Healthcare

A bridge too far

President Barack Obama will announce his revised, new, new, “this time really new” health plan today.

Allegedly, this new (did I mention it was new?) version will take into consideration Republican suggestions such as an “experiment” on medical malpractice, among other elements, discussed during last week's summit.

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A matter of process

Behind closed doors at the Capitol, Democrats are counting heads. Reconciliation, or what Democrats are calling "an up-or-down vote" or "a simple majority," is the last train out of the station for healthcare reform.

With even more retirements, the number of votes needed in the House may end up being 216 or 217 and in the Senate it stands at 50, since Vice President Joe Biden can step in and vote to break a tie. As of now, leadership doesn't have the votes in either chamber.

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The fallacy of the neutral default position

Republicans leaders handpicked Sen. Lamar Alexander (Tenn.) to make their opening statement at the Blair House healthcare summit. The central point behind Alexander’s opening statement was that the United States Congress, and government more broadly, don’t do big, comprehensive reform well and consequently should drop the current bill and start over with some sort of incremental plan: “Our country is too big, too complicated, too decentralized for Washington, a few of us here, just to write a few rules about remaking 17 percent of the economy all at once.”

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Summititis

The president has a bad case of summititis.

The man loves himself a good summit. He especially loves to talk at summits. According to time-keepers who pay attention to this sort of thing, the president out-talked not only all of the Republicans combined. He out-talked all of the Democrats combined as well.

I can understand why he would out-talk the Democrats. When you have to prop up the likes of Harry Reid and Nancy Pelosi, you might as well just keep on talking.

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KISS: Keep it simple, stupid

Obama is exactly right: Americans want the healthcare system fixed. Obama is exactly right: Republicans don’t have their own comprehensive plan. Obama is exactly right: Republicans are the “party of no” when it comes to this bill.

But though Republicans might lose today, Obama’s going to lose even worse for simple reasons: Americans hate this bill more than they want the system fixed. They hate this bill more than they care whether the Republicans have an alternative comprehensive overhaul. And they hate this bill more than they do the “party of no.”

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Logical healthcare reform

The United States spends twice the money as the next closest nation on healthcare per capita. Many of these countries have found phenomenal success in spending less, and with highly touted results in healthcare. The key to our success is to drastically remove the cost from our system. How do we then take advantage of the strengths that already exist in our current system? All of our diseases and procedures are categorized and coded. Our computer systems are unmatched in the world, which clearly indicates that we can do billings and collections electronically in an instant without needing mountains of paper and armies of people to push them around. This, of course, has created enormous administrative cost that is absolutely unnecessary.

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Will Americans object to reconciliation?

Senate Majority Leader Harry Reid (D-Nev.) has signaled that the way forward on health reform is through the reconciliation process. Republicans are predicting a backlash to this tactic; however, if they pay attention to the success of their own arguments, they might be disappointed by the forthcoming response from voters.

Let’s recap a bit. Republicans have successfully eroded public support for the process of health reform (the major components of health reform remain popular on their own) by arguing Democrats in Congress made distasteful backroom deals to satisfy the parochial interests of industry groups and obstinate senators. Republicans were able to paint health reform as an example of Congress at its worst: selfish, opaque and ineffectual.

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The REAL public view on healthcare

“Scrap it” … “Start over” … “Obama’s Waterloo” … “The public hates it” …

If you listen to some of the Republican rhetoric on the public’s view of healthcare, repeated over and over, you would come to the conclusion that the American people are not solidly behind change in the system.

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Senate should pass a compromise public option by majority vote

The president has left the public option decision up to Senate Democrats, who should fight for and win a compromise public option that would be open to states that opt in, and would return budget savings from the public option back to participating states to finance jobs programs.

In short, states that want the public option could have it. Those states, which offer stronger healthcare programs, would be rewarded with the money saved by the public option being plowed back to those states to create new jobs in those states.

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