Fred Hiatt's Strange Argument

by publius

You'll be shocked to learn that Fred Hiatt opposes the public option.  You'll be further shocked that his argument doesn't make much sense.

Hiatt's main concern is cost control.  He thinks (maybe correctly) that Congress is punting on controlling costs.  Instead, Hiatt wants Congress (1) to impose taxes on employer-provided health care benefits; and (2) to cede their power over Medicare reimbursement rates, etc.  (For the record, the Baucus bill includes the latter -- along with many other promising cost-reducing measures).

Nothing crazy so far.  But Hiatt goes off the rails when he tries to blame these cost problems on the public option itself.  The logic, as I understand it, is that adopting the public option prevents Congress from taking "real" steps on cost controls.

I'm sorry, but this is just gratuitous swiping.  For one, the public option would lower costs, particularly if it were expanded.  Second, precisely zero of Hiatt's cost concerns would be addressed by removing the public option.  All of the problems he cites will exist even if the public option gets scrapped tomorrow. 

Now, maybe that's a reason to criticize Congress, but it's no reason to criticize the public option.  These are just analytically distinct points. Congress is dragging its feet on cost-cutting because cost-cutting is politically treacherous.  The public option has nothing to do with it. 

The real story here is that Hiatt just really dislikes liberals.  His argument, frankly, seems more motivated by animus than by policy concerns (note the swipe against unions).

Of course, DougJ at Balloon Juice says all this more succinctly than I could:

To summarize here’s shorter Hiatt/Samuelson: the public option may not fully address increases in health care costs, so we shouldn’t have one.

That pretty much sums it up.

Comments

[Jay Jerome]

Publius, I don't have time or inclination to argue with you about your fixation on the public option (which probably aint gonna happen, except as a fall back, (as I predicted here back in Sept 08,2009 at 02:00 AM) -- but this may give you perspective on another option, from an academic who seems to know what he's talking about.

Read This

And This

And especially point (d) on raising federal revenue at this link, which offers an interesting way to finance it all

[cleek]

it is shocking to learn that a paper who will publish any nonsense from any conservative who wants to speak is working to hurt the Dems. shocking. really shocking.

[kyllaros]

@Jay: I'm not sure what you're taking away from those articles, but the author is clearly not negative about the public option. He seems to be just trying to clarify that he doesn't believe that the public option is an essential element of reform, though it might be a very nice thing. That's a common refrain from certain quarters, like say, Obama. There are surely arguments to be made about how necessary the public option is to reform, but most credible analysts agree that it's not bad thing (this is assuming that it is a self-sufficient type of public option - aside from the initial seed money, the government has no future financial obligation to the new public insurance company).

[dan]

A German-style plan would be great if America had anything like Germany's stomach for actually regulating any of its industries. Unfortunately we have a political system infested with Republicans and Hiattesque pseudo-moderates so we need to have a great big third rail of a public program as a guard against an eventual Republican resurgence and subsequent regulatory vandalism.

[Hartmut]

The GOPsters are already marshalling their troups to undo HCR the moment they get back into power (which they assume will be as early as 2012). I hope the openness about that goal alone will suffice to let it* fail but who knows?

*the goal not HCR

[Jay Jerome]

kyllaros: "the author is clearly not negative about the public option. He seems to be just trying to clarify that he doesn't believe that the public option is an essential element of reform, though it might be a very nice thing."

Right, it could have been a nice thing (if you had a savvier president and administration in office pushing the buttons) but there's not going to be a viable public option (except possibly as a kick-in trigger sop to keep Liberal Dems from throwing temper tantrums and refusing to vote for whatever 2nd rate, compromised, budget busting, bill finally is presented).

Therefore it's time for Publius and everyone else to stop moaning and groaning about other people criticizing the DOA public option and concentrate on what can be salvaged from the grotesque Chimera that's out there now -- like how to pay for it (Reinhardt's one-half of 1 percent suggested federal sales tax on retail sales for instance...)

[I Hate Chavs]

Right, it could have been a nice thing (if you had a savvier president and administration in office pushing the buttons) but there's not going to be a viable public option (except possibly as a kick-in trigger sop to keep Liberal Dems from throwing temper tantrums and refusing to vote for whatever 2nd rate, compromised, budget busting, bill finally is presented).

I agree that a better president might make a difference. But Jay, there's no way some bullsh*t trigger is going to keep this liberal dem from throwing a temper tantrum. An individual mandate without a public option is a giveaway to to the murderous insurance industry, plain and simple. If there's no public option this bill needs to be filibustered. Actually, progressives need to start thinking right now about putting a primary challenge together for 2012. If Obama signs a bill without a public option, I'll fight him in the primary and if that doesn't work I'll hold my nose and vote Republican.

[kyllaros]

@I Hate Chavs:

Yes. That type of thinking worked really well 2000. No matter how much Obama is annoying you right now, it is almost impossible that you would be anything but enraged by the actions of this hypothetical republican president. If, in what I consider to be an unlikely case, a HCR bill gets passed without a public option, there is still a lot in it to like. There a lot of new regulations that help end some insufferable abuses by insurance companies. In addition, it would still be possible to pass a public option separately by reconciliation (the CBO has indicated that the public option does in fact save money, so it passes the budgetary test). Finally, the Senate bills have to be merged and then House bills have to be merged. Those both have to pass their chambers. Then they have to go through the conference committee. There are so many times that the bills can be modified between now and the end that a lot of the kvetching is a bit silly. The Whitehouse and Reid have different ideas on what the strategy for the end game is. Reid thinks it would be beneficial for his reelection to show some spine and have the fight over the public option now rather than in conference. Obama thinks it is better to delay the fight over the public option to the conference. Obama's preference is clearly to bypass a filibuster threat by initially passing a weaker public option and then revising it in conference (which I believe cannot be amended or filibuster). There are obviously pros and cons to both approaches. Reid's version could fail spectacularly. If that happens, it will be hard to pick up the pieces. On the other hand, it does help reassure a flagging base. Obama's strategy could fail if the stronger version doesn't materialize in conference. It could succeed by getting a much stronger option than the Senate could muster by itself.

[I Hate Chavs]

No matter how much Obama is annoying you right now, it is almost impossible that you would be anything but enraged by the actions of this hypothetical republican president.

You're probably right. I don't actually want to see a republican president. But we have to be able to make a credible threat to Obama, or he'll keep playing us for suckers. This worthless motherf*cker has done nothing but spit in the left's face since he came into office. He doesn't even have the balls to repeal don't ask, don't tell. Axelrod and Rahm have made a calculated decision that progressives don't matter. So they feel safe in ignoring us.

That type of thinking worked really well 2000

I voted for Nader in 2000, and I don't regret it. I thought that screwing Gore and allowing Bush to (allegedly) win, would teach the Dems that we wouldn't accept this Dick Morris triangulation crap anymore. For a second, I was naive enough to think it paid dividends in 2008. But Obama is even worse then Clinton. Barack needs to go. As long as the left accepts phony progressives like B-man, the real left will remain permanently marginalized. I sick of being told to shut up, fall in line, and don't complain about the D's because the R's are worse. Enough is enough.

[kyllaros]

I just don't buy the line (I don't know if this is you, but I hear it a lot on the leftier blogs) that anything short of a result that leaves bankers and insurance execs on the gallows means that Obama is a corporatist. Canada's much praised health care system didn't spring fully formed from the legislature. It took several steps to get where it is today. The current HCR bills all take us at least one step down the road to a sensible health care system; some of them manage more than one step. There is continual talk coming out of Washington about financial reforms. I know that Reich has given up on the Obama administration to get decent financial reform, but it's hard for me to not think that he's jumping the gun with that proclamation. And again with don't ask don't tell, it sounds like hearings are starting up this week. If at the end of 4 years, DADT is repealed, reasonable financial reform is passed and HCR is passed, will you decide that maybe you were a little too hasty with your condemnation?

For all the talk that Obama is such an ineffective leader, the stimulus bill was passed in a relatively short time, and the HCR has already gotten farther than any other attempt. It feels like he's not being judged on a reasonable metric.

[kyllaros]

Also, apropos of nothing in particular, I really hate the undefended assertions that get made in the media all the time. 1) the public option is welfare/will bankrupt us etc - most versions of the public option are paid for through premiums, and as such, there is no sense in which it can be called welfare. Ben Nelson said this at one point despite the fact that he seems ok with subsidies for lower income people (which could more legitimately be called welfare). 2) people assert that unions will never allow a tax on very high premium insurance plans (cadillac plans) because unions have better health coverage than normal - as far as I can tell, that's completely untrue. The average union insurance plan costs only very slightly more than the unrestricted average, and it's well below the $21,000 price that the tax would apply on. 3) tort reform is anathema to Democrats because trial lawyers are a major constituency for them - find this very hard to believe. Many Democrats dislike the sort of heavy handed tort reform that Republicans suggest because capping awards could be an impediment to justice (if a medical error causes you to lose both your legs, is $250,000 really a just compensation?).

[PaulB]

Right, it could have been a nice thing (if you had a savvier president and administration in office pushing the buttons)

Oh, please... Congressional Republicans would have been just as adamantly opposed to the amount and kind of industry regulation that can replace a public option, and without that regulation, you could not have a viable alternative to the public option. The public option is actually easier to pass.

but there's not going to be a viable public option (except possibly as a kick-in trigger sop to keep Liberal Dems from throwing temper tantrums and refusing to vote for whatever 2nd rate, compromised, budget busting, bill finally is presented).

You are assuming facts not in evidence at this time, given that both the Senate and House bills include a viable public option. It's possible that Senate Republicans can muster the necessary votes to filibuster the result but Reid does not seem to think so. Moreover, if he takes the reconciliation route, they cannot filibuster.

Therefore it's time for Publius and everyone else to stop moaning and groaning about other people criticizing the DOA public option

Or tell those "people criticizing the DOA public option" to actually pay attention to reality? Sorry, but yours was a silly, and pointless, post.

[PaulB]

I just don't buy the line (I don't know if this is you, but I hear it a lot on the leftier blogs) that anything short of a result that leaves bankers and insurance execs on the gallows means that Obama is a corporatist.

I think that there were two things driving this: the first is the Obama administration's side, and hidden, agreement with a few of the major players, an agreement that appeared to give away far too much, and the second was the complete abandonment of the single-payer option and the apparent willingness to abandon any public option.

Obama started negotiations having given away entirely too much, both to corporations and to Republicans. You just don't do that, not if you're serious. Was some of the criticism overblown? Sure. Was a lot of it justified? Yup.

[J. Michael Neal]

Obama started negotiations having given away entirely too much, both to corporations and to Republicans. You just don't do that, not if you're serious. Was some of the criticism overblown? Sure. Was a lot of it justified? Yup.

What was his alternative? If we had started this fight with not only the Republicans unanimously opposed, but also all of those interest groups on the air immediately with poisonous ad campaigns, this effort would have died in June. It would have been the teabagger campaign run by much more competent, and less crazy, people. The way Obama played it, only one of the interest groups broke ranks, and did so far too late to be effective.

To get large scale reform, you need either some moderates from the other party, or all of the important interest groups to support you. Without them, it doesn't happen.

[Jesurgislac]

Wow, I have to go back to October to find a healthcare thread.

Okay: a cute little video called If Blue Cross Ran The Local Deli.