Saturday, June 13, 2009

Obamacare Proposals: '1984'-Type Newspeak in 2009

In late 1993 and truly getting going in 1994, the President and Mrs. Clinton unveiled a "Hillarycare" proposal for a new system of financing and organizing healthcare that had the advantage of being comprehensive and the disadvantage of being so unpopular that a solidly Democratic Congress never even brought any version of the plan to a floor vote.

The early portents from the 2009 version of Big Government-provided health care are worse, especially given that Mr. Clinton had the tactical brilliance to get a large tax increase in place before proposing spending lots of money to sort of socialize health care. The current President, unwilling to wait even one year for the economy to respond to his massive "stimulus" program, has in his proposal bowed to the bond market and proposed all sorts of cutbacks in care and tax increases. Since the majority of Americans have good health care coverage now, Mr. Obama has lots of selling to do. Worse, the language used to sell the program has become, predictably and sadly, Newspeak. Cuts in care are unspecified and unachievable "savings", efficiencies, productivity gains, and the like. These cuts are large and come out of bottom-of-the-barrel Medicare/Medicaid payment rates.

Those interested in the details may want to first review the White House's summary of its proposal, titled: Paying for Health Care Reform: $313 Billion in Additional Savings to Create a Deficit Neutral Plan.

Then, as an example of the practical problems involved, check out an article by a great friend of the President, the New York Times, from today with the understated title, Health Plan May Mean Payment Cuts. (Hint: "May" is the understated word.)

Or you may want to review's article, Obama Outlines $313 Billion in Health Care Savings, from which a brief section is copied here:

White House Budget Director
Peter Orszag said the additional revenue along with cuts and projected savings will cover the estimated $1 trillion cost of a health-care overhaul even if the final, total figures “are still undetermined.

“We are making good on this promise of fully financing health care reform over the next decade,” Orszag said in a conference call with reporters yesterday.

The administration’s cost estimates are lower than those of private analysts. Gail Wilensky, a former administrator at the Centers for Medicare and Medicaid Services, has said the cost may approach $1.5 trillion and other projections are as high as $2 trillion.

Given that that the Government cannot really "fix" the economy (to the extent that this remains a free enterprise system, an assumption that looks shakier by the month), but it can "fix" the health care "system", then it is incumbent upon the majority party to pass something that it believes in, no matter what the electoral consequences are. It did nothing in 1994 and got whipped big-time anyway.

Bob Woodward reported in "The Agenda", about Bill Clinton's first year in office, that he rejected enacting catastrophic rather than comprehensive soup-to-nuts health care coverage for all Americans as not grand (grandiose?) enough, even though covering catastrophes only would have passed very easily. That would have been a camel's nose under the tent, easy to expand upon. Will the Democrats go for an all-or-none approach again? If finances do not allow a huge program now, what's wrong with incrementalism?

A new President replacing an unpopular departing one, with a fawning press corps that in some mainstream circles is now comparing him to G-d, has had things almost all his way. A less popular new President, Bill Clinton, was able in 1993 to get a not-very-popular tax increase through by the narrowest of margins.

There is no predicting what will happen next in this battle.

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