by Damozel | Paul Krugman discusses the Republican party's historic hatred of programs to provide health care to the people who need it most and can afford it least.
Sarah Palin ended her debate performance last Thursday with a slightly garbled quote from Ronald Reagan about how, if we aren’t vigilant, we’ll end up “telling our children and our children’s children” about the days when America was free. It was a revealing choice.
You see, when Reagan said this he wasn’t warning about Soviet aggression. He was warning against legislation that would guarantee health care for older Americans — the program now known as Medicare.
Ah yes, I remember it well. In those days, my dad used to inveigh against it regularly. Now my mother---who is 80 and has serious health problems---depends on it. People's attitudes about Medicare has shifted now that so many baby boomers are reaching the age when earning power ends and health problems accrue. Republican legislators, who get their health care benefits free with the job, continue to hate giving away federal money to elderly others, as Krugman points out.
Conservative Republicans still hate Medicare, and would kill it if they could — in fact, they tried to gut it during the Clinton years (that’s what the 1995 shutdown of the government was all about). But so far they haven’t been able to pull that off.
So John McCain wants to destroy the health insurance of nonelderly Americans instead. (emphasis added)
That is to say, he wants to start with the nonelderly and specifically with people who have preexisting health conditions.
Krugman lays it out, and not for the first time. But can it really be explained too often?
Mr. McCain....wants to blow up the current system, by eliminating the tax break for employer-provided insurance. And he doesn’t offer a workable alternative.
Without the tax break, many employers would drop their current health plans. Several recent nonpartisan studies estimate that under the McCain plan around 20 million Americans currently covered by their employers would lose their health insurance.
As compensation, the McCain plan would give people a tax credit — $2,500 for an individual, $5,000 for a family — that could be used to buy health insurance in the individual market. At the same time, Mr. McCain would deregulate insurance, leaving insurance companies free to deny coverage to those with health problems — and his proposal for a “high-risk pool” for hard cases would provide little help....
The good news, such as it is, is that more people would buy individual insurance. Indeed, the total number of uninsured Americans might decline marginally under the McCain plan — although many more Americans would be without insurance than under the Obama plan.
But the people gaining insurance would be those who need it least: relatively healthy Americans with high incomes. Why? Because insurance companies want to cover only healthy people, and even among the healthy only those able to pay a lot in addition to their tax credit would be able to afford coverage (remember, it’s a $5,000 credit, but the average family policy actually costs more than $12,000).
Meanwhile, the people losing insurance would be those who need it most: lower-income workers who wouldn’t be able to afford individual insurance even with the tax credit, and Americans with health problems whom insurance companies won’t cover.
And in the process of comforting the comfortable while afflicting the afflicted, the McCain plan would also lead to a huge, expensive increase in bureaucracy: insurers selling individual health plans spend 29 percent of the premiums they receive on administration, largely because they employ so many people to screen applicants. This compares with costs of 12 percent for group plans and just 3 percent for Medicare. (emphasis added)
Which is why Krugman concludes that McCain's plan makes no sense.
But there's more that Krugman didn't discuss.
It seems that McCain, if elected, plans to live the Republican dream by finally slashing Medicare and Medicaid DDay discusses McCain's further ideas for "making a horrendous plan worse."
John McCain's health care idea is to get employers to throw their workers off of their health plans by taxing the benefits, leaving employees to the wilds of the individual insurance market armed only with a tax credit that is too small to actually pay for health insurance. Barack Obama's campaign has been hammering this of late, so McCain's team adjusted the tax hit, applying it to income taxes and not payroll taxes. But I guess the budget numbers didn't match up, so to pay for that too-meager tax credit, it turns out that McCain wants to cut Medicare.
It's true. Ask The Wall Street Journal, where Laura Meckler writes:
John McCain would pay for his health plan with major reductions to Medicare and Medicaid, a top aide said, in a move that independent analysts estimate could result in cuts of $1.3 trillion over 10 years to the government programs.
The Republican presidential nominee has said little about the proposed cuts, but they are needed to keep his health-care plan "budget neutral," as he has promised. The McCain campaign hasn't given a specific figure for the cuts, but didn't dispute the analysts' estimate.
In the meantime, as The Wonk Room says, there's a reason McCain hasn't really talked much about how he plans to keep his plan "budget neutral."
McCain’s cuts echo a 1995 effort to “cut $270 billion, or 14 percent, from projected Medicare spending” over seven years and force millions of elderly recipients into managed health care programs or HMOs. As Speaker of the House Newt Gingrich admitted, “We don’t want to get rid of it in round one because we don’t think it’s politically smart,” he said. “But we believe that it’s going to wither on the vine because we think [seniors] are going to leave it voluntarily.”
There's a certain irony in his wish to make it more difficult for the rest of us to pay our medical expenses. Last week, during McCain's angry interview with the editorial board of The Des Moines Register, one board member asked an obviously seething McCain to answer whether at any time in his adult life he hadn't been covered by a health care plan funded by taxpayers. If I correctly understood his answer, there was a brief period, between his leaving the military and joining the US Congress, when taxpayers weren't paying for his health care expenses.
But speaking of McCain, did you know that McCain was a POW back in the Vietnam era? If you lose your insurance, is that too much of a sacrifice for you to make compared to what he sacrificed? Did McCain get free health care during his five years at the Hanoi Hilton? Did he? I think not.).
If you think this is all right, you're a true McCain supporter and I am afraid there's no help for you. Just know you make Jesus (the real one, not the fake Republican one) cry.
But if reading the above caused your brow to wrinkle with consternation and your stomach to turn, you had better get your stomach seen to while you still have health insurance.
Then you need to vote for Barack Obama.
Because make no mistake about it: the current crop of Republican politicians aren't in DC to make life easier for small businesses or ordinary people. They're there to protect the wealth of the very few in whose hands most of our national wealth is concentrated.
Main Street may be catching on and employers who fund health plans have something they want you to know.
American business, typically a reliable Republican cheerleader, is decidedly lukewarm about Senator John McCain’s proposal to overhaul the health care system by revamping the tax treatment of health benefits, officials with leading trade groups say.
The officials, with organizations like the U.S. Chamber of Commerce, the Business Roundtable and the National Federation of Independent Business, predicted in recent interviews that the McCain plan, which eliminates the exclusion of health benefits from income taxes, would accelerate the erosion of employer-sponsored health insurance and do little to reduce the number of uninsured from 45 million....
Mr. Obama more accurately characterized the McCain plan as a swap but one that would work to the detriment of millions. Middle-class families, he said, would “watch the system they rely on begin to unravel before their eyes.”
The business leaders said that was also their fear. Despite steady declines this decade, employers still provide coverage to 62 percent of Americans younger than 65. Surveys show that they want to continue doing so to attract and maintain a productive workforce.
The business leaders forecast that Mr. McCain’s free-market approach would impose particular burdens on small businesses and old-line manufacturers that are already struggling.(New York Times)
In other words, smart business people know that what McCain is offering isn't what they or anyone else in this country need right now.
Don't get fooled again.
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If the government didn't tax people from cradle to grave they would have enough money to buy their own damn health coverage.....
WHY DO YOU DEPEND ON THE GOVERNMENT SO MUCH.. because you want to. It's easier to take from other people to cover your shortcomings than earn your way through life.
Posted by: jeff ridge | October 23, 2008 at 03:00 PM
Jeff,
Instead of speaking in terms of sensible-SOUNDING generalizations that may or may not be true, why not do some solid research about health care costs, the actual factors that have led to skyrocketing costs, and tax revenues -- then come back with some solid analysis?
Anyone can utter specious cliches and platitudes.
Posted by: Deb Cupples (Buck Naked Politics) | October 24, 2008 at 12:40 AM