HCR Repeal?

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Health Care

While the Right is in an uproar, screaming for news media to correct the “error” that the Right’s paranoid, eliminationist rhetoric might have been an influence in the Tucson shooting, as well as several others — this is what Orwell would call a “thought crime,” I believe — they are silent about some of the actual and verifiable lies reported in media everywhere.

For example, regarding the recent CBO report that said repealing health care reform would put a dent in the federal budget “in the vicinity of $230 billion” in the first decade — the GOP claimed that the HCR law will crank up federal spending to ruinous heights. And how did they figure that? By including spending that has nothing to do with the HCR law and which will happen anyway, even if it is repealed. For example, they are still trying to pin the cost of the “doc fix” on the HCR law, when it is really the fault of legislation passed back in 1997.

Anyway, House Republicans plan to put repeal of health care reform on the agenda for next week. It’s not going to happen, and not just because such a repeal (probably) would not pass in the Senate or survive a presidential veto. It’s not going to happen because the insurance industry doesn’t want it to happen. Industry bean counters have figured out that that 30 million new customers is nothing to sneeze at, which is what the individual mandate will give them.

So, the lobbyists have gone forth to tell their lapdogs Republican legislators that they had better back off the individual mandate.

For the insurers, the worst-case scenario would be if the “guaranteed issue” provision — that insurers can’t refuse to cover people with pre-existing conditions — remains in effect but the individual mandate is repealed. That really could be disastrous to the private insurance industry. So, that ain’t gonna happen.

Here’s the more interesting question, proposed by a diarist at Daily Kos (via Moonbat). They’ll keep the individual mandate, but eliminate …

… guarantee issue (cannot be denied insurance even at high cost due to pre-existing conditions) and community rating (price for insurance is not based on your individual risk, which is needed to make guarantee issue meaningful), the limits on medical expense ratio (insurance companies have to use the money to pay for health services, not overhead, marketing, profit and their own salary) and protection against rescission (dropping your coverage and refusing to pay once you get sick).

However, if the individual mandate remains but guaranteed issue and protection against rescission are dropped, it would leave millions of Americans with no way to purchase health insurance on the so-called “free market.” So either the individual mandate would have to be scrapped, or government would have to step in and provide a public “solution” — either make the “uninsurables” eligible for Medicaid or something similar, or set up a subsidized “public option” insurance program for people dumped by private industry. And that option (unlike the original one) would have to be subsidized by taxpayers up the wazoo because that risk pool would be filled almost entirely by higher-risk customers.

Bottom line — logically, the individual mandate and guaranteed issue cannot be separated; one can’t work without the other. That, of course, doesn’t mean the GOP won’t try to separate them, even if it means screwing the taxpayer. However, I agree the medical expense ratio limitation could be vulnerable.

Update: I forgot to mention — Republicans still have only the vaguest of notions of what they would provide in place of last year’s HCR law. Alex Seitz-Wald writes for ThinkProgress,

On Fox News Sunday today, conservative Weekly Standard Editor Bill Kristol could offer only the vaguest of promises about the replacement. When Fox News contributor Juan Williams challenged Kristol to explain “what are you going to replace it with?”, Kristol told Williams not to worry, because there would be hearings in a few months and Republicans would probably come up with something by then. …

… Just days away from the repeal vote, House leaders have no coherent plan to address health care if their repeal effort succeeds. The Washington Post’s Amy Goldstein reports that “according to GOP House leaders, senior aides and conservative health policy specialists, Republicans have not distilled their ideas into a coherent plan.

In other words, all those stacks of paper Republicans were waving around last spring and calling “their plan” were just props, as I said.

Update: See also “The Truth and Consequences of Repeal” and “‘Job-killing’ regulation? ‘Job-killing’ spending? Let’s kill this GOP canard.”

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19 Comments

  1. c u n d gulag  •  Jan 17, 2011 @8:58 am

    “Yo, give me a hand here.”
    “What do you want?”
    “Hand me that TNT over there.”
    “Why?”
    “I’m gonna blow this here building up.”
    “WHY?”
    “‘Cause you built it.”
    “But people are just starting to move in.”
    “That’s the problem. Gotta blow it up before people start to like it,”
    “What are you going to build in it’s place?
    “In it’s…. buil… Hey, what are you, some kind of SocialistFascistCommunist or something? DEstruction’s MY game. CONstruction’s someone elses. Now, hand me that TNT!”

  2. c u n d gulag  •  Jan 17, 2011 @9:32 am

    An addendum:
    “WAIT! We used YOUR plans and blue-print!”
    “Why?”
    “We thought you’d like it. That you’d support it.”
    “What if you hadn’t? What if you designed it yourselves?”
    “Well, the building would be a lot taller and wider, and could fit everyone in it.”
    “So, you’re saying you used our ideas to build this thing?”
    “Yes!”
    “Then I know it sucks. Hand me the TNT!”
    “But at least it’s a start, we can buil…”
    KABOOM!

    This whole ‘job-killing’ repeal BS is Kabuki. Their Corporate Overlords will let them dance and preen for a little while, then close the show. And then it’ll be onto the “Debt Ceiling” dog-and-pony show. More Kabuki.

  3. jugheadjack  •  Jan 17, 2011 @10:41 am

    I don’t know if the repubicans have the know how to come up with a different health care plan. They certainly don’t act like they do, and besides their over lords in the health care industry wouldn’t let them. I think they should stick to cutting taxes, and of course cutting their pay in half, because we all know that the lobbyist, pay them well also, so they are right now recieving a pay check from the Amreican people through taxes, they are also recieving pay checks from lobbyist. No small wonder that these self serving people want to serve in the house or senate.

  4. maha  •  Jan 17, 2011 @11:26 am

    I don’t know if the repubicans have the know how to come up with a different health care plan.

    I don’t think they do. Last year what they were calling health care plans were more like wish lists. Beyond some vague promises to establish committees and commissions, they provided no clue as to how they were going to achieve the wishes.

  5. c u n d gulag  •  Jan 17, 2011 @11:27 am

    jugheadjack,
    And think of the benefits they get! They’re very well covered while they legislate to cut any you or I might ever get, or try to take advantage of.

  6. c u n d gulag  •  Jan 17, 2011 @11:55 am

    They don’t have a health care plan of their own because we basically adapted theirs as ours hoping that they’d go along for the ride. But instead of going along for the ride, they’re more than content to stand on an overpass and hurl boulders down, hoping to snarl traffic and progress. That’s what’s known as “Leadership” in their circles.

  7. moonbat  •  Jan 17, 2011 @2:40 pm

    I was lying in bed and this bizarre notion came to me. Obama pushed what essentially is Romney-Care on the country, and despite great obstacles, got it passed. The Republicans are screaming and howling about it, and it will be a year or so before we know how well it survives.

    Eventually all its provisions kick in, and the public gets acquainted with how well or how badly it works. You will see reports of how expensive it is, compared to other countries – things that lefties already know, and that even the Wall Street Journal acknowledged. This will ultimately lead to a push for single payer, years from now, to replace it.

    In my twilight reverie, I was half dreaming that maybe Obama saw all of this, but but felt it was necessary to give the Republicans the rope they need to hang themselves, so their system can be tried and disproved by the whole country, before we can move on and get the much better solution of single payer, long after he’s gone.

  8. Felicity  •  Jan 17, 2011 @3:01 pm

    I remember reading that often uninjured people die immediately after a crash or other disasters because the mind is unable to focus. Its ability to focus deteriorates in survival situations when sound decision making is essential. If I substitute ‘uninjured people’ with Republicans, their behavior may be explainable, they’ve lost their marbles?

  9. Tim  •  Jan 17, 2011 @4:46 pm

    Krugman’s column is based upon three assertions. Number one, that the large divergence in the cost of a mortgage versus an inexpensive dinner is comparable to the cost of future fixes versus the total cost of health care reform. Let’s consider that one first. The average monthly mortgage payment is around $1,750. An inexpensive dinner for two is around $50. Krugman tells us the cost of fixing Medicare for 10 years is $208 billion. The CBO’s revised estimate for health care reform, which does NOT include the Medicare fix, is $1,055 billion. (The Republicans say that the total will be $2,600 billion, but we’ll go with Krugman’s favored estimate just to be fair to him.)

    So, the Nobel Prize-winning economist Krugman is claiming that 1750/50=208/1055, or that 35=0.197. And you wonder why the economy is in such dire straits…

    Number two, Krugman is assuming that the Medicare fix is as inevitable as a mortgage payment. But this quite clearly isn’t the case; whereas not making the mortgage payment entails losing the house, (or at least it did back when mortgage banks held legitimate title to houses and were actually willing to foreclose on properties and write off the bad loan), the possibility that doctors might elect not to see Medicare patients hardly makes increasing Medicare payments a necessity. There are other options available that don’t require spending the money, which is not the case when it comes to making mortgage payments.

    Number three, Krugman declares that “the modern G.O.P. has been taken over by an ideology in which the suffering of the unfortunate isn’t a proper concern of government, and alleviating that suffering at taxpayer expense is immoral, never mind how little it costs.” But if this were actually the case, then the modern G.O.P. would simply solve the budgetary problem by not spending the $208 billion instead of insisting that it be counted as part of the cost of health care reform. Even if we ignore the fact that this is the fiscally responsible decision as well as the Constitutionally correct thing to do since Medicare is not a legitimate function of the federal government, Krugman’s failure to realize that the Republicans are not advocating this only underlines his complete logical incoherence.

    Far be it from me to defend the Congressional Republicans, but for all their ill-conceived enthusiasm for illegitimate military adventures, a war on logic is not one in which they are presently engaged. It is instead Paul Krugman who is waging a public one-man crusade against it.

  10. maha  •  Jan 17, 2011 @8:47 pm

    Tim: I responded in a separate post: http://www.mahablog.com/2011/01/17/12626/

  11. uncledad  •  Jan 17, 2011 @4:47 pm

    “Republicans have not distilled their ideas into a coherent plan”

    Why didn’t leader Boner just have a cocktail party for the republicant members? I believe it was the same day as the Tuson Memorial, surely they must have distilled some ideas then!

  12. c u n d gulag  •  Jan 17, 2011 @5:50 pm

    “…since Medicare is not a legitimate function of the federal government,…”

    Of course, far be it from YOU to defend the Congressional Republicans!
    Uhm, Tim dear, you kind of gave yourself away with the line I quoted. So, I’m calling you on your bullcrap.
    Do come back when you have a Doctorate in Economics, teach at a world reknowned college, and have an Op-ed column in the NY Times.
    Until then, you’re just a (semi) concern TROLL.

    “And you wonder why the economy is in such dire straits…”
    No, actually, I don’t. I know. And it has nothing to do with Krugman and little to do with the Democrats.
    But thank you for asking…
    ‘Far be it from me to damn the Congressional Republicansm though…’

  13. slimslowslider  •  Jan 17, 2011 @6:33 pm

    Tim’s comment at 4.46 is lifted from the Vox Populi blog.

  14. gypsy howell  •  Jan 17, 2011 @6:34 pm

    That’s why I plan to ignore the whole stupid debate. The republicans are just using it to blow a bunch of smoke up the teabaggers’ asses, to get them to fork over campaign donations to their corporate-sponsored overlords in Congress.

    Much ado about nothing. Much like most of the crappy HCR bill that was passed.

  15. Jennifer  •  Jan 17, 2011 @6:40 pm

    So, the Nobel Prize-winning economist Krugman is claiming that 1750/50=208/1055, or that 35=0.197. And you wonder why the economy is in such dire straits…

    Um…that equation should be 1750/50 as 1055/208. The numbers look like this: 35 : 5.07. Seven times, but not 178 times bigger than each other. I suspect you aren’t a Nobel Prize winner, though…

  16. c u n d gulag  •  Jan 17, 2011 @6:55 pm

    Jennifer,
    No, but Tim stayed at a Holiday Inn last night! 🙂

  17. Bill Bush  •  Jan 17, 2011 @7:36 pm

    Tim, I have a degree in English, so my math skills are focused on understanding what a word problem is really asking and determining which numbers represent the aspects of the question. Of course, that includes determining whether there is sufficient information present in the problem as presented to allow an answer at all. I read the Krugman article this morning, and I don’t think he was presenting a formula.

  18. maha  •  Jan 17, 2011 @8:45 pm

    I read the Krugman article this morning, and I don’t think he was presenting a formula.

    Exactly right. Krugman was presentng an analogy, not a formula, which flew right over “Tim’s” head.

  19. c u n d gulag  •  Jan 17, 2011 @7:37 pm

    Poor Tim,
    What a @#$%ing loser. You can’t even be original enough to come up with your own criticism.
    Bye, TROLL!

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