- Ian Rankin, The Complaints
It’s desperate times here at the SMB. Over the past week, we’ve searched for something – anything – that could be labeled a coherent conservative argument against the healthcare bill. It has not gone well. Instead of vigorous, manly debate, we’ve heard nothing but an empty desolate silence, broken by the faint, fading whisper of “you socialist . . .”
It didn’t used to be like this. Once upon a time, the Strawman Blogger delighted in crossing intellectual sabers with his witty conservative opponents. But those halcyon days are long gone. It appears the crème of intellectual conservatism has died, been excommunicated, or fired in disgrace. And some have just gone plain fucking crazy.
So the Strawman Blogger needs your help. We’re looking for smart, conservative arguments to healthcare reform, and we want you post them below.
But, of course, we have some ground rules.
The Ground Rules
Here’s the deal. It would never do to have you scampering about this blog, shouting “filthy liberal!” until you go hoarse. You can criticize the bill, but with one special caveat: You have to criticize something actually in the bill.
Now, we have a sneaking suspicion that you may not actually be terribly familiar with the innumerable nuances of this legislation. So to make things easy for you, we’ve prepared a list of questions for you to ponder.
We can’t cover everything, but we’ve tried to capture the essence of the new law. So go ahead, my conservative friends! Select your most hated amendment, the foulest part of this legislation, and amaze us with your flawless logic. Post your answers in the comments below. This is your time to shine.
We won’t be holding our breath.
The Questions
1. A Republican Bill – This bill is nearly identical to RomneyCare, the popular conservative reform passed by Republican Governor Mitt Romney in Massachusetts. It is almost exactly like the conservative reforms suggested by Bob Dole. The basic plan was approvingly suggested by the ultra-conservative Heritage Foundation early in the last decade. It is further to the right than the healthcare deal suggested by Richard Nixon. How can a bill be considered a deeply Republican reform in 1974, 1992, 2002, and 2006, but is a socialist takeover in 2010?
2. 4% – A common Republican argument against healthcare reform is limiting the size of government. This bill will amount to around 4% of total healthcare spending. The government will not employ a single doctor. It will not write a single insurance plan on the exchanges. 96% of healthcare spending will continue to be administered by the existing market. If you have health insurance from your current employer, nothing changes. In what way is this a government takeover, and what is a credible Republican alternative?
3. The Exchanges – This bill creates a system of healthcare exchanges. They function as a simple marketplace, where people who are uninsured can purchase a policy from a private insurer. People save money by purchasing insurance as a group, much like we do through employers. Since the exchanges match private insurers with private citizens, how can this be considered an assault on the private market?
4. Public Ratings – This bill allows you to rate your insurance provider based on their performance, and that rating can be seen by the public. When you shop for a new insurer on the exchange, you’ll be able to research how well they’ve served people like you – rather like the product ratings on Amazon.com. How would the market benefit from preventing individuals from speaking their minds about the behavior of their insurer?
5. Pre-existing conditions – Starting today, children can no longer be denied insurance based on pre-existing conditions - and they can no longer cancel your coverage if you get too sick. In 2014, that protection will be extended to adults. People will be able to stay on their parents plan until the age of 26. Would individuals benefit if insurers retained the right to deny coverage to children and adults based on conditions like cancer, AIDS, and hereditable disease?
6. Cost controls – The health care bill reduces the deficit by $1.3 trillion dollars over 20 years – and much more beyond that. It experiments with cost controls like bundling payments to hospitals, so that they’re paid by how quickly you get well, not how many treatments they perform. It researches comparative effectiveness, to see what treatments work better. It creates an independent board to evaluate waste in Medicare. How can a bill that reduces the deficit, cuts costs, and involves less than 4% of total healthcare spending be considered budget busting?
7. Insurance spending – Starting immediately, insurers will have to spend at least 80 cents out of every dollar on medical care. If an insurer spends less than that on care, they’ll have to rebate the difference to its customers. Should less insurance dollars be directed to actual care?
8. Medicare Expansion – This bill leaves our current system of private insurers alone. If you’re currently insured by your employer, nothing changes. If you’re insured as an individual, you’ll still be able to choose your policy – you’ll just be given more information and cheaper premiums. If we went with a liberal option, we would extend the popular Medicare program to all Americans, either directly, or by allowing people under the age of 65 to buy-in. This bill prevents that. How can a bill be credibly considered as advocating big government, when the most likely alternative involves enrolling every single American in a massive government program?
9. Premiums – According to the CBO, premiums on the employer-provided market will become slightly less expensive. Premiums on the individual market, on the other hand, will go down by 7-10%. Why is it bad if existing policies from private insurers become more affordable?
10. Subsidies – Currently, we give the poor insurance through Medicaid. We give the uninsured free emergency care through hospitals, at great expense to responsible adults with insurance coverage. But we had no mechanism to help out middle-class families struggling with insurance premiums that grow at rates in excess of 7% a year. This bill assists middle-class families in affording insurance by providing scalable subsidies to families earning up to $88,000 a year, helping them purchase private insurance for themselves and their children. Why do the poor deserve free care, and the rich the capacity to afford it, but the middle-class has to shoulder the burden on their own?
That should give you something to chew over. We could go on, but ten is a nice round number - and we're getting just a little bit bored. Comments below - do your best.
