
As tcl said earlier, I have heard a lot of doctors say that they would prefer to go back to the way of pay-as-you-go. They would charge much lower fees for their services in order to be able to provide better care. Taken out is the middle man (insurance company) whose requirements are unreasonable, unmanageable, and expensive.
My BIL is a doctor who works in a small town hospital and moonlights at a large urban hospital when they need the extra help. He is very opposed to this bill and would prefer to use a pay as you go system, bypassing insurance companies for the most part. He thinks it would be more affordable for patients, less bankrupting for providers, and less regulated by the feds.
34. Bill
- 03/19/2010 2:49 pm CDT
Though not as bad a situation as Jared's (and possibly not a bad situation at all, as we haven't received a bill yet) - my company switched to Blue Cross/Blue Shield last year to try and contain/lower costs. We were on better insurance before that. My eldest daughter worked last summer for someone who did insurance administration of some sort - and the first thing she said when I mentioned that was "Oh, they're really bad to deal with"
Anyway, a few weeks ago our twelve year old was horsing around w his buddies and got a bad ding on the head that was bleeding. It ended up needing one stitch. Our regular doc didn't have an opening so we took him to the ER, etc.
A week later we got a letter from BC/BS - it said that they covered $250 of the cost, and that we *might* get a bill from the hospital for FOURTEEN HUNDRED DOLLARS that they weren't covering.
We haven't gotten a bill yet. But we're talking about one stitch. BC/BS estimated the whole thing (or had already heard from the ER, it's not clear) at $1,650. . .
Something's messed up, big time. I don't know what it is (and I'm not buying the typical political villain-casting "us against them" stance that it's all the insurance companies, though I know they aren't completely blameless).
More's coming out on how bogus the CBO score is. . . On a side note, after this healthcare episode of the past year, regardless of what happens, I'm of the opinion that we need to relieve our entire Congress of their duties. All of them (Repub and Dem). Our legislative process used to be more veiled. We didn't know how the sausage was made.
Now we know. It's rank bribery.
Out with all of them.
35. Evan
- 03/19/2010 3:31 pm CDT
I misspoke - not 15%. Premiums could go up ten to thirteen percent. (These numbers according to the CBO) It's not too different, but in the interest of truth - ahem - I thought I should correct myself.
You know, when I was first starting out as a young accountant, I had a boss who told me the first commandment of accounting was "Thou shalt not measure with a micrometer, that which you lopped off with a meat cleaver."
That is exactly what the CBO is being asked to do with this health reform bill. Use broad meat cleaver assumptions, including many deliberately manipulated to achieve an answer that will never realistically happen, and then use a micrometer to ridiculously measure whether those assumptions would result in (ahem indeed) 13% or 15% rate increases.
It's all nonsense. All this bill does is more cost shifting from some groups of people to others. It does nothing to lower the real costs of health care, and unfortunately, likely even decreases the few existing market incentives for people to take better care of themselves.
36. Quaid
- 03/21/2010 4:33 pm CDT
Well, it appears that I was wrong . . .
Stupak and friends are now voting in favor of the bill and its fate is practically sealed. I'm still interested on what the final vote will look like, but it doesn't seem to matter.
Drudge had a couple of headlines that hold out hope - firstly, that Sen. Hatch noted the House would have to vote on it at least a couple more times based on procedural points of order that would be brought up by Senate Republicans. If this is true, then those who voted in favor of it today would have to hold onto that position for at least a little while longer.
Secondly, that there may be language in the House bill which disqualifies it for reconciliation. I'm not certain if this is true and if it's true what it means. Does that mean differences could take place in conference committee? That would still have to be voted on in the Senate, though, therby killing the bill.
Now, on to the States' lawsuits, I suppose. I'm not sure that anything more can be done at the Congressional level. If this bill passes later today and holds over the next months, I'd be interested to see how far into their session it takes the Texas Legislature to instruct our Attorney General to file suit.
This is a truer definition of March Madness.
37. Bill
- 03/21/2010 5:00 pm CDT
When Scott Brown was elected I thought it was a foregone conclusion that this bill was dead.
It's been obvious to me for the past week or two that the only foregone conclusion was that the democrats will never give up until they pass this thing. So today's no surprise to me.
I think any hope left in these piddly procedural nickknacks is misplaced. If it passes today (which it looks like it will) it's over.
Lawsuits by states is a different matter entirely.
The next question: How bad, really, will the passing of this bill hurt Democrats? People love a winner. I'm not convinced that it's going to hurt them as badly as many Republicans hope. We'll see, I guess.
38. Quaid
- 03/21/2010 6:00 pm CDT
I think the Dems will bounce back from this UNLESS it can be dragged out in the news for a while (a long while).
Despite the fact that the Republicans will be the ones dragging it out, it will consistently (and effectively) remind everyone how much they hate this bill, how much it does squat to help the economy and jobs, and how much the Dems own the last year of junk that has been the Federal Government.
Drudge is saying that the procedural steps the Reps are taking might eliminate the effectiveness of the house amendments and we would ultimately see the Senate Bill pass in all of its earmarked glory.
(Wanna move to Nebraska, Bill?)
39. Bill
- 03/21/2010 6:16 pm CDT
Well, time will tell. Aside from the fact that I've gotten a lot better at predicting (the Obama victory and this bill's passage as two examples) I can't predict the political future. A large part of me doesn't care, because I'm more or less in a general anti-incumbent mood.
I think that bills such as these are pandora's boxes. We've opened the gate on lots more government interference in our lives, and I think once that happens, the only direction (Europe as an example) is toward more statism. Because who will take benefits away from people? It's impossible, even if said benefits are not benefitting as many as promised and are costing way more than advertised.
We'll see. As Jared said today on FB, Jesus is king.
Hopefully things will work out and the bill will actually help people. We'll see.
40. Quaid
- 03/21/2010 10:04 pm CDT
I'm certainly glad that so many people who could not afford healthcare will now be able to (supposedly) access care. I hope this leads to many lives saved.
I hope that we can do whatever we need to do to limit the devastating effects this could have on our economy. Let's see what good we can take away from this while eliminating the bad.
In the meantime, I'm okay with getting rid of incumbents, except that the representative of my district holds similar philosophical views and, as far as I know, no one is running against him.
41. Bill
- 03/21/2010 10:32 pm CDT
Well, why don't you run?
Seriously, out with all of them. Even the Republicans who have fought hard and well against this - what were they doing 2000-2008? They are statists too and they spent money like crazy as well.
Out. All of them.
42. Quaid
- 03/22/2010 8:58 am CDT
Well, I think you know why I don't run.
Turning to the thoughts of repeal . . .
While I think it's the right thing to do, if Republicans make this their headline issue (and not jobs/economy), they're in danger of losing all of the political ground they've picked up in the last six months. Election day is seven and a half months away - too many things can happen between now and then.
I think they work 100% on jobs/economy and trumpet repeal from the rooftops, secondarily. OR, perhaps, frame repeal within the context of the economy.
Winning 2010 elections is simple. Remind everyone about the economy. It's easy to do. You can phrase it in 1,000 different ways so you don't sound robotic. But if campaigns are a one-trick pony consisting purely of REPEAL! then the Republicans aren't going to pick up near as much ground as they may hope.
43. Frank Gallagher
- 03/22/2010 9:02 am CDT
I lurk here from time to time, but am too hot-headed to post (hey, just being honest). But I mourn that the national discussion on health care couldn't have been as calm, evenhanded and reasoned as the thread here. As Christians, shouldn't one of our primary responsibilities in the political sphere be to encourage this sort of discussion, rather than what's been ocurring? Wouldn't that do more good than the rabid partianship that we're always tempted towards?
44. Quaid
- 03/22/2010 4:35 pm CDT
Frank-
I think what was commented above (#17) about protecting/guarding/emphasizing truth certainly speaks to Christians' responsibility in the political sphere.
Also - the bulk of commenters here trend conservative, so I'm not certain that you could describe the blog as evenhanded, although I do think there's always a welcome invitation for all views, when presented in love, buttressed by truth.
Of course calm discussion would be better than what we have now. I think that's part of Bill's throw-them-all-out hope/dream/plan. Firing everyone in Congress might be the thing that encourages discourse.
Of all the things that disappoint about Obama's Presidency, I think your comment hits on the most pointed failure - the promise of effective discourse. So far, the best he's done is host conservative members of the media at his place before the inauguration and the farce that was the bi-partisan talks a couple of weeks ago at Blair House.
Sure - on the topic of reasoned discourse, it takes two to tango. But there is always one who ought to lead. The Republicans haven't been easy to deal with, but the Change that Obama spoke of is not only non-existant, it isn't even a hope any more. And so his allure is gone. He can't run as an outsider any more.
The worst thing about it is that I don't know if we'll ever believe that someone can change Washington again. They'll just have to do it - we'll all be pleasantly surprised.
45. Frank Gallagher
- 03/22/2010 10:27 pm CDT
Quaid,
Yes, there's certainly more conservative than liberal opinions being expressed. So not "evenhanded" in that sense. But the tone is set in the very first post, often echoed, that opposes the bill without trying to make it into the apocalyse that so many conservatives have tried to paint it as. No mention of death panels or the end of freedom in this country(at least in my quick read). By the way, these are also lies. fwiw, I basically support the bill. My concern is how effective can government be at this and how are we going to pay the bills--not just for this program, but for everything that the government's committed to do. The same concerns most people have I imagine. My biggest disappointment with Obama is that, like almost every other politician, he refuses to tell the hard truths. I.e. if we want the government to do these things for us we have to find ways to pay for them. (Raise the minimum age of retirement for Social Security and Medicare for a start--and I say that as an almost-60 year old with no savings to speak of.) A lot of us thought he would really be different. But the fact that he's not puts him in a big club. Maybe Bill has the right idea, throw them all out.
46. Quaid
- 03/23/2010 12:43 pm CDT
I found a column today that echoed my sentiments in comment #8. It appears that Washington Post columnist Chris Cillizza and I have the same ideas about the White House having no problem with the Republicans winning back a majority in either the House or Senate (or both).
He even used the word "foil".
47. Bill
- 03/23/2010 7:28 pm CDT
Quaid,
I still think that's ridiculous (with all due respect :-).
Winning is always better than losing.
48. Bill
- 03/23/2010 7:31 pm CDT
Although, what do I know. I didn't think Obama was as good a politician as he proved to be over the past few weeks. He got healthcare through. So maybe he has a master plan that involves using Republicans as a "foil" to win the 2012 election.
But he has more of a chance of winning with a Democratic congress. And he'd be foolish to assume that the Republicans learned nothing following what Clinton did to them in the 90s. Republicans can be dense, but I think they picked up a few pointers then about how not to become a foil (and let's not forget that, foil or not, a lot of conservative goods got done in the 90s).
49. Frank Gallagher
- 03/23/2010 7:46 pm CDT
Since we're engaging in friendly political speculation, I'd like to suggest a more optimistic spin on the (surprisingly strong) possiblity that the Republicans might take over the House or Senate in 2012. Not that it's better for Obama, but actually better for the country to have a Dem prez and Rep congress. That Obama might actually get Social Security reform through a Republican congress that he wouldn't be able to otherwise, and that no Republican prez would dare propose. Sort of like Clinton getting welfare reform through or Nixon going to China.
50. Frank Gallagher
- 03/23/2010 7:51 pm CDT
And just because I think David Brooks is the voice of sanity in an insane political landscape:
http://www.nytimes.com/2010/03/23/opinion/23brooks1.html?src=me&ref=general
In the context of his other columns on health care reform, I think he's saying that this final passage can either be a triumph or a disaster. It depends on what comes next.
51. Quaid
- 03/26/2010 8:49 am CDT
"Winning is always better than losing."
Exactly. They hope to win in 2012. After that, if successful, they work hard to get Dems the control again so they can pass a bunch of stuff in the final two years.
I think Obama skates into office with a Republican Congress, if the economy does any turning around at all. But if Dems maintain their majority in both realms of Congress, it will take more than a slight economical bump. He'll be out.
Why? Someone needs to be blamed for our problems. And no one buys that it's the Republicans fault we're in this mess, except for hard-core libs. If the Reps gain control, they can be the scapegoat for all our woes.
This all assumes the Reps put up a decent candidate who has strong ideas and can communicate. If Health Care rules the day as the main issue, it simply can't be Romney. His health care mess in MA is too similar to Obama's plan.
52. Bill
- 03/26/2010 1:20 pm CDT
Ok, I'll play along.
So, Quaid - you believe that in Obama's campaign war room they are purposefully planning on losing Congress to the Republicans in 2010, so that he can win in 2012? That's they're actual strategy?
He's already using Republicans as a foil . . .
53. Quaid
- 03/26/2010 9:23 pm CDT
"So, Quaid - you believe that in Obama's campaign war room they are purposefully planning on losing Congress to the Republicans in 2010, so that he can win in 2012? That's they're actual strategy?"
Yes.
"He's already using Republicans as a foil . . ."
Not at all effectively. He's using them, but it isn't "taking".
There's no traction. People don't buy it. They know that all the Republicans can do is talk. That's it. The Republicans have been "more" against the Dem health care reform plan than anything that I can remember in a long time and they were ultimately powerless to stop it.
I think the White House believes that things won't turn around enough by 2012 to convince us that they deserve another four years. They've already announced that unemployment will pretty much remain where it is throughout this calendar year. If it doesn't get better soon after that, Katy bar the door. (It's interesting to think that next year, candidates will already be in Iowa and New Hampshire)
At any rate, you don't have to play along with me if you don't really want to. I can pick up my toys and go home :) But I really believe what I'm writing.
54. Bill
- 03/26/2010 10:30 pm CDT
At any rate, you don't have to play along with me if you don't really want to. I can pick up my toys and go home :) But I really believe what I'm writing.
Wait! Wait! Quaid - of course you believe it, and I never meant to imply you were being anything less than sincere. Drat on me and my inability to express via impersonal blogging.
I know you believe this. I don't think you're crazy or disingenuous, I just disagree. I think Obama and the dems will do anything they can to retain the Congress in 2010, and - if they can - continue to build on their left of center legislative agenda.
But I've been wrong many times before. Agree to disagree . . .
55. Quaid
- 03/27/2010 8:12 am CDT
I think the disagreement centers on our beliefs about the motivations of the Obama camp.
I think we both believe the overarching philosophy of the Obama White House is that they want to permanently effect change in the government by expanding its reach and head towards more government controlled programs when it comes to any and every segment of the economy.
The difference comes down to my belief that they want to change the world, but think they'll need a full eight years to do so. So their primary motivation, in order to achieve their ultimate philosophical goal, is to get reelected. In the meantime, they'll do what they can without jeopardizing job one.
That's why I think there was such an urgent timetable for health care (as stated several weeks ago). If it drags on too much longer, it becomes detrimental to reelection hopes. After November and certainly by this time next year, we'll see most of the radical proposals for change evaporate into thin air as Obama attempts to center himself for 2012.
You seem to believe that getting elected is secondary to changing the world. Sure - they'll strive to get elected at any cost, except for their agenda.
So, (follow me here) I believe their agenda is secondary to re-election for the sake of . . . wait for it . . . their agenda (to restate, their agenda is primary for the long-term). You believe their agenda is primary in both the short and long terms.
All of my talk about who wants who to win rests on this theory.
56. Bill
- 03/27/2010 8:58 am CDT
So, (follow me here) I believe their agenda is secondary to re-election for the sake of . . . wait for it . . . their agenda (to restate, their agenda is primary for the long-term). You believe their agenda is primary in both the short and long terms.
I agree with you here. For me it's just more of a "that's a crazy strategy" reaction (when it comes to the idea that losing Congress would be good for Obama). Politics-heads think that stuff up, but I'm trying to picture the political consultant trying to sell to Obama the idea of losing Congress next year as a positive.
"Here's what we do, see. Hear me out on this - how about we purposefully lose the Congress next year!?" - I'm picturing someone out on their ear. I think Obama wants it all, retain democratic control of Congress, progress on his agenda, get re-elected. Losing Congress in 2010 has too much of a "First I'll access the secret military spy satelite that is in geosynchronous orbit over the midwest. Then I'll ID the limo by the vanity plate "MR. BIGGG" and get his approximate position. Then I'll reposition the transmission dish on the remote truck to 17.32 degrees east, hit WESTAR 4 over the Atlantic, bounce the signal back into the aerosphere up to COMSAT 6, beam it back to SATCOM 2 transmitter number 137 and down on the dish on the back of Mr. Big's limo... It's almost too easy" feel to it.
But we'll see. I just don't see them celebrating in the white house, even in secret, in November if they lose significant ground in Congress.
57. Bill
- 03/27/2010 9:34 am CDT
In summary, I think your scenario is "Plan B" if they lose Congress. But "Plan A" is to retain Congress. Plan A+ is to retain it and gain seats. It's a long time until election day.
59. Quaid
- 03/29/2010 7:03 am CDT
In case it wasn't clear earlier, let me also state that I don't think that Obama is actively working to get the Dems ousted. I think he's throwing caution to the wind, however, and putting their political futures far behind that of his own.
Essentially, it's like David pulling all of his troops so that Uriah might die on the front lines. Did David actively go out to kill Uriah himself? No. Did he "murder" Uriah? Yeah - definitely.
Obama will still be campaigning (for Dems who voted for Health Care) this fall, but his eye is on the prize in 2012. I think he views these next nine months as the last chance to push his agenda, Congress be dam*ed. After that - we're in campaign mode.
So the strategy isn't to get his party ousted, per se, but neglecting public opinion on legislation that affects 1/6 of our economy equates, in my opinion, to pulling back the army and leaving all of those Dems from conservative districts on the front lines, taking the sword for the king.
Leave a Comment:
Will they vote on the bill this week? Yes, this weekend.
Will it pass? They won't vote on it unless they already have the votes to make it pass, so yeah.
Will this be a good thing? I don't think so. The bill in question is full of blathergate and jabberwocky, will *not* be "deficit neutral" and will certainly not save money over the short or long term. But we'll be stuck with it so hopefully I'm wrong about it.