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

[Carleton Wu]

Or we could just settle on that this is a very subjective thing, and that lack of health insurance works as a cause of death from your POV, but not from mine.

There is a difference between something being less proximate and something being subjective. In many (most? almost all?) cases the more distal causes could have been ameliorated by some other factor (ie were sufficient as causes based on the circumstances).
Yet this is still considered causative. "Several people were trampled to death because the fire exits had insufficient capacity and were poorly planned". Or were they?

Redefining the word "cause" is not subjective.

[Hartmut]

Mabye 'facilitated' would be a better choice than 'caused'. Without insurance (or seat belts) it is easier to die from causes that otherwise might not inevitably lead to death.

[Slartibartfast]

And the fact they died as a result of not getting treatment?

"Not getting treatment" doesn't map 100% onto "doesn't have health insurance".

But, Slarti, do you agree that people without health insurance have died sooner than they would have if they did have health insurance?

Sure. But they also died sooner than they would have if they were a billion dollars richer. Lack of access to essentially unlimited funds I don't consider a cause of death, either.

But don't pretend not to know what it means and try to characterize is as being absurd.

I'm completely free to characterize is as being absurd, HSH. It still looks that way to me.

[hairshirthedonist]

I'm completely free to characterize is as being absurd, HSH.

Well, sure. The implication is, though, that you won't be taken seriously. You're also completely free to cite the three-headed love-child of the Abominable Snowman and Easter Bunny as the source of your views. ;)

Really, I don't seem to care as much today. I'm about the love now - easy like Sunday morning. Love, peace and hair grease.

[Nate]

Sebastian: If it helps, characterize "died because of lack of health insurance" as "died from a cause that could easily have been prevented if the person in question had either money or health insurance to provide the proper, widely available treatment or prevention, which they could not afford because they lacked "unlimited funds" or decent health insurance."

Or perhaps "People who died of something that's @$!#ing embarrassing someone should have died of in the richest @$!#ing country in the world."

[Nombrilisme Vide]

Lack of access to essentially unlimited funds I don't consider a cause of death, either.

Slarti - it could also be said that they died for lack of access to an unlimited number of medical nanobots that would repair any and all injuries to their bodies. It could, but it would being a meaningless distraction, as it's not within our power to give people access to such a thng. Likewise, it is not within our power to give most or all of the population of the US "access to essentially unlimited funds". The same cannot be said about health care. Your comparison is a coy distraction.

The meaning of "X people died from lack of health insurance" is commonly understood, and that commonly understood meaning is neither controversial nor absurd. Please don't be an uncooperative listener. Pragmatics exist; stop pretending that meaning is wholly derived from semantics. It's unbecoming, and disrupts the flow of conversation to no good end.

[Carleton Wu]

Sure. But they also died sooner than they would have if they were a billion dollars richer. Lack of access to essentially unlimited funds I don't consider a cause of death, either.

This just isn't what "caused" means in English. Or, that's not all that it means. In order to accept your redefinition, "Several people were trampled to death because the fire exits had insufficient capacity and were poorly planned" becomes objectionable, because the poorly planned fire exits could not cause deaths without other factors (ie a fire or other disturbance, panic behavior on the part of the crowd, etc). "Cause" doesn't just mean "both necessary and sufficient to cause".

I find it very hard to believe that you actually only use the word "cause" in the manner you describe.

[Slartibartfast]

The implication is, though, that you won't be taken seriously.

I am in no way demanding that you take me seriously, nor do I require that you agree with me.

The same cannot be said about health care.

I beg to differ. It's not at all within my power to give everyone in the country unlimited health insurance.

I find it very hard to believe that you actually only use the word "cause" in the manner you describe.

Ah. Well, maybe that's because I do fault tree analysis. I tend to be literal about such things.

[hairshirthedonist]

My comment at 1:54 PM yesterday might be relevant to fault tree analysis if you convert the alphabetical symbolic logic into gates.

[Nombrilisme Vide]

"The same cannot be said about health care."

I beg to differ. It's not at all within my power to give everyone in the country unlimited health insurance.

...and here we go again. Who said anything about you personally giving everyone in the country unlimited health insurance?

OTOH, you just shot your "but I must take everything 'literally'" posturing in the foot. I never said anything about giving everyone in the country health insurance. I meant it, but I accidentally said health care. Strangely, you had no problem sussing the intended meaning of my misstatement in context. Funny, that.

Slarti, your stubbornly overfine semantic parsing is adding nothing to the conversation. To the contrary. And pretending that you must take (certain arbitrary) statements "literally" makes you look, well, absurd. But like I said, uncooperative listening. If that's what your heart is set on, we're not gonna sway ya. Have fun with that.

[LeviticusSnoutfur]

Or we could just settle on that this is a very subjective thing, and that lack of health insurance works as a cause of death from your POV, but not from mine.

Posted by: Slartibartfast | November 07, 2009 at 12:39 PM
............................................
When logic and facts are both against you, Slarti, I'd say it was time to fold. That's more honorable than conjuring up false equivalencies when human lives are at stake.

[Carleton Wu]

I find it very hard to believe that you actually only use the word "cause" in the manner you describe.

Ah. Well, maybe that's because I do fault tree analysis. I tend to be literal about such things.

My point, which you continue to elude masterfully, is that you are not using the literal meaning of "cause". Restricting it to mean "necessary and sufficient cause" that makes it a very different word. Perhaps it has that technical meaning in your field, but you can hardly expect others to know this or to use words consistently with your jargon.

Redefining words is your prerogative; as you point out, you're under no obligation to use normal definitions, or be consistent, or even to make sense at all. But if you're going to participate in discussion with other people, it doesn't make sense to me that you'd choose idiosyncratic definitions- you might as well bang on your keyboard with your fist a couple of times and then hit enter.

[colby]

Wow, ObiWi has really gone downhill in the past few months. Hilzoy is gone, and instead we get posts like this.

Are you guys doing some sort of Andy Kauffman-esque performance art, seeing how much your audience can take before it just gives up?

[matttbastard]

Are you guys doing some sort of Andy Kauffman-esque performance art, seeing how much your audience can take before it just gives up?

Apparently you missed the Charles Bird era.

[russell]

Are you guys doing some sort of Andy Kauffman-esque performance art, seeing how much your audience can take before it just gives up?

You been here four post!
You go now!

[Rob in CT]

Yardstick...

If you're trying to measure a piece of crap, using the "crap-o-measurer" then this looks good, apparently.

Otherwise, it looks like, well, a piece of crap.

Not that the Dem plan is w/o its warts...

[CaseyL]

What y'all are overlooking is that conservatives aren't interested in a government that actually functions well for its citizens.

In fact, that's the last thing they want.

The only legitimate domestic policies, pace conservatives, are ones that transfer and concentrate wealth upward.

Anything that interferes with that is bad. Anything that doesn't directly facilitate that is bad.

HCR with a public option is obviously bad for insurance companies, in that it might interfere with their ability to make $300 million in annual profits by recissions and refusals of coverage. Therefore, von opposes HCR with a public option.

HCR that consists of limits on med mal, and that permits insurance companies to evade state consumer protection laws, is obviously good for medical care provider consortiums and insurance companies. Therefore, von advocates for med mal limits and nulllifying state-based insurance laws.

It has very little to do with ideology, per se, unless you consider Mammonism an ideology.

[dwight thieme]

Taking a peek in here, I'm sorrowed but not surprised to see that my decision was correct. For all the talk of a policy of fomenting civil discourse, the banning procedure is a joke. von should have been banned ages ago with the sort of disrespect that this post typifies, slarti should have been taken offline for a week with a warning for yet another exhibition of exteme bad faith.

When policy is not enforced, nay, when policy is differentially enforced, well, you're not going to see too many people wanting to stick around.

[Jesurgislac]

CaseyL: 220-215, bitches!

I just noticed this. Yeah, some of my friends are the bitches in question who found themselves being told by male Democrats to suck it up - they needn't expect that bitches would get equal access to healthcare in the US when there are men around to prevent it.

[Jesurgislac]

Bugger. Should have clicked "next". Also should have read the date

CaseyL, I apologize for associating your comment with the Stupak Coathanger amendment.

Dwight, you're being either foolish or trollish.

[brantl]

Slarti, seek psychiatric help, urgently,.