By E. J. Dionne

Unreason On Health Care

December 17, 2012 12:00 am Category: Memo Pad 16 Comments A+ / A-
Unreason On Health Care

WASHINGTON — The human capacity to put passion and intense feeling over cool rationality does not surprise us when it comes to love, sex, family, friendship, certain kinds of religious commitment and even devotion to sports teams.

But emotional approaches can be quite dangerous in public policy, and on no subject is irrationality as pronounced as it is in health care.

Here’s the difficulty: Conservatives who were once genuinely interested in finding market-based alternatives to government-provided health insurance have, since the rise of Obamacare, continued to make choices that are dysfunctional, even from their own point of view.

Start with the decision of the vast majority of Republican governors to refuse to set up the state insurance exchanges required under the law. The mechanisms would allow more than 20 million Americans to buy coverage. They were originally a conservative idea for large, trustworthy marketplaces where individuals and families could buy plans of their choice.

Many liberals preferred a national exchange in which the federal government could institute strong rules to protect consumers and offer broader options. This was the path the House took, but the final Senate-passed law went with state-level exchanges in deference to Republican sensibilities.

To ensure that governors could not just prevent their citizens from having access to the new marketplaces, the bill required the federal government to run them if states defaulted. So, irony of ironies, in declining to set up state exchanges, conservative governors are undermining states’ rights and giving liberals something far closer to the national system they hoped for. As Robert Laszewski, an industry critic of Obamacare, told The Washington Post’s N.C. Aizenman, conservative governors are engaging in “cut-off-your-nose-to-spite-your-face” behavior.

This is one of many forms of conservative health care unreason. The fiscal cliff debate has been distorted because the problems confronting federal finances are consistently misdescribed. We do not have “an entitlement problem.” We have a giant health care cost problem.

Our major non-military fiscal challenges lie in Medicare and Medicaid. In principle, conservatives should seek to find ways of holding down health care inflation in both the private and public sectors. In practice, they see most efforts to take on this issue system-wide as examples of big government run wild. They seem to have a vague idea that markets can yet solve a problem that markets have not been very good at solving.

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Comments

  • nobsartist

    I fail to understand why republiCONs hate nationalized health care so much.

    Then I remember its because they ruined it in 1982 with the failed health care bill that they created. As I remember it was “free market competition that would keep prices down” and the fact that raygun gave all of the tax payer built hospitals to the “for profit” disaster that he created.

    The problem with the failed republiCON health care bill of 1982 was they failed to provide restrictions on the “for profit” disaster that they created. No law prohibiting ridiculous CEO salaries, “donations” to politicians or collusion to fix prices between “for profit” health care companies.

    Make “for profit” insurance illegal and FIRE all of the employees. It was fine to eliminate MILLIONS of manufacturing jobs and throw those people out on the street. Time to throw the “for profit” health care people out on the street for the betterment of all of America.

  • Jim Lou

    In many ways the GOP is all talk and very little action. They make noise about how they want to reduce the size of government but they are the 1st in line for many of the things they want to tear down.

    • latebloomingrandma

      That is surely the truth. Much is made of Obama’s “spending”, yet in actuality, his rate of spending is much lower than the last several presidents. Much is made of the Bush spending–2 wars, tax cuts, and Medicare Part D. But don’t forget about the Dept of Homeland Security. I read somewhere that this dept has added a trillion dollars, including at least 220,ooo employees. Think about it. A group of would-be terrorists spent about $100,000 on airplane flying lessons, a few bucks on box cutters, probably from Home Depot and created a horror scene that killed 3000 Americans over a few short hours. This poker in the eye of the billion dollar American military behemoth, has caused our nation to go hog wild and spend ourselves into oblivion. Yet the carnage on our own streets, such as occurred last week continues. We can never forget or diminish the 3000 lost on 9/11, but put in perspective the money spent on this, as compared to the nothing being done on thousands killed in our streets by our own citizens. It’s time for us to turn the corner on this and get some common sense.

    • http://twitter.com/LostAnarchist S-3

      We need a Violent Revolt or Anarchy in our time to deal with these scum, especially in regards to shit like this. And I will be on the front-lines, helping to ensure that future date comes to fruition in order to save us all!

  • http://www.facebook.com/dominick.vila.1 Dominick Vila

    If Obamacare had been written by and signed by Republicans it would have been hailed as a giant step forward to reduce medical costs in America while making preventive medicine available to ALL Americans. Since it was championed and signed by Democrats, a legislation conceived by the Heritage Foundation and modeled after Mitt Romney’s healthcare plan in Massachussetts is portrayed as evil socialism and rejected by Republican governors who, incredibly, suggest that if the states can not support the Federal government mandate, the Federal government is responsible for all related costs. Conservative governors with Republican legislatures are, in effect, promoting socialism!!!

    • nobsartist

      We already have a health care system created by the republiCON genius’s. It doesnt work.

      Now we have another one and it wont work either.

      “For profit” health care simply has no place in our society but then again, neither do republiCONs.

  • http://profile.yahoo.com/YTRZ24AI5F4L4T4VSV37AM27GA William Binckes

    Under New York State’s health insurance exchange my annual premium will plummet from more than $15,000 per year to under $5,000. I’ll be able to buy health insurance as part of a group for the first time. I won’t soon forget the politicians who worked hard against the changes in law that lead to these savings.

    • http://profile.yahoo.com/RFEPMKNCBVGJYV2X7LBNDGRUEY William

      The GOP doesn’t care about your savings, only Insurance Companies profits, that’s why they eliminated the public option which would have given you even more savings. I hope they pay for their choices in future elections.

  • http://profile.yahoo.com/RFEPMKNCBVGJYV2X7LBNDGRUEY William

    What a joke, Death Panels. The GOP answer to the problem, get sick-die quickly. The GOP only cares about you until you are born, after that they just use and discard.

  • howa4x

    People don’t realize we have an illness intervention system based on maximizing profits of the participants, and not a health care system. These profits are huge with Big pharma projecting a 500 billion profit in the next 10 yrs. Every hospital and doctors group makes a profit and even the unsurers make a 20% profit. This is the problem that no one wants to talk about. The quest to gain higher profits has led the pharma industry to make drugs, that don’t really cure you , but maintain your illness so you don’t get better or worse just functional. Doctors just keep prescribing drugs they know won’t work, but have sometimes life threatening side effects, or will give you permenent liver damage. So the conservative idea of letting the markets work to reduce cost doesn’t happen in this industry because of the profit motive. So if goal is to make a profit rather than create a healthy population then there is no incentive to lower costs. So doctors and drug companies will get sick individuals on multiple drugs, and the more doctor visits and the more drugs the higher the profit. Hospitals just get a peice of the action on every patient that goes there. A large nuber of paitents go into a hospital due to that fact that the drugs they are taking don’t really work anymore and now they are in a life threatening situation. Think of coranary by-pass.
    So the exchanges will only push more people into a profit system, and will not lower costs.
    Instead of setting up insurance exchages, we should be setting up primary care centers to get people into the system through the lowest cost portal and to try to deal with their illness in a community based setting. We are not going to control costs no matter who is paying the bill if the illness system is only intrested in maximizing profits.

    • http://www.facebook.com/dominick.vila.1 Dominick Vila

      Unfortunately, the chances of passing a single payer system in the USA at a time when pubic opinion has been influenced by a barrage of propaganda from special interests is slim to none. The best we can hope for is incremental gain. ACA is far from perfect, but it is a step in the right direction. The key is to change it slowly with focus on reducing cost and improving services.

  • adriancrutch

    I ws laid off on 3/01/2012 and 7/7/2012 I went into the hospital with a gall bladder attack that was already a week old. My insurance was still in force when checked by the the hospital staff. I spent 6 nights getting stints and cleaning up my blood. I got out and my meds were covered. Three weeks later on 7/29/2012 the company I was laid off from went bankrupt. Then the insurance company said I wasn’t covered. So I just keep stacking up the medical bills as they hit the mailbox. Total bill was around $45,000. My brother in law was kept (alive) as a cashcow till finally the hospital owned up that he was going to die! He died the next day after they removed his support. Total cost to his insurance was close to $800,000. So there much to be gleaned from the HealthCare industry. I’m alive and busted flat!

  • http://twitter.com/LostAnarchist S-3

    These bastards in South Carolina better not even try to stop me from purchasing decent healthcare, or I will proudly end up executed for stopping them!

    I AIN”T FUCKING DYING FOR NOR SERVING A COUNTRY NOR STATE THAT WON’T GIVE ME SOMETHING I NEED AND WANT TO HAVE TO ENSURE MY OWN SURVIVAL, AND AT A DECENT COST, TOO, IF IT IS SOMETHING BENEFICIAL TO ME!!!

  • http://profile.yahoo.com/JCDYOUQPDL6RBF2WIQY7IHJ4BM batavier

    Republicans are like a bunch of felines suffering catnip-deprivation…

  • onedonewong

    Republicans have smartly decided to hang this albatross around bark’s neck

  • http://profile.yahoo.com/JMT6C3LHLJDD4RX4NB4KY5ICAE gargray

    There is one option we all ignore, ( do th;e right thing ). greed and corruption cloud our visions.

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