As with Medicare in the 1960s, Dems should do it alone

Like most health policy professors I have been thinking about healthcare reform for years, so when the issue finally took front stage I was elated. I strongly supported President Obama’s objective of working with Republications to find a bipartisan solution, so although I favor Senators Edward Kenney and John Dingell’s “Medicare for all” approach, I understood that would never secure Republican support. So I got behind the President’s strategy of taking single payer off the table. But now, I must conclude I was wrong. There is no hope for biparti sanship. Republications have no interest in solving the healthcare problem. They merely want to see the President defeated. Republican Senator Jim DeMint made the strategy clear when he fashioned healthcare reform as President Obama’s Waterloo.

In last Tuesday’s New Hampshire town hall meeting, President Obama gave a “shout out” to Republication Senators who he felt were working in a spirit of bipartisanship to find solutions. Said the President, “now, I think that there are some of my Republican friends on Capitol Hill who are sincerely trying to figure out if they can find a health care bill that works -- Chuck Grassley of Iowa, Mike Enzi of Wyoming, Olympia Snowe from Maine have been.” (Click here for the text of the President’s remarks).

Less than 24 hours after the President’s “shout out” Senator Chuck Grassley was caught on tape spreading the "Obama death panel" lie. At an appearance at a town hall meeting in Iowa Senator Grassley told the crowd they were correct to fear that the government would "pull the plug on grandma."

Where did the death panel lie originate? Republication Senator Johnny Isakson of Georgia proposed that doctors be reimbursed by Medicare for time spent counseling patients and their families on end-of-life decisions, such as making a living will, or informing doctors about the patent's desire whether or not to remain on life support. This inherently reasonable Republican proposal somehow morphed into Obama's “death panels.”

Senator Grassley is not alone. Other national Republication leaders are also distorting Republican Senator Isakson’s proposal and acting as if the proposal was made by the President. Perhaps the most egregious case came from failed Vice Presidential candidate and failed Alaska Governor Sara Palin who went as far as to state that “Obama's death panel," might kill her infant son, Trig. “The America I know and love is not one in which my parents or my baby with Down syndrome will have to stand in front of Obama's ‘death panel’ so his bureaucrats can decide, based on a subjective judgment of their ‘level of productivity in society,’ whether they are worthy of health care. Such a system is downright evil.”

So here are three facts that seem to be getting lost in all the noise:

(1) President Obama has not presented ANY healthcare plan. He has left it to Congress to work out a bill.
(2) There are proposals making their way through the House of Representatives, but there still is no final House bill.
(3) The Senate has not even written a Bill yet.

The President's Town Hall Meeting

The president appears to be taking a new tack in his effort to make the case for healthcare reform. I watched his town hall meeting from New Hampshire today. He made all the right arguments. He focused on the personal stories of individual Americans who had suffered in the present system. He defused the lies and rumors… death panels, and such. I always get a chuckle when I hear people rant against “government healthcare” while insisting that the government not “mess with their Medicare.” But, most importantly he responded to the reasonable concerns that people have about healthcare reform. For example, one man suggested that a public option would inevitably kill private insurance companies, since “no company could compete with the government.” President Obama’s deft reply was that Federal Express and UPS are able to compete effectively against the US Postal Service, and in fact it is the USPS that has the constant financial problems. Another man asked about tax increases. The President pointed out that the previous administration (self-defined as fiscally conservative) added a new pharmaceutical benefit to the Medicare program without figuring out how to pay for it. Many of the same members of congress who now express concern about costs of healthcare reform voted to create this new benefit even in the face of massive income tax cuts, two wars, and a mounting budget deficit. My only quibble with the President’s message is on the cost issue. If you provide care to 47-50 million people who currently don’t have access to care, you are going to have to pay for it, and there are only three possibilities. (1) Increase revenue by raising taxes, fees or some other device; (2) cut services somewhere else in the budget; (3) add the costs to the deficit. None of these are pleasant options. However, in the end one of these things will have to be done.