Friday, December 25, 2009

Ideology -Health Reform - "Screaming Big Deal" to Progressives, "Monstrous Big Price" to Conservatives

Matthew Holt, a transplanted Englishman, hangs out in San Francisco, where he preaches the gospel of government-directed care and care transmitted to consumers via Health 2.0. He is a co-founder of Health 2.0, and he directs The Health Care Blog, a widely read blog where he occasionally features my work. In any event, here is his take on the necessity of health reform.

Senate Passes Bill, More To Come


It's Christmas Eve and the Senate just passed a major health reform bill. Personally I think the reforms in it are relatively minor, but the passage of the bill itself is a screaming big deal. When I say minor, what I mean is that we’re leaving in place the inefficient employment-based health benefits system, and we’re expanding insurance mostly by putting more people into the separate but equal Medicaid program.
But this bill is a statement, and an important one.

For the first time we’re acknowledging that everyone ought to have health insurance and that those unable to afford it should be subsidized by the government. We’re also saying that insurance companies should take all comers at a consistent price without respect to health condition (and hopefully we’re implying that their job is to manage care not risk-select). Finally we’re saying that the majority of the cost can be paid for by redirecting inefficient spending within the health care system, and by taxing benefits that are only tax-free because of historical accident.
Building on those principles it may be possible to get us to a more equitable and more efficient health care system."

KARL ROVE: "Real Price of The Senate Health Bill," The Wall Street Journal

Karl Rove, the so-called architect of conservative politics thinks differently than Matthew Holt. He calls the Senate Health plan a "monstrosity" - a government "gift that will keep on taking."

Here is his statistical thinking on why government will take more than it will give,

1. It will keep on taking taxes in these yearly increments from 2010 to 2019 (in billions of dollars) - 1.9 (2010) 7.1 (2011), 9.1 (2012), 32.6 (2013), 39.3 (2014), 57.5 (2015(, 75.9 (2016)*, 88.6 (2017), 98.9 (2018), 106.8 (2019)

2. It will keep on cutting Medicare (in billions of dollars) - 0.4 (2010), 9.9(2011), 15.9 (2012), 25.1 (2013), 48.4 (2014),51.3 (2015), 58.8 (2016)*, 74.5 (2017), 80.6 (2018), 106.8 (2019)

3. It will keep on increasing spending (in billions of dollars) - 2 (2010), 4(2011), 5 (2012), 6 (2013), 60 (2014), 99 (2015), 151 (2016)*, 172 (2017), 184 (2018), and 199(2019)

Please note the Rove factors - more taxes, more Medicare cuts, more spending - escalate about 2016, the year after Obama would leave office if he were to be re-elected in 2012. But taxes start up now, Medicare cuts crank up after next fall's election, subsidies for the uninsured and underinsured commence in earnest in 5 years. The total cost is not $871 billion, says Rove, but $2.4 trillion if you count tax credits and Medicaid expansion.

For progressives, the government giveth; for conservatives,the government taketh away.

So much for the give and take of politics, as seen from the left and right.

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