Quasi-interesting piece by David Brooks in today's NY Times on the Obama health care speach.
http://www.nytimes.com/2009/09/11/opinion/11brooks.html
Brooks is a staunch conservative who has concluded -- are you listening, wing-nuts? -- that the current health care system is unsustainable and presents a grave threat to the country's long term economic outlook.
My response follows.
Mr. Brooks:
I'm a liberal (my definition; not necessarily those of other liberals, and certainly not the caricature beloved by conservatives) who reads your column, but I admit I'm not of the "David Brooks is the Conservative Even Liberals Respect" school. Mostly you exasperate me, and I'll further admit that I have difficulty approaching your current work objectively owing to what I perceived as eight years of defending/enabling the thoroughly indefensible and detestable Bush regime, which -- putting aside ideology -- even the most charitable could only rationally describe as (at best) incompetent.
But you've apparently made a reasonably objective and intellectually respectable study of health care issues and I'd like to respond to a few points in your column of 9/11/2009.
>>...the House health care bill. That bill would add $220 billion (that’s 2.2 trillion dimes) to the deficit over the first 10 years and another $1 trillion (10 trillion dimes) to the deficit over the next 10 years. >>
Surely, Mr. Brooks, neither you nor anyone else can know this. I do not accuse you of inventing the numbers, although you offer no citation, but of repeating with certitude an inherently highly questionable estimate that pretends to exactitude.
But my objection does not rest solely, or even primarily, with educated-guesswork, crystal-ball-gazing and subjectivity masquerading as hard data ("The color blue is 18.694% prettier than the color red")
The primary problem with such a statement is that it ignores key, salient points justifying the whole exercise of health care reform to begin with, to wit: to have it function more efficiently; to ultimately reduce health cares cost as a percentage of GDP; to reduce the financial burden on American corporations and individuals.
At the risk of sounding like a loony supply-sider: must not, for example, the resultant corporate savings, increased corporate competitiveness and increased corporate profits, resulting in turn in increased tax revenues and increased numbers of employees (who also pay taxes thus augmenting the government's treasure rather than being the drains on the economy they would be if unemployed) be netted against the gross costs? I don't for a moment pretend to know the exact number of the off-setting revenues ("You're wrong; the color red is, in fact, 14.673% prettier than the color blue"), but it seems a reasonable assumption that they would not be insignificant.
>>There is no way to get from the House bill to deficit neutrality>>
As I said above, it depends on who's doing the math and the underlying assumptions/variables employed by the mathematician.
>>...accepted the principle of tort reform to reduce the costs of defensive medicine. Once again, the specific proposal Obama mentioned is trivial...>>
I'd be glad to see some sort of tort reform enacted, if for no other reason than to silence (although a healthy bite of facts never do seem to stopper their mouths) the seemingly substantial numbers of people on the right who claim to believe that this alone is the crux of the problem with the current system. As the experiences of Texas and Florida (where vigorous tort-reform legislation was implemented and hasn't made a dent in per capita costs or rate of increase relative to the rest of the country) as well as the recent, oft-cited article by Atul Gawande in The New Yorker make abundantly clear, "trivial" is probably as good a word as any to describe the likely effect of even the most aggressive approach to tort reform. But I dislike lawyers as much as the next right-thinking fellow and I’ll cheerfully toss them under the bus on this one.
>>...the public option...the president praised it, then effectively buried it. White House officials no longer mask their exasperation with the liberal obsession on this issue>>
I don't know that this particular liberal is "obsessed" with it, but a single-payer system is simple, efficient, proven to be cost-effective, has been used and continually refined over the years all over the world, is overwhelmingly approved of by the populace of nations where it is in place, and certainly would beat the hell out of the mind-numbing complexity and dubious efficacy of the horse-designed-by-committee we are likely to wind up with in its stead. Can you say "re-inventing the wheel?"
>>...the president also buried the soak-the-rich approach. The House Ways and Means Committee came up with a plan to raise taxes on the rich to pay for health reform. That’s dead, too…The president underlined his resolve to cut $500 billion from Medicare and Medicaid. This is a courageous move that moderates appreciate. >>
Cutting Medicaid courageous?! Certainly history has taught us that nothing in this country requires less political courage than "soaking-the-poor".
As to "soaking-the-rich"...how about as a starting point merely restoring top marginal rates to those in place during the reign of that famous socialist, Ronald Reagan? I've no idea what the political calculus is inside the White House, but it is surely astute to separate the two issues. Let's reform the health care system without getting demagogued by the FOX "News", AM radio lackeys of the moneyed interests who invariably -- and oh so easily! -- manage to persuade people making $40,000 per year that they will wind up destitute if marginal rates on incomes over $200,000 per year go up a point or two. No, no, by all means let it lie, for now. Then we can soak the rich.
>>Which is not to say that this is effective health reform...Obama said that parts of the system work...they don’t...>>
Amen, brother. Our proposed solutions differ, as do our underlying philosophies, but we certainly agree on that.
Regards,
Len Safhay
We've lost more people due to our health insurance system than in both World Wars, Vietnam and Iraq: the U.S. suffered about 416,000 casualties in WWII, 116,000 casualties in WWI, 50,000 casualties and Vietnam and, so far, several thousand casualties in Iraq and Afghanistan. We are losing 10-15,000 American lives each year due to lack of health insurance, and that doesn't count the number who die because their treatments are denied or delayed by insurance company malfeasance. It's been a 70 year fight against the insurance and drug industry for insurance for all, and it is time to bring an end to the casualties. The "death panels" are not in government, but in corporate America.
ReplyDeleteKT
NYC
Let's talk about The Double Standard. You know, that's the one where conservatives spend us into oblivion on two unfunded wars and Medicare Part D, then have the gall to complain about spending on the health of the American people.
ReplyDeleteSo how about this? Write a column demanding that all future wars be deficit neutral AND with a 4 year waiting period before you can start them. No need to soak-the-middle class to support the rich who benefit from war-profiteering at everyone else's expense.
Kathleen
Florida
We can't create a single dime of deficit on Health Care and caring for our people..!
ReplyDeleteWe can only create deficits to kill people...!
That's what we need that money for...killing people and Tax cuts for the top 1%, not providing Health Care for the rest of our people..!
Why don't people just understand this, Brooks?
TJ
Boiceville, NY
3000 souls needlessly lost one day and the Congress votes en masse to add over 2 trillion dollars to our debt attacking an uninvolved country.
ReplyDeleteOver 18,000 souls needlessly die every year because they are uninsured but we won't add a dime of debt?
God Bless America.
Peter
Newburyport
When George Bush was spending wildly, where were all these conservatives screaming about how to pay for it? Now we need to spend money on the American people for decent health care coverage, and they can't stop talking about the cost for all of it. The people that need this are our own people. How can any moral person deny people health care? These conservatives are always talking about family values and "Christian" values, but they have no idea what those phrases really mean. I would ask these people "What would Jesus do?" If you are a real Christian, you already know the answer. I never want to hear another conservative talk about their values or morals, and then watch them walk away from families, denying them health care.
ReplyDeleteJ. Toscano
Bklyn, NY
Unlike the accursed war in Iraq, a national health care plan with the potential to save the lives of many American citizens could well justify adding to the deficit...but I suppose only if you are sane.
ReplyDeleteMichael
Florida
Wow, republicans, after eight years of spending taxpayer dollars like drunken sailors, lying us into a war in Iraq, and making every attempt to destroy the constitution and civil liberties, have COME TO JESUS. They now want to be fiscal conservatives.
ReplyDeleteLying is still ok, though. Mr. Brooks, like most republicans is indeed a hypocrite.
Jay
Florida
The US pays the most per capita of any OECD nation, by over $2000 per annum. The US, by most accounts, ranks about 23rd in health care outcomes.
ReplyDeleteSeems simple to me, what you are currently doing isn't working so maybe it is time to look around at what other OECD nations are doing differently.
M Stewart
Sydney, AUS
Well, the CI certainly seems to have hit a nerve with this one! As I've said before, the first Republican member of Congress who can explain what's wrong with their "socialist, government run, taxpayer funded" health care plan, and why they've opted out of it based on government interference with their health care, I'll listen to. On the other hand, Rep. Bart Stupak, Democrat from the UP of Michigan, has refused his congressional health care plan until every American has an equal or better access to health care - now THAT's integrity on the issue. Let the Repubs save $$ on health care in America by refusing to accept it also!
ReplyDeleteZenCane (Marvin Roberson)
The UP, Michigan
So long as the federal government would rather squander trillions of dollars of our money on ridiculous wars on the other side of the planet and call it national security we will never have a real worthwhile health program in America. It seems to me that we the people, who are in dire need of better health care, schools, police and city rebuilding come last in the great scheme of the powers that be.
ReplyDeleteWhen rebuilding Iraq and Afghanistan is more important than our own country you better believe there is something radically wrong with our leadership. The best thing Obama could have said in his speech was that he was bringing the troops home, and that alone would pay for full healthcare for all.
Jerry
St. Louis
Funny, I don't recall Brooks saying that President Bush's credibility was at stake on the claim that his tax cuts went to the middle class, that they would not increase the deficit, that Iraq had weapons of mass destruction, that Iraq was involved in 9/11, that Medicare prescription coverage would cost a certain amount, that...
ReplyDeleteskeptonomist
Tennessee
My uncle was out of state and enroute home by car when he suffered a medical crisis and had to be air-lifted to a trauma hospital. Due to scar tissue that had built up from previous minor surgery, his intestines were perforated and he now has septic poisoning. Two weeks later his leg was amputated, he required heart surgery, and is still on life support. Right now we are most concerned that he live. However, I can't help but wonder if the scar tissue from a previous long ago surgery will be classified as a pre-existing condition and his health insurance be denied. Regardless, 2 weeks and many more to come in ICU, a helicoptor transport, months of physical therapy, and co-pays and the thousands not covered by insurance, will surely mean whatever savings they have at the age of 60 will be spent, and they now face the very real possibility that they will lose their home. It's sad and difficult enough to deal with a life-changing physical condition that will impact their daily lives forever. To think that my aunt and uncle will now have to worry about losing their home while Congress argues over the right to affordable health care for all Americans makes me want to scream.
ReplyDeleteLinda
CT
Hey, great, Obama is once again proven to be a moderate (gasp!). And he's outlined a moderate - and very necessary - approach to healthcare reform, which gives the GOP many of the things it wants.
ReplyDeleteWill anyone in the GOP support it? Not bloody likely.
So, once again, the Republican party will prove itself to be irrelevant or worse when it comes to social justice and dangerous when it comes to fiscal responsibility.
Despite the excellent proposals Obamas has made, the GOP - desperate to deal Obama a political blow at any cost - will continue to focus on non-existent issues like death panels, euthanasia and phantom benefits for illegal immigrants.
I've never seen grown men act so irresponsibly. Limbaugh in 2012!
Justin
NY
Mr. Brooks has coined a new oxymoron - "intelligent Republicans"! A group with less class and worse manners is hard to imagine. If I were Rep. Kantor's father, I'd take him over my knee and beat some manners into him. Clearly, there will be no Republican votes in the House for any plan.
ReplyDeletePED
Maryland
All to telling that Brooks calls the public option a liberal "obsession" and "tort reform" "centrist".
ReplyDeleteA public option is a compromise for single payer, the one system that has proved to be successful at bringing down costs and insuring everyone around the world. And single payer systems have as good or better results than the US system.
That is not an obsession, it is realizing the facts of what works. To the contrary tort reform where implemented has never brought down health costs. I'm not against tort reform, but it's a minor detail. The evidence is public health care works even in the US. Look at Medicare, people are more satisfied with it than people are with private insurance.
The only intransigent ideology is on the right. Against all evidence of public insurance working in this country and around the world, the right will not accept a public plan even if they are not required to join it, and not required to pay a "dime" for it. A public option is not ideology, it is pragmatism supported by FACTS! No cogent argument has been made by the right against it. The right says that it is "socialism" (That's not an argument, it's a boogeyman) and a government takeover (it is not and neither is Medicare). You and the right are the ones "obsessed" about it!
Paul
Charlottesville, VA
By now, we should know the formula: Republicans, when they govern, wreck the federal finances with unaffordable tax cuts and military adventures like Iraq. And then, when out of power, they use outrage about the deficit as an excuse not to fix problems. Our healthcare problem is our deficit problem and putting a first stake in the ground will allow the political possibility in future of carrying the country with you as you continue reforming things. After borrowing to pay for the Iraq war and expensive tax cuts that didn't generate any growth in median wealth for American families this decade (the Census data don't lie), it would be immoral and unfair to ask the uninsured to wait 10 years for things to settle down before addressing their 70 year old problem.
ReplyDeleteArvend
MI
The camera sweeps during the president's speech showing the Republicans illustrated their stupidity and callous disregard for anything that made any sense. They looked like a bunch of middle school boys acting stupid in a class they had no interest in. That's the problem. The right wing is only attractive to the "great unwashed" in our society, who are so ignorant they will go along with anything these jerks have to say, not knowing that the jerks are only out for their own enrichment and could care less if half of America drops dead.
ReplyDeleteOur system of health care deliverance is callous, greatly rationed, and just plain immoral. ALL the insurance companies are legalized "death panels." Introducing a single-payer plan by rolling together Medicare and Medicaid into one big comprehensive plan would make health care more democratic and much cheaper in the long run. I don't understand how people who supposedly know better keep insisting that we can't afford it. I haven't decided whether they are being disingenuous or they are just plain stupid. Probably a little bit of both. Just by getting rid of the Medicare prescription plan with its non-negotiation clause and ridiculous "donut hole" and ridding ourselves of payments to insurance companies for "Medicare Advantage" would save billions every year.
I could list many more ways we could save. I won't even bother listing them however, because any half-wit should know what they are, and the half-wits that don't know them wouldn't believe them anyhow. It looks to me as though we may get a bill with a few little changes, mainly laws against some of the more egregious policies of the insurance companies, but it's doubtful that they would be enforced to any extent. Our government is too pro-business to get really tough on big business.
Health care will continue to be a drag on the economy, keeping our businesses non-competitive and sending more jobs offshore. More and more Americans will lose their coverage as the premiums get too expensive and illnesses won't be addressed until people are at death's door. Some people say we can't saddle our children and grandchildren the debt of health care reform, but we're more than happy to saddle them with the debt and the immorality of a health care system designed for profit only.
Carole A. Dunn
Ocean Springs, Miss.