The Curve-Benders Circle the Wagons!

A mostly political weblog.
July 22 2009 6:31 AM

The Curve-Benders Circle the Wagons!

The estimable Jonathan Cohn is remarkably unconvincing  in arguing that long term health care cost-curve-bending is politically essential, right now, for the Democratic Party --as opposed to essential for some Blue Dog Dems who want to posture as non-big-spenders. If Congress passes a bill that basically produced universal, secure coverage and was deficit neutral over 10 years, are Dems really going to be punished at the polls because it doesn't also reduce the rise in medical expenses that's expected in years 11-30? 

It seems particularly unlikely that, as Cohn argues, long term curve-bending is essential for its political appeal to moderate income voters: 

Advertisement
If Democrats don't make the difficult decisions on raising revenue and controlling costs, then the reform they pass won't do much to help middle class Americans.  

a) Huh? Isn't the reform offering health security to middle class? Cohn should read Drum . b) Cohn suggests that lower subsidies will hurt the near-poor, who are middle class. But that's an argument for higher short term subsidies, which would have to be paid for by short term cuts or revenues. Long term curve bending doesn't affect those subsidies, at least not for a long time; c) In the long run, I suppose, Cohn's argument would be that the expected rise in medical costs will make health care less affordable to those in the middle, taking a bigger bite of their paychecks. True enough. Against this, though, you have to balance understandable middle class fears that Orszag's untested cost-bending solutions, involving empowering bureacrats to deny reimbursement for treatments on grounds that--well, who knows what the grounds will end up being --would bend the curve by undermining the very health security reform promises . That seems, at best, a wash.

I mean, do you really think the middle class Americans will oppose (or not care about) a historic, 10-year-deficit-neutral universal care bill that doesn't bend the curve, but suddenly burn up the Capitol Hill phone lines to demand that the package be passed when they learn that it contains an "Independent Medicare Advisory Commission"?   That's red meat out in the suburbs!**

I share the Obamist consensus that failure to pass a health bill would be politically disastrous for Dems, including the very moderates in swing districts who are currently making demands . Democrats need a victory. But a  historic coverage-securing bill that isn't a "curve bender" would be more than victory enough. ... And if Republican candidates then really started making a fuss about the perils of rising costs in 2024--as opposed to making a fuss about, say, government-mandated cost-control rationing near the end of life--the stage would be set for the Orszagists to push their curve-bending plans.  (Or is it because Cohn et al know this won't happen that they're desperately trying to portray curve-bending as politically essential this year?) ...

**--Isn't it more likely that empowering this cost-cutting commission will open up the reform to a Dick Morris-style they're-destroying-Medicare attack ? ...  4:11 A.M.

___________________________

TODAY IN SLATE

Technocracy

Forget Oculus Rift

This $25 cardboard box turns your phone into an incredibly fun virtual reality experience.

Republicans Want the Government to Listen to the American Public on Ebola. That’s a Horrible Idea.

The 2014 Kansas City Royals Show the Value of Building a Mediocre Baseball Team

The GOP Won’t Win Any Black Votes With Its New “Willie Horton” Ad

Sleater-Kinney Was Once America’s Best Rock Band

Can it be again?

Politics

Smash and Grab

Will competitive Senate contests in Kansas and South Dakota lead to more late-breaking races in future elections?

I Am 25. I Don’t Work at Facebook. My Doctors Want Me to Freeze My Eggs.

These Companies in Japan Are More Than 1,000 Years Old

  News & Politics
The World
Oct. 21 2014 11:40 AM The U.S. Has Spent $7 Billion Fighting the War on Drugs in Afghanistan. It Hasn’t Worked. 
  Business
Business Insider
Oct. 21 2014 11:27 AM There Is Now a Real-life Hoverboard You Can Preorder for $10,000
  Life
Quora
Oct. 21 2014 11:37 AM What Was It Like to Work at the Original Napster?
  Double X
The XX Factor
Oct. 20 2014 6:17 PM I Am 25. I Don’t Work at Facebook. My Doctors Want Me to Freeze My Eggs.
  Slate Plus
Tv Club
Oct. 20 2014 7:15 AM The Slate Doctor Who Podcast: Episode 9 A spoiler-filled discussion of "Flatline."
  Arts
Behold
Oct. 21 2014 12:05 PM Same-Sex Couples at Home With Themselves in 1980s America
  Technology
Technology
Oct. 21 2014 10:43 AM Social Networking Didn’t Start at Harvard It really began at a girls’ reform school.
  Health & Science
Climate Desk
Oct. 21 2014 11:53 AM Taking Research for Granted Texas Republican Lamar Smith continues his crusade against independence in science.
  Sports
Sports Nut
Oct. 20 2014 5:09 PM Keepaway, on Three. Ready—Break! On his record-breaking touchdown pass, Peyton Manning couldn’t even leave the celebration to chance.