Blog Watch

Archive for July, 2009

Change the Tone

The House is officially adjourned and lawmakers are skipping town – back to their districts for the month-long recess (aka “health reform war of the airwaves.”) But the advice from reformers (and their advisors) coming from the blogs is a change of tone.

The New Republic’s editorial for its newest issue calls for a shift to a more emotional plea:

Something strange, and not entirely welcome, has happened in the last few weeks: The focus on policy minutiae has crowded out part of the big picture. Health care has become almost entirely a technical discussion, rather than a personal one. It’s all about deficit neutrality and bending the curve, instead of making sure every American can get affordable medical care.

Likewise, TPM’s Josh Marshall is concerned about the administration’s strategy going into recess:

But I don’t feel like I’m hearing from the White House any clear narrative, any clear and digestible argument for why this is necessary. I hear the phrase ‘public plan’. But it’s such a blah-blah gobbledegook phrase that even though I’m fairly deep into the policy details of this debate, half the time even I find myself forgetting exactly what that even means.

Peter McMenamin on the Health Affairs Blog has also picked up on that concern and suggests “some simpler clarifying questions” for public plan supporters to address that would demonstrate “specific ideas on how to get there (wherever there is) from here.” He continues, “Proponents should be expected to provide practical demonstrations of how a public plan could work in a real world.”

But the Obama administration has gained a key online ally: the Atlantic’s Andrew Sullivan explains his support for a public plan: “Pure pragmatism given the fiscal and economic costs of the status quo which are simply unsustainable. Sure, I’m worried the government might abuse their market power, but there could be ways to limit that.”

Meanwhile right-leaning bloggers are seizing on news that the “Cash for Clunkers” has already run out of money after one week. J.D. Foster of the Heritage Foundation thinks the experience offers “so many valuable lessons to be drawn from this sorry episode it’s hard to know where to begin … this was a simple program, and Congress botched it twice over, once by thinking it was a good idea and again by underestimating the demand and hence the cost.” Foster has some advice about a parallel scenario for a health overhaul “Look to the Cash for Clunkers program for a clue and multiply many times over.”

Insure Blog’s Bob Vineyard went the satire route: “Obamacare hit the wall today due to lack of funding. The Obamington administration announced today the wildly popular Cash for Health Insurance program is being suspended due to overwhelming demand. The program allowed insureds to trade in their old health insurance plan for a new, government issued plan and receive cash rebates up to $4500.”

Elsewhere, Joanne Kenen of the New Health Dialogue focuses on an effort in the Nation’s Capital to improve the sad state of the health of Washingtonians (life expectancy eight years below national average).

The Incidental Economist believes that several prominent liberal bloggers as well as mainstream news media often use studies with “selection bias” to prove a point, for example, on people’s satisfaction with their health insurance.

Kimberly Krautter has another installment of a series on Huffington Post that’s seeking to “un-spin the healthcare reform debate.”

Friday, July 31st, 2009

Tags: obama, reform
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Tired of words alone, commentators get creative

Tired of analyzing policies in the Democrats’ health reform bills with words alone, commentators and activists have turned creative.

First, we have Health Care Harry from public interest advocacy group PIRG.

PIRG’s interactive patient, based on the board game Operation, is plagued by “endless red tape” and the “rug pulled out” from under him. Poor Harry.

Next there’s skeptical Andrew Malcolm of the Los Angeles Times’ Top of the Ticket with a script imagining President Obama as a door-to-door salesman for health reform:

(Doorbell) “Hello. You don’t have a vicious dog, do you? I’m selling healthcare reform on your street and I want to tell you a little about it.”

“Well, we already have healthcare insurance at work and we’re really quite happy with it.”

“Ah, yes, but you might not have it for long because costs are spiraling out of control and…”

“You know what? When did costs ever go down? I paid 27.9 cents a gallon for gas to the prom and $2,400 for a full year of private college.”

“Yes, but 47 million Americans don’t have health insurance and…”

“Well, I’m sorry for them. Truly. But right now our family is more worried about the economy and keeping our own paychecks. How’s that job jolt stimulus thing coming along that was so urgent last winter? Because we haven’t seen…”

“That’s another issue completely. This summer I’m selling healthcare reform. We don’t have all the particulars from Nancy Pelosi and Max Baucus yet, but I can guarantee you the reforms won’t add another dime to the federal deficit.”

“Yeah, right, and the Cubs are gonna win the World Series.”

“They are? Even with Reed Johnson out for a month?”

Uwe Reinhardt on the New York Times’ Economix blog is in a list-making mood: his “All-American Wish List for Health Reform,” is rife with conflicting desires, pointing to a graphic from another article:

Ron Barrett for the New York Times

But back to wordsmithing, The New Republic’s Jonathan Cohn analyzes yesterday’s events on Capitol Hill, noting “reform advocates both on and off Capitol Hill seem more than a little bit concerned.” After reviewing Thursday’s reported deals with Blue Dog dems and developments on the Senate Finance Committee, Cohn concludes:

What happens next? I’m not quite sure. While delays would seem to strengthen the opponents of reform, an August vote was already off the table anyway. It’s not clear this latest stoppage in Finance, at least, is a problem for its own sake. If anything, a little respite might do some good. It’s easy to forget, but congressional staff and the members themselves are human beings, prone to same behavior as anybody else when under stress. Everybody is tired and on edge. Tempers are flaring. This is not an environment conducive to progress of any sort. … In an ideal world, one way or another this latest episode will shake things up in a way that produces better legislation.

Critical Condition’s Tevi Troy critiques Democratic political strategy demonizing insurance companies and rises to the defense:

No one is willing to pay all costs out of pocket because of the risks of catastrophic conditions, and the American people seem fairly exercised about the notion of a government-run public option. This leaves us with private insurers to pay for health coverage, and 70% of covered Americans rate their coverage either good or excellent. …In fact, much of the current debate is about how to get more people, not fewer, covered by private insurance.

Troy says the best way to get better care and insurance coverage is to “promote competition” among insurers by allowing the sale of insurance across state lines.

Wonk Room’s Igor Volksy, who advocates a totally different approach to refrom from Troy, goes after the newest Republican health reform alternative plan and concludes, “Like it’s predecessors, this legislation would break-up employer-based coverage, endanger the coverage of Americans with pre-existing conditions, and drive-up health care spending.”

Finally, the Washington Post’s Ceci Connolly looks at opposing positions of some business groups on health reform.

Friday, July 31st, 2009

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Let’s Make a Deal

A key feature of the Blue Dogs’ deal with Energy and Commerce Committee Chairman Rep. Henry Waxman, D-Calif., is an agreement to vote after the August recess, a move contrary to President Obama’s schedule but also a priority for Republicans. The Senate Finance Committee continues to move forward as well after a favorable CBO score. Bloggers spent the morning weighing in on the developments.

As Jacob Goldstein of the Wall Street Journal’s Health Blog writes, “For the moment, anyway, the health-overhaul narrative out of Washington is that the congressional logjam may be breaking up, with things starting to flow again.”

The New Republic’s Jonathan Cohn reacts:

But, once again, it’s easy to overlook what’s actually a pretty big step forward. If this deal holds–and that’s not certain, particularly given the anxiety of liberal Democrats over what is being given away–three House committees working together will have passed nearly identical pieces of legislation. And while it remains to be seen exactly what the final bill looks like, chances are it will still be very good legislation.

Bob Laszewski isn’t impressed with the reported compromises coming out of the Senate Finance Commitee either:

“I am concerned that in their efforts to find compromise they are headed for a health care bill that is based on a formula of cost containment “lite,” minor paring of Medicare and Medicaid provider payments, and at least $500 billion in new taxes. I don’t see much changing fiscally if that is the final result in a health care system that is already unsustainable …. From what we have heard, their bill would hardly “bend” any curves. … Being good guys and bipartisan doesn’t necessarily lead to the best policy! ” (Emphasis his)

The Republican Health Care Caucus is live-blogging the House Energy and Commerce Committee bill markup today.

The ‘Botax’? Bloggers are getting imaginative in response to reports that some lawmakers are considering a tax on cosmetic surgery. Catherine Rampell of the New York Times’ Economix rounds up blogger opinions on whether such a tax could lead to a tax on another elective medical procedure — abortion. Rampell indicates that legal scholars are opining on whether the tax would be constitutional. The Atlantic’s Derek Thompson jumps into the debate as well with a dose of skepticism: “The most important similarity I see between taxing nose jobs and taxing abortions is that neither is likely to happen.”

Regardless, the American Spectator’s Quin Hillyer has a mantra for opponents of reform: “It’s not a crisis, but just a problem. Barack Obama’s solution is neither safe nor sensible, but reckless and risky.”

Elsewhere:

Marilyn Werber Serafini queries her experts: “Will Congress ever really be willing to relinquish power about Medicare payment decisions, or will it be tempted to micro-manage? What are the benefits and dangers in these options? What is the likely impact on health care costs?” Responders include Karen Davis, John Goodman, Uwe Reinhardt, Kenneth Thorpe and Gail Wilensky.

Heritage’s Ed Haislmaier examines insurance reforms in Utah.

Ezra Klein follows up on yesterday’s post arguing for less emphasis on a public plan and comments on proposals to create nonprofit cooperatives instead: “I’m not an opponent of the co-op idea. So far as alternatives to insurance go, the more the merrier. But as a midpoint between a real public option and private insurance, it’s the most bankrupt sort of compromise.”

Thursday, July 30th, 2009

Tags: blue dogs, finance committee, Tri-Committee, waxman
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Will Obama agree to drop a public plan and employer mandate? Should he?

Another day, another health reform timeline. The newest is courtesy of the Wall Street Journal, which takes on a stealth veener using a black background and short descriptions:

But the spotlight is back on Obama as the President is on the road again, stumping for his health care overhaul. ABC New’s Jake Tapper reports that Obama will lay out “eight specific consumer protections that he wants to be part of reform” in today’s event, including: no preexisting condition exclusions, no gender discrimination in pricing and no lifetime or annual caps.

Time’s Karen Tumulty scored an interview with Obama yesterday. He explained the basics of how he defined a public plan — that it ought to be a taxpayer-subsidized system, self-sustaining through premiums, competing with private insurers. And she pressed the President on whether a nonprofit cooperative would be a sufficient stand-in for a public plan option:

And would a co-op fit that definition?

[Obama]: Well, I think in theory you can imagine a co-operative meeting that definition. Obviously sort of the legal structure of it is less important than practically how can it operate. There are concerns that in the past, attempts at setting up co-ops have not been successful because they just haven’t been able to get off the ground; sort of the start-up energy involved may not exist if you’re doing a state-by-state co-op effort as opposed to a broad national plan.

The Washington Post’s Ezra Klein would probably agree with the President — Klein devotes an entire post to progressives’ emphasis on a public plan, arguing:

The public option is not now, and has not ever, been the core of the argument for heath-care reform. It is the core of the fight in Washington, D.C. It is an important policy experiment. But it was not in Howard Dean or John Kerry or Dick Gephardt’s plans, and reformers supported those. It was not in Bill Clinton’s proposal, and most lament the death of that. It is not what politicians were using in their speeches five years ago. It is a recent addition to the debate, and a good one. But it is not the reason were are having this debate.

Klein stresses the rare opportunties for significant reform (perhaps he’s been brushing up on his timelines), and concludes: “There are many themes in the sad and frustrating history of health-care reform. But one of the central ones is that there were many points when Democrats could have accepted a compromise and did not. … Put more sharply, the question should be whether this bill is better or worse than another 19.5 years of the deteriorating status quo.”

What about the other item the Senate Finance Committee might drop – the employer mandate? John Tozzi of Business Week’s The New Entrepreneur tracks recent comments and concludes that Obama and lawmakers are moving toward nixing the mandate to provide health insurance to employees: “It sure sounds like Obama’s signaling that he’d sign a bill without an employer mandate, and that would help bring moderate Republicans like Snowe on board.”

Would such a move satisfy Michael Cannon? His article in the new National Review argues that employer (and individual) mandates are “socialized medicine with a private façade.” Cannon surmises: “We’ll know by watching Senator Grassley whether conservatives have learned that lesson.”

James Capretta of Diagnosis isn’t convinced — he calls the proposal to enact a free-rider clause in place of a mandate “a distinction without a difference.” Capretta continues:

Businesses not offering insurance today would still be forced to pay a hefty fine for all of their workers who got newly subsidized insurance through the so-called “exchanges.” That’s the exact same concept behind the House’s “pay or play” employer mandate. Employers either get their workers into job-based plans — or else. How is that not a mandate?

But Gerald Seib, the Wall Street Journal’s executive Washington editor, thinks the stalemate on Capitol Hill would have been eased if not for “the absence on the front lines of four big personalities — Rep. John Dingell, Sen. Ted Kennedy, former Sen. Tom Daschle and Sen. John McCain — that helps explain why Congress and the Obama administration are having such a hard time getting something done.”

Either way, it’s July 29th, and the clock is ticking.

Wednesday, July 29th, 2009

Tags: co-ops, employer mandate, finance committee, history, obama, public plan
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Dems’ Health Efforts Test Opposition’s Patience

Unlike the liberal bloggers, moderate, libertarian and conservative commentators had little to say about recent reports on the Senate Finance Committee’s negotiations. Instead they’re focused on the options currently on the table.

Bob Laszewski returns from vacation with a post expressing strong opposition a recently floated proposal to tax insurance companies to raise revenue for reform. Laszewski calls the idea a “chicken tax” and elaborates:

Chicken because the politicians aren’t willing to look voters in the eye and tell them that with $10 trillion to $12 trillion in waste they still have to raise their taxes by at least $500 billion [over 10 years] to pay for a health care entitlement expansion and chicken because those same politicians can’t face the “millionaires,” or unions, or even soda bottlers, or people with “gold plated” health care directly, or the rest of us for that matter, and tax us all directly.

Laszewski also believes insurers would simply pass on the cost of the tax directly to consumers.

Cato’s Michael Cannon is also talking about insurers — his new analysis argues a national health insurance exchange (which he terms “Fannie Med”) would decrease options for consumers by “driving lower-cost health plans out of business.”

Others are taking taking stock and registering multiple objections: James Capretta and Tevi Troy have an article in the newest issue of National Review that skewers certain provisions of the current Democratic health reform bills as intrusive, expensive, and causing limits on personal freedom, to name just a few. The authors also believe Dems are driven by another aspiration: “These bills are a massive overreach by the Democrats, who see this year as a once-in-a-generation opportunity to have something like a New Deal or Great Society moment.”

Keith Hennessey concludes, “the fight about the House bill is over by a technical knockout (TKO)” after the Congressional Budget Office sent a letter to four congressional Republicans that the bill would increase the federal deficit long term.

Last, Randy Pate of Heritage is focused on whether health reform would provide public funds for abortions and says, “Pro-life Democrats are under extreme pressure from members of their own caucus and the Obama Administration to compromise on abortion and other issues in the health care legislation. So far, committees in Congress have rejected all attempts to exclude abortion from coverage in nationalized health care.”

Tuesday, July 28th, 2009

Tags: reform, Tri-Committee, tricommittee
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Photo of Finance Committee Negotiators Tests Liberals’ Patience

The Senate Finance Committee has taken center spotlight as news emerging from the Committee’s closed-door hearings is that a public plan option and an employer mandate may end up off the table. Today the New York Times published a graphic identifying the negotiators, below:

Liberal bloggers are not pleased. The New Republic’s Jonathan Cohn writes, “It’s important to note just how skewed this group is.” Cohn laments the absence of Ron Wyden, who garnered Republican support for the plan he pounded away at for two years. Cohn also points out the absence of long time liberal reform advocate Democrat Jay Rockefeller.

The Washington Post’s Ezra Klein agrees: “This is not the Finance Committee’s bill. This is the Max Baucus Committee’s Bill. And there’s not a liberal — or even a Democrat traditionally associated with health-care policy — working on it.”

David Waldman of Daily Kos concludes that the Finance Committee “arrived at a compromise wherein Democrats give up everything and Republicans agree to allow them to do it.”

Complaints from the left may have little impact compared to the looming August recess: the Committee has yet to release or approve a bill.

Tuesday, July 28th, 2009

Tags: baucus, finance committee
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CBO’s Saturday Smackdown

The legislative landscape for health reform was tricky enough last week – and then came the Congressional Budget Office’s Saturday surprise. In a July 25 letter to House Democratic leaders and a July 26 post on the Director’s Blog, CBO Director Douglas Elmendorf provided the estimates regarding savings created by the Independent Medicare Advisory Council Act of 2009.

“CBO estimates that enacting the proposal, as drafted, would yield savings of $2 billion over the 2010–2019 period (with all of the savings realized in fiscal years 2016 through 2019). … Looking beyond the 10-year budget window, CBO expects that this proposal would generate larger but still modest savings on the same probabilistic basis.”

Office of Management and Budget Director Peter Orszag was quick to respond, reminding folks of his own CBO credentials and calling the IMAC plan a “game-changer” and put some spin on the “modest” $2 billion savings:

“The point of the proposal, however, was never to generate savings over the next decade. (Indeed, under the Administration’s approach, the IMAC system would not even begin to make recommendations until 2015.) Instead, the goal is to provide a mechanism for improving quality of care for beneficiaries and reducing costs over the long term.”

This “exchange-by-weekend-blog” highlights the growing tensions between the budget office and the administration. Jake Tapper on ABC’s Political Punch described this back and forth as “the latest chapter of [the White House’s] continuing disagreements with Congress’ independent budget-analyzing arm.”

Ezra Klein focused on those differences, with a post that starts: “I’m not sure what it says about me that I’ll interrupt my weekend for a new Congressional Budget Office report, but whatever it is, consider it said.”

He defends IMAC, noting that the potential savings aren’t something easily translated into the variables of a formula.

“…the point of IMAC is not that it would implement the best ideas we have in 2009, but that it will give a body of experts the ability to implement the best ideas they have in 2022, and 2034, and 2019, and every other year. CBO can’t guess at what those ideas will be any more than I can. We don’t have the data they’ll be using, we don’t know the technology they’ll be able to employ, and it’s impossible to estimate the political climate. May as well ask what the top-rated NBC show will be in 2029.”

Jonathan Cohen offers readers of The Treatment a reminder that CBO’s numbers shouldn’t always be viewed as gospel.

“… It’s important to realize that CBO projections are just that: Projections. And particularly when you’re talking about the possible political behavior of Congress and appointed experts in ten or twenty year[s], the uncertainty level is high.”

Chatter on the right attached stronger meanings to these estimates.

KeithHennessey.com, weighs in with a blog post titled “CBO Kills The President’s Medicare Commission Proposals,” and notes that the $2 billion figure is small change compared to the real dollars on the Medicare table. Hennessey writes it is actually a reduction equal to seven-hundredths of one percent of Medicare spending during that time period. He also details a whole host of tragic flaws attached to the proposal and declares the “death of IMAC” to be “a black eye for the Administration and another step backward for the pending health care reform bills.”

And on the Heritage Foundation’s Foundry, Conn Carroll writes that Elmendorf’s letter was the second time in two weeks the CBO “dealt a crushing blow to President Barack Obama’s health care plans.” The Foundry notes that the $2 billion of savings generated by the IMAC plan would leave “the House bill still $237 billion short of meeting Obama’s promise to not add a dime to the deficit over the next ten years.”

Monday, July 27th, 2009

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Is Obama’s Schedule Busted?

The blogs are still a-buzz digesting the news that Senate Majority Leader Harry Reid, D-Nev., told reporters the Senate would not vote on a health overhaul bill before the August recess.

Politico Pulse sums up reform advocates’ worst fears:

The delay opens the most ambitious legislative initiative in 40 years to a month of fierce scrutiny as special interest groups ramp up what was already expected to be a firestorm of ads, organizing and lobbying. Democrats will head home without a single plan to tout, complicating efforts to counter a suddenly more cohesive Republican opposition built around the plan’s trillion-dollar price-tag.

Rachel Martin, Jon Garcia and Karen Travers of ABC News’ Political Punch report on the President’s reaction:

(Obama was) quick to draw parallels with other historic and monumental achievements in American history, like the Apollo 11 landing on the moon 40 years ago this week. ‘If we’re going to move this country forward, we can’t be afraid to change, especially a system that we know is broken, ‘” said Obama. ‘We’ve got to get it done and we’ve got to get it done soon. ‘ … But after today, it appears that “soon” means anytime between now and 2010.

Chris Cillizza of the Washington Post’s The Fix says the delay until September “sets up a one-month campaign sprint between supporters and opponents of the legislation that will span over Congress’ August recess.” He continues:

The most important player in this fight — aside from the president himself — is Organizing for America, the group set up within the DNC to manage the massive 13-million person e-mail list built up during Obama’s presidential campaign. … There will be “intensive OFA activity”, promised one senior Administration official and, as if on cue, OFA sent out an e-mail appeal late Thursday night aimed at securing one million public supporters for health care reform before the end of next week.

Hot Air’s Allah Pundit (who remains anonymous) thinks the delay could be a major problem for Obama, , who said yesterday the delay was “OK”:

Well, no, champ, it’s not okay. It’s a huge, potentially crippling setback, and a personal embarrassment for him that his big health-care pep talk [Wednesday] night — which even his fans in the punditocracy are panning — was greeted this morning by Harry Reid deciding to pull the plug before the “deadline.”

Kathryn Jean Lopez of Critical Condition posts an email from Rick Scott, leader of a key opposition group, Conservatives for Patients’ Rights:

Thanks to a collective effort by a loose-knit coalition of free market health care advocates, conservative grassroots groups, and some reasonable-minded elected officials, I am very confident, after meetings on the Hill this week, that if Congress does not pass a health care bill with the public option before Labor Day, the public option is dead. While Victory is near, we must not rest.

That point of view is irritating the Washington Monthly’s Steve Benen:

Remember, the Republican strategy, which they’ve openly acknowledged, has been to force the delay in order to improve their chances of killing the bill. Conservatives and other opponents of reform will see this as a tactical victory, and evidence that the larger effort is in peril. It will be up to Democrats and reform advocates to prove them wrong.

But Health Beat’s Maggie Mahar thinks it’s up to Democratic leaders, “Now it appears that Reid and other Democrats have capitulated to the Republicans. I hope I’m wrong. Much depends on the degree of spine Reid shows while weaving the two Senate bills together—with help from the White House—during the month of August.”

The Atlantic’s Marc Ambinder echoes Mahar’s sentiment with a prediction:

Sen. Harry Reid’s decision will generate an intense negative reaction among activist Democrats and liberals. Bad Harry, weak Harry. But I suspect that the ratcheting down of pressure will be somewhat of a relief to the Finance Committee negotiators. Less pressure means more time to think — and to haggle civilly, as opposed to haggling with a looming deadline.

Friday, July 24th, 2009

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Bloggers React to Obama’s Presser

President Obama took to the prime-time air waves last night to deliver an address and press conference on health care reform in an effort to put the public at ease with the issue and pressure opponents in Congress to move forward with legislation. Kaiser Health News has full coverage of the event, including a Daily Report, the transcript and video.

D. Brad Wright of Health Policy Analysis looked at word clouds (the cloud for Obama’s prepared remarks is above) of the President’s speech and Q&A session and and then asks “What conclusions can we draw from all of this?” He answers:

That President Obama is on the offensive when it comes to health reform–he wants to see this pass. That he’s walking a tightrope between a strict timeline and a politically and technically feasible solution to the nation’s health care crisis. That he genuinely believes that health reform is advantageous for the country as a whole, and something with which all of us need to be concerned. As he said Wednesday night, “This isn’t about me. I have great health insurance… Reform is about every American. Not just the 47 million uninsured.” I couldn’t agree more.

MSNBC’s First Read reflects the non-wonk, non-advocate view from Chuck Todd, Mark Murray, Domenico Montanaro and Ali Weinberg : “A snoozer conference: Last night’s primetime news conference, President Obama’s fourth since taking office, was as much a dry health-care symposium as it was a give-and-take with reporters. Honest question: Is there a point when the president knows too much about an issue?”

Time’s Joe Klein was impressed: “He’s good. You forget that when you haven’t seen him in a while. He seemed entirely in command, not at all rattled by the toxic political dust storm swirling in Washington. His answers were supple, substantive.”

Republicans offered a “fact-check” by Republican House Minority Leader John Boehner on his site.

John R. Graham of the National Journal Online’s Critical Condition felt the presser was ineffective:

I think this evening’s press conference achieved nothing. He has only the slightest understanding of what he’s talking about. This is the second time I’ve heard him claim that “if the red pill works just as well as the blue pill, but costs half as much, let’s use the red pill.” … Does he really think it’s that simple? Red pill versus blue pill?

The New Republic’s Jonathan Cohn thought Obama had a “grown-up talk with America,” writing: “the most striking thing to me was Obama’s willingness–in that question about doctors and a few others–to speak candidly about his health plan, even if that meant giving openings to some of his critics.”

Con Carroll of the Heritage Foundation watched the press conference and thinks Americans should be wary of Obama’s proposal to create a MedPac-like commission:

Obama wants Americans to believe that his health plan covers the uninsured, improves patient care, puts “more money in people’s pockets,” all while adding nothing to the deficit. Obama is trying to convince Americans to disregard every ounce of common sense that they have and believe he is selling them an actual free lunch. Americans have every right to be skeptical. Take Obama’s claims that he can control health care costs by giving more power to a group of experts known as MedPac (Medicare Payment Advisory Commission). … But what if Obama’s MedPac idea did work? That might even be a bigger threat to American’s health care. It would be the equivalent of a federal health board determining how health care was rationed for all seniors. Combined with the public plan proposal, that would be another huge lurch towards taking the control of health care out of the hands of patients and their doctors.

Last, Anthony Wright of the Health Access Weblog liked Obama’s answer about what reform can do for the average American, but wonders if it will penetrate: “It’s a strong argument. Hopefully it won’t be obscured by all the race horse coverage about the political horserace (rather than the substantic policy issues).”

Thursday, July 23rd, 2009

Tags: obama, reform
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Action Swirls Around CBO Director

Congressional Budget Office Director Douglas Elmendorf, the man at the center of renewed uproar about the cost of health reform, gives readers the dirt on his meeting with President Obama and others at the White House:

I was invited to the White House to meet with the President, his key budget and health advisers, and some outside experts. The President asked me and the outside experts for our views about achieving cost savings in health reform. I presented CBO’s assessment of the challenges of reducing federal health outlays and improving the long-term budget outlook while simultaneously expanding health insurance coverage–just as we had explained these challenges in a letter to Senator Conrad and Senator Gregg last month. I also described CBO’s view of the effects of the health legislation we have seen so far, as I did last Thursday in a hearing at the Senate Budget Committee and a mark-up at the House Ways and Means Committee. In addition, I discussed various policy options that could produce budgetary savings in the long run, drawing on CBO’s Budget Options for Health Care released in December, our letter to Senators Conrad and Gregg last month, and my comments last Thursday. Other participants in the meeting expressed their own views on these various topics.

Also, an intriguing post from Andrew Biggs at AEI asks if changing Peter Orszag’s job from head of CBO to director of the Office of Management and Budget was Obama’s “worst personnel move.” According to Biggs:

The problem isn’t with Peter himself, who has both strong technical abilities and (rarer still) the ability to make complex points understandable to the press. As an advocate for his positions, he is extremely effective. The problem is that Obama’s health plans need a favorable CBO score a lot more than they need another effective advocate, and right now they’re not getting much joy from the CBO under current director Doug Elmendorf.

Related, Politico Pulse this morning reports:

Want to make (Budget Commitee Chairman Kent) Conrad speechless? Ask him about Peter Orszag’s comment Tuesday that the so-called doc fix — a $245 billion proposal to raise fees for doctors treating Medicare patients — would not be covered by Obama’s pledge to fully pay for health care reform. Orszag told reporters on a conference call that the administration always assumed the money would need to be spent to avoid a scheduled 21 percent reduction in doctor’s fees. … “That is an interesting concept,” Conrad said. So is fair to say you don’t agree with him? “Just call the CBO,” Conrad said as he booked out of an exit off the Senate floor. “I’m advising you to talk to others, you know. Call objective third parties and ask them.”

Meanwhile, Obama is scheduled to hold a prime-time news conference this evening to discuss his goals for a health overhaul as what appears to be part of a broader effort to pressure Congress. Time’s Karen Tumulty reports, “With Congress looking less and less likely to make Obama’s deadline for House and Senate passage by the August recess, however, there are signs that he is shifting into a different gear. One close Obama ally predicted to me: ‘He’s going to become increasingly specific–and increasingly persistent–about the things he does and doesn’t want’ in the health care bill.”

Keith Hennessey has “20 questions” for Obama’s presser, like “Experts across the policy and political spectrum say that repealing or limiting the tax exclusion for employer-provided health insurance is a good way to bend the health cost curve down. Some powerful unions oppose this change. Your position has so far been ambiguous. Do you think this change would be good policy? Are you willing to support it if it attracts Republican votes?”

Elsewhere, the Heritage Foundation has a new paper from James Sherk and Robert Book that argues “Congressional rhetoric to the contrary, much of the burden of paying for an employer mandate will fall on ordinary Americans, and lower-income workers will be hit the hardest.”

Think Progress says that insurer lobby AHIP is recycling the strategy used against Michael Moore’s SiCKO documentary to stake out their position on the current overhaul legislation.

The Washington Post’s Ezra Klein looks at Republican National Committee Chairman Michael Steele’s speech Monday opposing Democratic health reform efforts. Klein notes, “At one point, a questioner asked whether Republicans support covering everybody. ‘I don’t do policy,’ replied the leader of the Republican Party.”

Wednesday, July 22nd, 2009

Tags: cbo, elmendorf, employer mandate, obama
Posted in Blog Watch | No Comments »

KHN: Kaiser Health News

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