In response to my claim that the government isn't taking over health care, I was recently asked what's all the fuss about, then?
My answer: politics
(most of what follows is h/t Ezra Klein)
As Maggie Mertens recently pointed out (link) and summarized with the table at the end of this post, the current senate health care bill is remarkably similar to the bill proposed in 1993 by a moderate Republican senator (John Chafee), 19 other Republican senators, and 2 Democrats - considered the major GOP proposal at the time. Naturally, therefore, the Republicans are celebrating that the Dems some 17 years later are pushing a GOP health care bill. Not so much.
Instead, here's a sampling of what we get...
We get this from the Republican National Committee (link):
and we get commentary like this by conservative pundit Mark Steyn from the National Review (link):
I’ve been bandying comparisons with Britain and France but that hardly begins to convey the scale of it. Obamacare represents the government annexation of “one-sixth of the U.S. economy” — i.e., the equivalent of the entire British or French economy, or the entire Indian economy twice over. Nobody has ever attempted this level of centralized planning for an advanced society of 300 million people. Even the control freaks of the European Union have never tried to impose a unitary “comprehensive” health-care system from Galway to Greece. The Soviet Union did, of course, and we know how that worked out.
Annexation of 1/6 of the economy? Ezra Klein rebuts (link):
Putting aside the question of whether government regulations are the same as "annexation" (in which case, the apple I'm eating is federally annexed, and I never knew socialism could be this crisp and delicious), the regulations in question are limited to insurance being offered on the exchanges.
Why does that matter? Because the exchanges, as you can see on Page 20 of this CBO analysis, are expected to serve 25 million people by 2019. That is to say, these regulations will be limited to less than 10 percent of the market. And that 10 percent of the market will be primarily composed of the uninsured.
Why would conservatives be freaking out so extravagantly about a health bill nearly identical to their own from 17 years ago? Did the GOP propose a socialist health care bill in 1993? Were they plotting an unprecedented expansion of government, an annexation of 1/6 of the economy? No. Then what is all the fuss about?
The fuss is all about politics (Waterloo).
From Kaiser Health News (link):
| Major Provisions |
Senate Bill 2009 |
Sen. Chafee (R) Bill 1993 |
Rep. Boehner (R) Bill 2009 |
|
Require Individuals To Purchase Health Insurance
(Includes Religious and/or Hardship Exemption)
|
Yes |
Yes
|
No (individuals without
coverage would be taxed)
|
| Requires Employers To Offer Health Insurance To Employees |
Yes (above 50 employees, must help pay for insurance costs to workers receiving tax credits
for insurance)
|
Yes (but no requirement to contribute to premium cost)
|
No
|
| Standard Benefits Package |
Yes
|
Yes
|
No
|
| Bans Denying Medical Coverage For Pre-existing Conditions |
Yes
|
Yes
|
No (establishes high risk pools)
|
| Establish State-based Exchanges/Purchasing Groups |
Yes
|
Yes
|
No
|
| Offers Subsidies For Low-Income People To Buy Insurance |
Yes
|
Yes
|
No
|
| Long Term Care Insurance |
Yes (sets up a voluntary insurance plan)
|
Yes (sets standards for insurance)
|
No
|
| Makes Efforts To Create More Efficient Health Care System |
Yes
|
Yes
|
Yes
|
| Medicaid Expansion |
Yes
|
No
|
No
|
| Reduces Growth In Medicare Spending |
Yes
|
Yes
|
No
|
| Medical Malpractice Reform |
No
|
Yes
|
Yes
|
| Controls High Cost Health Plans |
Yes (taxes on plans over $8,500 for single coverage to $23,000 for family plan)
|
Yes (caps tax exemption for employer-sponsored plans)
|
No
|
| Prohibits Insurance Company From Cancelling Coverage |
Yes
|
Yes
|
Yes
|
| Prohibits Insurers From Setting Lifetime Spending Caps |
Yes
|
No
|
Yes
|
| Equalize Tax Treatment For Insurance Of Self-Employed |
No
|
Yes
|
No
|
| Extends Coverage To Dependents |
Yes (up to age 26)
|
No
|
Yes (up to age 25)
|
| Cost |
$871 billion over 10 years
|
No CBO estimate
|
$8 billion over 10 years
|
| Impact On Deficit |
Reduces by $132 billion over 10 years
|
No CBO estimate
|
Reduces by $68 billion over 10 years
|
| Percentage Of Americans Covered |
94% by 2019
|
92-94% by 2005
|
82% by 2019
|
