GOP:coverage for uninsured not the priority

[summer]

www.npr.org/blogs/health/2012/07/27/157439331/gop-says-coverage-for-the-uninsured-is-no-longer-the-priority

For decades, the primary goal of those who would fix the U.S. health system has been to help people without insurance get coverage. Now, it seems, all that may be changing. At least some top Republicans are trying to steer the health debate away from the problem of the uninsured.

The shift in emphasis is a subtle one, but it's noticeable.

Take this exchange between Fox News Sunday host Chris Wallace and Senate Minority Leader Mitch McConnell (R-Ky.) earlier this month, just after the Supreme Court upheld most of President Obama's health law.

Wallace: "What specifically are you going to do to provide universal coverage to the 30 million people who are uninsured?"

McConnell: "That is not the issue. ... The question is how can you go step by step to improve the American health care system? It is already the finest health care system in the world."


Wallace: "But you don't think that 30 million people who are uninsured is an issue?"

McConnell: "Let me tell you what we're not going to do. We're not going to turn the American health care system into a Western European system. That is exactly what is at the heart of Obamacare. They want to have the federal government take over all of American health care."

By "Western European," McConnell means government-run or primarily government-run. Western European countries also pretty much don't have people who don't have health insurance. And by the way, there are closer to 50 million Americans without health insurance; 30 million is the number the health law is estimated likely to cover.

But McConnell isn't the only top Republican saying covering the uninsured should no longer be the top priority.

"Conservatives cannot allow themselves to be browbeaten by failing to provide the same coverage numbers as Obamacare," Sen. Orrin Hatch, R-Utah, told a conference at the conservative American Enterprise Institute. "To be clear, it is a disgrace that so many American families go without health insurance coverage. But we cannot succumb to the pressure to argue on the left's terms."

So if getting more people coverage isn't the goal, what is?

"Your goal should be reducing costs, and expanding individual liberty," said Dean Clancy, who also spoke at the AEI conference. He's legislative counsel for Freedomworks, a group that supports and trains Tea Party activists.

But Clancy says reducing costs doesn't mean doing nothing, even though that's what many of the people he talks to would prefer. "What they don't often understand is the government has already screwed it up significantly, such that we have no choice but to try to reform, to undo the wrong things we've done," he said.

Clancy is only one of many policy types who are trying to convince more Republicans to put expanding coverage on the back burner. Another is Michael Cannon, head of health policy at the libertarian Cato Institute.

Cannon has long questioned the idea that expanding insurance coverage should be the holy grail of health reform.

"The idea that the government should guarantee health insurance to everybody passes as really gospel in health policy circles, without any serious consideration, without any sort of examination of why is it that we want people to have health insurance, is health insurance the best way to serve those goals, could there be lower-cost ways of achieving those goals," he said.

People need to have the freedom not to have insurance if the marketplace is to function properly, he says. "Because if they don't have freedom, if the government is requiring them to purchase health insurance either from a private company or the government, then the government gets to define what health insurance is, and that stifles a lot of innovation in the health insurance and health care delivery markets, and we're suffering under that sort of regulation right now," he says.

But supporters of the health care law say arguments about making the marketplace function better are all a big smokescreen.

"Every once in a while, the Republicans have rare moments of honesty. And so when they say that they don't want to expand coverage, this is one of those rare moments," says Ethan Rome, who runs Health Care for America Now, an advocacy group working to promote and defend the health care law.

"They look around and they see middle-class families and others in need, and what do they want to do? They want to give tax breaks to the super rich," he says. "That's who they are and what they do. And I think that's why they're starting to talk about how they don't want to expand coverage. Because they at least want to be truthful about a couple of things. And those are the ways in which they want to abandon certain populations and be frank about it."

Other analysts see a more calculated political tactic, however, in GOP efforts to downplay coverage expansions. They say it's more like class warfare: Republicans want to paint the health care law as requiring people who already have health insurance to help pay for those who don't. It will be up to supporters to demonstrate how the law is helping those who do have insurance keep it and pay less.

[IIOY]

Jul 31, 2012 4:54:11 GMT -5 summer said:

They say it's more like class warfare: Republicans want to paint the health care law as requiring people who already have health insurance to help pay for those who don't. It will be up to supporters to demonstrate how the law is helping those who do have insurance keep it and pay less.

If the primary goal of the ACA via the mandate, er, tax, is not to subsidize healthcare for more people, then what is it?

[teflep]

Jul 31, 2012 6:16:37 GMT -5 IIOY said:

Jul 31, 2012 4:54:11 GMT -5 summer said:

They say it's more like class warfare: Republicans want to paint the health care law as requiring people who already have health insurance to help pay for those who don't. It will be up to supporters to demonstrate how the law is helping those who do have insurance keep it and pay less.

If the primary goal of the ACA via the mandate, er, tax, is not to subsidize healthcare for more people, then what is it?

obviously to keep it cheap for those with it, per this nor story.

[secretlyevil]

I started c&ping all the excerpts that deserved an and then I realized that it was the majority of the article (all the quotes).

This one, however, deserves two.

"The question is how can you go step by step to improve the American health care system? It is already the finest health care system in the world."


If it is the "finest in the world" then why does it need to be improved? Because let's see - actual cost is astronomical, people have to choose between food and their meds., and oh I don't know 50 million citizens do not have health insurance which leads to a whole list of additional problems.

[IIOY]

Jul 31, 2012 6:20:16 GMT -5 teflep said:

Jul 31, 2012 6:16:37 GMT -5 IIOY said:

If the primary goal of the ACA via the mandate, er, tax, is not to subsidize healthcare for more people, then what is it?

obviously to keep it cheap for those with it, per this nor story.

And the biggest selling point for keeping it "cheap" is giving more people access, yes? Expanded access was one of the primary selling points (if not *the* primary selling point) of the ACA and the reason people were having socialism-related meltdowns at townhall meetings. The justification for the mandate was that we needed healthy, non-consumers to expand the pool of coverage to bring the costs down. This is precisely what insurance pools are all about and was supposed to help put health care in reach for millions more.

I feel as though use of the term "class warfare" in the context of this election and politics in general has shifted so as to imply that an argument is inherently spurious. It's become a shorthand dismissal without an examination of the underlying merits. I don't like this regardless of which direction it flows.

[teflep]

Jul 31, 2012 6:32:46 GMT -5 IIOY said:

Jul 31, 2012 6:20:16 GMT -5 teflep said:

obviously to keep it cheap for those with it, per this nor story.

And the biggest selling point for keeping it "cheap" is giving more people access, yes? Expanded access was one of the primary selling points (if not *the* primary selling point) of the ACA and the reason people were having socialism-related meltdowns at townhall meetings. The justification for the mandate was that we needed healthy, non-consumers to expand the pool of coverage to bring the costs down. This is precisely what insurance pools are all about and was supposed to help put health care in reach for millions more.

I feel as though use of the term "class warfare" in the context of this election and politics in general has shifted so as to imply that an argument is inherently spurious. It's become a shorthand dismissal without an examination of the underlying merits. I don't like this regardless of which direction it flows.

I was agreeing with you, but thought it was more constructive than eye rolling the quoted part

[Deleted]

He hit all the GOP talking points, "America has the finest healthcare system in the world," western europe = bad, obamacare = socialized medicine. Bravo Mitch McConnell for avoiding the issue.

[ttt]

I'm glad to see the Republicans are no longer pretending to care about Americans without health insurance.

[msmerymac]

Jul 31, 2012 6:29:21 GMT -5 secretlyevil said:

I started c&ping all the excerpts that deserved an and then I realized that it was the majority of the article (all the quotes).

This one, however, deserves two.

"The question is how can you go step by step to improve the American health care system? It is already the finest health care system in the world."


If it is the "finest in the world" then why does it need to be improved? Because let's see - actual cost is astronomical, people have to choose between food and their meds., and oh I don't know 50 million citizens do not have health insurance which leads to a whole list of additional problems.

Yeah, that was the first 8-D for me too. If it's the best in the world, why wouldn't you want everyone in this country to have access to it? Why make it better for the people who HAVE it and ignore those who don't? Now who's engaging in class warfare?

This was my second big eye-rolly moment:

People need to have the freedom not to have insurance if the marketplace is to function properly, he says. "Because if they don't have freedom, if the government is requiring them to purchase health insurance either from a private company or the government, then the government gets to define what health insurance is, and that stifles a lot of innovation in the health insurance and health care delivery markets, and we're suffering under that sort of regulation right now," he says.

WTF does that mean? People need to have the freedom to not have health insurance? Why do people want that freedom?!

[basilosaurus]

Part of what makes our system the best (in their view) is restricted access. They don't want to have to share a waiting room with the unwashed poor. So, why fix the problem of the uninsured? They see it as a benefit.

[ringstrue]

One thing we should stay focused on is to only find solutions that no European country has ever tried and proved to be successful.

What's Antarctica's healthcare system like?

[Deleted]

I agree that the US has the best health care system in the world, for those that are either insured or rich. But when 10-20% of your population doesn't have access, thats a problem.

I dont think that by opening up coverage the US is suddenly going to lose their 'status' as having the best health care. If anything, other countries will respect it even more. That being said, I'm not sure other countries' respect really matters, the important thing is that everyone can access it.

[MrsAxilla]

Jul 31, 2012 11:18:54 GMT -5 ringstrue said:

One thing we should stay focused on is to only find solutions that no European country has ever tried and proved to be successful.

What's Antarctica's healthcare system like?

it's totally socialist. There's one or two docs who take care of everyone....FOR FREE! Of course, there's also no hospital so if you need more than a band aid you're fucked.

[basilosaurus]

Jul 31, 2012 11:22:33 GMT -5 MrsAxilla said:

Jul 31, 2012 11:18:54 GMT -5 ringstrue said:

One thing we should stay focused on is to only find solutions that no European country has ever tried and proved to be successful.

What's Antarctica's healthcare system like?

it's totally socialist. There's one or two docs who take care of everyone....FOR FREE! Of course, there's also no hospital so if you need more than a band aid you're fucked.

Bootstraps! Don't you remember that woman operating on herself? That's the American way!

[heyjude]

Can you imagine America hosting the Olympics and featuring our healthcare system in the opening ceremonies? What would that look like?

[Deleted]

Jul 31, 2012 11:32:01 GMT -5 heyjude said:

Can you imagine America hosting the Olympics and featuring our healthcare system in the opening ceremonies? What would that look like?

LOL.
One could argue that if canada did that, everyone would be lined up in a giant line

Although I called my GP's office this morning to book a non-urgent appt (talk about my anxiety) and Im in Friday morning. So actually, the "Lineups" (according to Republicans) aren't always so bad.

[soontobeka]

Jul 31, 2012 11:04:19 GMT -5 basilosaurus said:

Part of what makes our system the best (in their view) is restricted access. They don't want to have to share a waiting room with the unwashed poor. So, why fix the problem of the uninsured? They see it as a benefit.

Sibil- IMO, you have hit the nail on the head.

[wawa]

Jul 31, 2012 11:13:25 GMT -5 mr+ms said:

Well, in a way I can see their point about having the "freedom" not to have health insurance.

My personal pet peeve about this debate is how insurance-centric it is, as if we can't ever hope to pay for anything at all without a fucking insurance company holding your hand (all the while intervening in relationships where they don't belong and creating a ridiculous amount of clutter with all of their stupid networks and rules and paperwork).

OTOH, as it is, insurance = access unless you are considerably wealthy or so poor/old that you qualify for medicaid or medicare.

I completely agree with this. I'm frustrated that the entire debate has been centered on increasing access to health insurance. As if it's impossible to increase access to health CARE without touching insurance.

But the way our system is set up...yeah, it is kinda impossible. And if that's what they meant (that they'd rather increase access to care without adding the complications of full-coverage HI for everybody) then they said it very badly.

[bqbride]

Jul 31, 2012 11:32:01 GMT -5 heyjude said:

Can you imagine America hosting the Olympics and featuring our healthcare system in the opening ceremonies? What would that look like?

The zombie dance from Michael Jackson's Thriller video was the first thing that came to mind....

[ttt]

Jul 31, 2012 11:32:01 GMT -5 heyjude said:

Can you imagine America hosting the Olympics and featuring our healthcare system in the opening ceremonies? What would that look like?

This would be awesome. You could have a field full of people waiting on hold to speak with their insurance companies about disputing a denied claim.

[aurora]

Jul 31, 2012 16:35:36 GMT -5 ttt said:

Jul 31, 2012 11:32:01 GMT -5 heyjude said:

Can you imagine America hosting the Olympics and featuring our healthcare system in the opening ceremonies? What would that look like?

This would be awesome. You could have a field full of people waiting on hold to speak with their insurance companies about disputing a denied claim.

And a big read "Denied" stamp that randomly comes down and squashes the performers!

[ttt]

Jul 31, 2012 17:17:18 GMT -5 NewOrleans said:

Of course the uninsured are not the GOP's priority. Abortion is.

And teh gayz!