Friday, July 10, 2009 - Posts
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sponsorship
Tremors: The key sentences from Jonathan Cohn's worry about the House's delay in unveiling its latest health bill:
But lurking behind all of these complaints, according to several sources I consulted Thursday evening, is a general wariness of taking a political plunge on health care. Like their counterparts in the Senate, House members don't like taking hard votes. Raising taxes, cutting spending, anything that takes money out of people's pockets--these are not things they want to do, even in the service of a greater, more popular cause.
And now they're getting nervous. They're seeing the president's popularity dipping, however incrementally. They're watching the Senate chase its tail over the same controversies. And having just taken what were--for many of them--similarly tough votes on an energy bill, they're not exactly thrilled about "walking the plank" again.
Cohn is the last guy to indulge in generic pontificating about "the president's popularity dipping," so if he's now worried about the president's popularity dipping I figure there's reason to worry about the president's popularity dipping. ... I also assume it's still more dangerous for Democrats to not pass a health bill than to pass one. What are Dems good for if they can't do that? But the bad economy gives them a ready excuse for further study. Mike Kinsley is now pointing in that direction. ["Even the liberal" Mike Kinsley?--ed No. He'd be among the first to be alarmed by future deficits.] ... 12:42 P.M.
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WaPo's Alec MacGillis notes that Obama's health care reformers
are clearly spooked by the notion that they could be accused of denying, for example, hip surgery to an 80-year-old.
If so, they largely have themselves to blame. They brought it up! It wasn't the Republicans who billed health care reform as a cost saving, budget-balancing measure that would start to deny payments for treatments deemed "ineffective," or (as one acolyte put it) when "a person's life, or health, is not worth the price." And to think when they heard that people started to worry about rationing! Fancy that.
MacGillis also makes it clear that the Obama wonks are hiding the ball on the ultimate decisions their cost-cutting mission might entail:
A senior administration official who requested anonymity to speak candidly acknowledged that while research might point to obviously wasteful practices, the reform would for the time being not get at the "harder question" of what to do "if new technology does work better and reduces risks but costs a lot more, and how to evaluate that."
Unfortunately voters, who may deal with expensive new medical technologies every other day, aren't dumb enough not to see this "harder question" coming down the pike.
Why raise the cost-cutting issue at all? Especially if you're not going to do much about it!
In their unconvincing second-stage fallback arguments the "rationing" charge--Stage 1: No, of course we won't ration! Stage 2: Sure, we'll ration! But we're rationing now!--Dem reformers note that price is a particularly nasty way to limit access to health care:
Others retort that the United States already has rationing: The uninsured and under-insured do not get the care they need.
So why not bill health reform as ... giving the uninsured and uninsured the care they need! Hey, there's an idea. In fact, why not simply say you're reforming health care to provide health security to all Americans, including the always-anxious middle class--instead of suggesting that you are funding care for the poor out of the hip replacements of the elderly affluent? Give everybody the medical care Medicare recipients now enjoy in, say, McAllen Texas. Pay the bill with higher taxes. Then worry about reining in overtreatment and rationing later. (My bet: Voters will prefer to keep paying the bill, if that's necessary to keep the hip replacements and cancer drugs coming.)
P.S.: Kirsten Powers' excellent column today makes this same basic point. Except she has polling data to back it up. ... 3:33 A.M.
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When Father Hesburgh throws down ... How can we know when the tide of respectable opinion has decisively turned against the teachers' unions? When a panel that includes Father Hesburgh, Birch Bayh,. Bill Bradley, Eleanor Holmes Norton and Roger Wilkins goes medieval on them, saying their resistance to reforms designed to hold schools accountable has hurt "disadvantaged students" and led to "calcified systems in which talented people are deterred from applying or staying as teachers ..."
Here are two undiplomatic grafs from the report's final page:
The unions have battled against the principle that schools and education agencies should be held accountable for the academic progress of their students. They have sought to water down the standards adopted by states to reflect what students should know and be able to do. They have attacked assessments designed to measure the progress of schools, seeking to localize decisions about test content so that the performance of students in one school or community cannot be compared with others. They have resisted innovative ways-such as growth models-to assess student performance.
In their attack on education reform, the national unions have often been unconstrained by considerations of propriety and fairness. They have sought to inject weakening amendments in appropriations bills, hoping that they would prevail if no hearings were held and the public was unaware of their efforts. They have used the courts to launch an attack on education reform, employing arguments that could imperil many federal assistance programs going back to the New Deal. They have failed to inform their own members of the content of federal reform laws.
The report follows up a much heralded establishment call for reform in 1996 that was endorsed by two union presidents. But it notes that in the twelve years since, "few of the necessary reforms" have been put in place. ("Twelve years--the entire length of a child's education--is a long time.") In other words, it implicitly serves as an argument against trying to reform the schools in cooperation with the unions, and in favor of trying to reform the schools by defeating the unions. ...1:48 A.M.
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