New York Times's Brooks Misses the Politics of Healthcare Reform
By Robert Schlesinger, Thomas Jefferson Street blog
David Brooks has a typically interesting column in today's Times arguing in favor of ending the tax exemption on employer-provided health benefits specifically and more broadly for a health overhaul plan (which contains that idea) cosponsored by Sens. Ron Wyden, an Oregon Democrat, and Bill Bennett, a Utah Republican. But Brooks makes the mistake of assuming that because an idea makes practical sense it is politically viable.
Now you might think that in these circumstances someone might take a second look at the ideas incorporated in the Wyden-Bennett plan, which already has a good C.B.O. score, bipartisan support and a recipe for fundamental reform.
If you did think that, you are mistaking the Senate for a rational organism.
This laudable proposal, Brooks continues, is being ignored by villainous committee chairmen and their staffs, not to mention "the left," unions, and so forth. "Campaign consultants are horrified at the thought of fiddling with a popular special privilege," he writes.
Actually the Wyden-Bennett approach is unlikely to gain any traction because the Senate is a rational organism. As Washington Whispers reported yesterday (and Bonnie noted this morning), a mere 3 percent of respondents in a recent poll supported taxing employer-paid benefits. Supporting a huge public policy proposal that has only 3 percent popularity is the very definition of lacking political rationality ... unless you're in a very safe Senate seat.
And a perusal of the bill's cosponsors shows (h/t to the excellent U.S. News library for compiling the data) a list almost entirely composed of safe senators. To wit:
- Wyden: Up for re-election next year, but won 63-32 in 2004 and is listed by Charlie Cook as safe.
- Bennett: Also up in 2010, but won by an even wider margin, 69-28, last time out.
- Lamar Alexander, a Tennessee Republican who won re-election last year with 65 percent of the vote.
- Maria Cantwell, a Washington Democrat who won re-election in 2006 by a 17-point margin (57-40) and is not up for another four years.
- Mike Crapo—my personal favorite—an Idaho Republican who re-election in 2004 with, wait for it, 99 percent of the vote.
- Lindsey Graham of South Carolina, a Republican who won re-election last November with 58 percent of the vote.
- Judd Gregg, a Republican of New Hampshire who might have faced a tough re-election fight next year ... if he weren't retiring.
- Daniel Inouye, the Hawaii Democrat who won re-election five years ago with 76 percent of the vote.
- Mary Landrieu, a Louisiana Democrat who had what passes in this group for a tough re-election fight, winning 52-46 last November—but won't face voters again for six years.
- Joe Lieberman, the McCainiac "Independent Democrat" who is still four years away from his next election.
- Jeff Merkley, the junior Democrat from Oregon, who won a narrow election but won't face voters again until 2014.
- Bill Nelson of Florida, a Democrat who won re-election with 60 percent of the vote in 2006.
- Debbie Stabenow, a Michigan Democrat who scored a 16-point victory (57-41) in 2006 and so won't stand for re-election until 2012.
There's one interesting name on the sponsor's list: Arlen Specter, Republican-turned-Democrat of Pennsylvania. I don't know the Pennsylvania electorate well enough to say for a certainty that "he wants to tax your healthcare benefits" will be as damning a political attack in a primary or general election race as it sounds on my computer screen, but we can be sure that Joe Sestak and Pat Toomey plan to find out.
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Tags: healthcare | politics | Senate
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Reader Comments
costs of healthcare or heist of the millenium
Re: Healthcare cost debate or “heist of the millennium”
Dear Sir or Madam,
It troubles me when I hear endless discussions about little things that don’t really matter that much while avoiding the most fundamental problem.
Here is what I think it is:
It is a well known fact that At 16+% of GDP or 2.2 trillion dollars per year American healthcare costs twice as much as healthcare in any other developed country, while the outcomes (morbidity and mortality) are worse and 15% of the population (45 million) is not covered. Unfortunately the debate at this point focuses only on the 45 million people that are not covered and how to find even more money to cover them. In addition an argument is frequently made that American healthcare is the best in the world, without any evidence to prove it, and thus needs to be preserved. At the end of the discussion a passing reference is usually made to the need to do something about the rising costs.
What about the costs that are already there?
Unfortunately, not a single person said this – by doing simple arithmetic, based on the above facts, one can easily arrive at the following - If this extra 8% of GDP isn’t producing any improvement in the health of this nation, then it is a WASTE?
In other terms, more than 1 trillion dollars per year goes to the “Medical industrial complex” without producing any benefit for the country. Clearly this amounts to massive and systematic wealth transfer, comparable to the Wall Street deeds over the last few years. This astronomical amount of waste exceeds the GDP of the most countries in the world. And there is nothing to show for it.
So this trillion dollars is either stolen or wasted every year and it is rising at the rate of 12-15%per year.
Who pays for it? We, the taxpayers, through lower wages, higher taxes and insurance premiums.
Some of this extra $1trillion/yr cost is illegal (like overbilling, etc), some is borderline, although should be illegal (like price fixing by the providers in the particular part of the country), some has to do with plain mismanagement, but most of it is probably legal and done “by commission or by omission”. In other words, it had to be intentionally designed into the system.
This system is designed to “be best at being the most expensive”. One can only imagine the amount of influence the stakeholders on a receiving side can afford to buy with just 5 percent of this extra trillion dollars per year.
One can also imagine that if this waste were to be eliminated, assuming that the government had the courage to do it (and no one else can even try to handle this task), the savings to the economy would be sufficient not only to cover the 45 million people (this would cost less than 100 billion dollars per year), but also, enough to rebuild the whole American industrial and transport infrastructure within just a few years.
If so, then the whole different set of issues has to be discussed:
1. Why is this 1 trillion dollars continues to be wasted? Why is this allowed to go on? How do we as a nation get our 1 trillion dollars/year back?
2. Who are the main beneficiaries of this 1 trillion/yr of national wealth transfer and who allowed them to do this to us? Where specifically is all this money going, to whom?
3. Why do the lawmakers, the law enforcement, federal and state governments allows this to go on? Who and why allowed this to happen?
4. how do we get the healthcare cost down to 8% of GDP? How and when will this nation get its 1 trillion dollars/year back
5. Who will be responsible to stop this “heist of the millennium”?
Even Pres. Obama hinted in one of his earlier speeches that this problem is so bad that it might bring this country to bankruptcy (and as such is a matter of national security).
Unless we address these issues, rather than talk around them, we don’t stand a chance as a nation.
The Honest Doctor
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There would not be such opposition
to ending the tax-free status of employer-provided health insurance if people understood they would be getting something in return:
1) a PUBLIC plan you can always buy into
2) a PUBLIC plan to control costs
3) a public plan to set the standard of what "good" health insurance is to be and include
4) an end to worries over pre-existing conditions
NO ONE would ever go bankrupt over having benefits taxed. At the moment, many people can and do go bankrupt all the time with our existing "system".
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