It depends on the yardstick

by von

The CBO's numbers are out on the GOP's health care plan and they are .... well, not bad.  If you measure it by the right yardstick, that is. 

Yes, this is gonna be one of those von posts that generates a little fire in the comments among our left-leaning commentators.  You're just gonna have to ride it out.

The important thing to realize is that the GOP plan is not a comprehensive reform effort.  It has a small but measurable impact on the uninsured.  I'll readily concede, however, that the small-but-measurable is all-but-negligible when it comes to the scope of the problem.  The GOP plan doesn't do anything that I can tell to resolve the problem of covering folks with preexisting conditions. Nor does it separate health insurance from employment -- the bete noir of the current health insurance market, at least for me.   

If you assess the GOP's plan by the yardstick of incremental improvements, however, it isn't bad at all.  The GOP plan cuts the deficit by $68 billion over ten years.  It cuts insurance costs for current enrollees "by 7 percent to 10 percent in the small group market, by 5 percent to 8 percent for individually purchased insurance, and by zero to 3 percent in the large group market."  The health-insurance haves -- who are the vast majority of people -- probably gain more under the Republican plan than under most Democratic proposals.  Republicans can also claim that their plan helps the "have nots" a bit, although, as noted above, it's a very little bit.  And the GOP does all of the above without raising taxes or cutting Medicare spending, unlike Democratic plans. 

Now, nothing in the GOP plan will satisfy someone who thinks that the current system requires immediate reform.  And the GOP plan is ultimately unsatisfying to me because it defers a lot of the hard choices.  On the other hand, if you think that the Democratic plan is worse than the status quo, maybe a little deferring is a good thing. 

And there's the political problem for Democrats:  Although the Democratic plan is more comprehensive, expands coverages, and arguably fixes more problems -- while potentially creating others -- the Republican plan is likely better for more folks who already have insurance.  It is also likely be perceived as being better for seniors because, unlike the Democratic proposals, it doesn't cut Medicare.   Folks who already have health care and seniors are not just the vast majority of voters, they also vote in vastly greater numbers than the primary beneficiaries of the Democratic plan.

I was complaining a little while back that Republicans didn't have a response to Team Obama on health care.  I take it all back.  The GOP plan is pretty good, if you apply the right yardstick.  The question for the electorate is:  which yardstick are you gonna apply?

* * * * * * *

As for me, I'll wait a bit longer and see what develops in the Senate.  The GOP plan is attractive on the merits* only if I become convinced that the Democratric cure is worse than the disease.  That's because the GOP plan is, essentially, a good punt.  I'm not ready to punt yet.

One prediction, though:  Olympia Snowe just got a lot more powerful. 

The CBO's formal letter to Rep. Boehner is here [.pdf].

*That's not to say that I'm not in favor of individual parts of the GOP plan.  For example, like Andrew Sullivan, I'd like to see med mal reform.  Unfortunately, that's not gonna happen while the Democrats control Congress.

Comments

[Bran Dikson]

I'm sorry. This is so much horseshit. I wonder if you did such careful accounting prior to either of our latest foreign wars.

Nope?

Didn't think so.

But now that millions of Americans' health and thousands of lives are at stake, it's suddenly time to crunch and scrutinize and balance and weigh and...

Fuck.

People are dying, suffering. We have the money. The Republicans don't give a shit if people suffer and die, and you reveal yourself to be the same with your "measured" accounting crap.

You really, really aren't civilized or human.

[Nate]

So... It lowers the deficit less than the Democratic proposals, it does nothing to deal with the growing ranks of the uninsured, it doesn't deal with the actual root causes of malpractice suits, it doesn't change any of the incentives in the health care system, and it barely increases insurance company competition by allowing people to buy over state lines. It doesn't even address the conservatives' pet issue of people getting too much treatment "for free" under their insurance plans.

"It cuts insurance costs for current enrollees "by 7 percent to 10 percent in the small group market, by 5 percent to 8 percent for individually purchased insurance, and by zero to 3 percent in the large group market.""

So...single digit decreases for small businesses and the individual market, and next to no effect for people who get passable health insurance through their employers. That's not incremental, that's miniscule. It's hyperbole to say it's "better for people who have insurance" when most people who have passable insurance get it through the large group market from their employers, and would see next to no change from this plan.

That's...not really much of a plan, honestly. It doesn't address the biggest problems, or the root problems, and its "incremental effects" approach zero.

Have you, or any other conservatives, got a response to my (and others) points about the root causes of medical malpractice suits, and why 'tort reform' of capping the amount people can be awarded is more desirable than dealing with the underlying problems?

[Point]

Seems Nate beat me to the punch, but then so did Ezra.

"The health-insurance haves -- who are the vast majority of people -- probably gain more under the Republican plan than under most Democratic proposals."

How does it do this?