Why’d he do it? Why did George Bush propose a series of initiatives widely-acknowledged as “dead on arrival”? Obviously to distract from his foreign policy woes—but his proposals also serve as an attempt to recast the healthcare debates in terms favorable to the insurance industry, while gumming up the drive for genuine healthcare reform that our nation so badly needs. We’ll take a look at the evidence—and the unfriendly reaction this plan received around the nation.
The Wall St. Journal, long cheerleaders for America’s current healthcare system, give us our first clues to the political thinking behind Bush’s proposals:
Most Americans can see for themselves that the current employer-based system is breaking down, as more companies pass along the rising cost of their insurance to employees (in higher co-pays and deductibles). Yet the system remains opaque and frustrating because of the underlying tax bias for businesses instead of individuals.
This status quo won't hold, and the political race is going to be between those who want to move to a more genuine market and consumer-based health care, and those who want to move toward Canada, Europe and more government control. The Bush plan ought to jump start that debate.
And there we have it. Bush is throwing out rhetorical head feints not as serious policy but in order to shift the debate in ways that encourage “more of the same” health policy—specifically a “killer” market for health insurance companies. This is a dichotomy that the California Nurses Association calls “market-centered” vs. “patient-centered” approaches. More of the same, or single-payer?
It is cheering, or course, that the WSJ (and apparently Bush) fear the coming move to the patient-centered systems, a la Canada and Europe, also known as single-payer healthcare. They are cheaper and more effective—just what Americans are looking for in their health reform.
And, by the way, WSJ--it’s not the tax biases that make the system opaque and frustrating; it’s the system that does that.
In a different column in the Journal (reg. req’d.), editorialist Alan Murray lays it right out there: "Still, the Bush plan is a big idea that will help frame the health care debate for the future."
This PR campaign is apparently coordinated on a wide basis. Media Matters notes that all the administration’s cheerleaders are reading from the same talking points.
In line with the goals of this reframing campaign, Ruth Marcus in a widely-discussed Washington Post article attacks healthcare reform advocates for daring to not buy into Bush’s reframing of the healthcare debate. She writes:
And, yes, it's fair to argue that a more comprehensive approach -- Sen. Ron Wyden (D-Ore.) has proposed one -- is needed
But Democrats -- if they care more about addressing health-care needs than scoring political points -- ought to be finding ways to improve and build on the Bush proposal, not condemning and mischaracterizing it.
While Bush’s proposals recast the long-term debate, insurance companies are short-term beneficiaries. According to the AP:
President Bush's State of the Union proposal aimed at increasing health coverage for uninsured Americans might provide a boost to managed care providers such as UnitedHealth Group Inc., Wellpoint Inc. and others looking to increase their enrollment numbers.
At first, it would appear that hospital companies would benefit from Bush's proposal because fewer uninsured would mean less bad debt. However, Bush is proposing to take money from funds given to hospitals that serve large numbers of Medicare and Medicaid patients and give it to states to bankroll their plans to expand health insurance. Plus, analysts said that if Bush's proposal pushes people into plans with less generous coverage, more individuals will struggle to pay their hospitals bills.
And Maggie Fox at Reuters notes:
President George W. Bush's proposed health-insurance plan will raise taxes while helping only a few people, and may eviscerate existing coverage, critics said on Wednesday.
The National Association of Health Underwriters and America's Health Insurance Plans welcomed Bush's ideas.
One result of this giveaway to the insurance industry? A possible hospital vs. insurance war? Proof that the coalition propping up our broken healthcare system might be finally breaking down.
Elsewhere, an LA Times reporter calls Bush’s proposal “dead-on arrival,”
a California blogger coins the term “cancer tax,” and CNN Money suggests that it’s really a plan to soak the sick, while editorialists across the country took issue with the proposal. I like the article in the Des Moines Register:
The president’s plan represents a piece-meal approach to a national problem demanding a comprehensive solution. What ails this country’s health-care system can’t be fixed by fiddling with the tax code.
This country needs a national approach to health care that offers basic coverage to everyone, perhaps similar to Medicare for seniors.
There are no guarantees of universal coverage and states are unlikely to receive additional funds to implement this plan, which will likely face opposition in Congress.
Bush would also like to tax employer-based health care plans starting in 2009, and offer a $4,500 tax deduction to individuals who purchase their own insurance plans for $3,000. Assuming, of course, that they earn enough for the tax deduction to matter.
Employer-based health care no longer works for the country, offering fewer options and costing more to employers and employees alike. But taxing those who are happy with their plans hardly seems right.