June 21, 2009

I feel like I'm turning into Jerry Seinfeld: Have you ever noticed how only Democratic deficits are a problem? Republicans are sticking to their Frank Luntz-authored talking points on health care (as Chris Dodd points out about Lindsey Graham on This Week this morning) and pulling their beards, speaking ponderously of the horrors of spending money to save money:

STEPHANOPOULOS: Republicans seem to be digging in, Senator Graham, on a couple of big issues. On the issues of taxes to pay for health care, on the issue of a public health insurance plan. But let me show you this New York Times poll that's just out this morning showing 72 percent, 72 percent of the public supports a government health insurance plan and 57 percent of the public is willing to pay more taxes for universal health care. They seem to be ready for the kind of change that Republicans are fighting.

GRAHAM: Well, it's just not Republicans, George. The reason you're not going to have a government run health care pass the Senate is because it would be devastating for this country. The last thing in the world I think Democrats and Republicans are going to do at the end of the day is create a government run health care system where you've got a bureaucrat standing in between the patient and the doctor. We've tried this model -- people have tried this model in other countries. The first thing that happens -- you have to wait for your care. And in socialized health care models, people have to wait longer to get care and the government begins to cut back on what's available because of the cost explosion.

Lindsey, you silly thing! I know you're only saying what Frank told you to say, but since you've apparently had government-run health care most of your adult life (in the military and in public office), you probably don't know: We already have bureaucrats standing between us and our doctor. We already wait for care, and it's already rationed. That's why these talking points from Frank aren't working - they're not our reality.

The CBO estimates were a death blow to a government run health care plan. The finance committee has abandoned that. We do need to deal with inflation in health care, private and public inflation, but we're not going to go down to the government owning health care road in America and I think that's the story of this week. There's been a bipartisan rejection of that.

STEPHANOPOULOS: Well, you call it a death blow. Let me just press that point. Are you saying now that Republicans just as we saw in the stimulus where I think only three Republicans voted for the president's stimulus package -- if there's a government run health insurance plan, are Republicans going to vote on that against this package?

GRAHAM: I don't think it's just going to be Republicans. You've got Senator Conrad talking about a co-op. You've got other Democrats running away from the government-run health care where the bureaucrat stands between the doctor and the patient. I think this idea is unnerving to the members of the Senate and will be to the public when they understand what it means, that you'll wait longer to get treated and you'll get health care the government decides for you, not that of your doctor. So yes, I think this idea needs to go away and replace it with something maybe like Kent Conrad's proposal.

STEPHANOPOULOS: Now Senator Dodd, I think that Senator Graham talked about the public there. We just saw that hole. But his read of the Senate seems pretty accurate right now. You have not only Republicans but several of your Democratic colleagues, including the chairman of the Senate Finance Committee, Senator Baucus saying the public option isn't going to fly in their committee. They want something bipartisan and that can't include this public health insurance option.

DODD: Well, again, I'm delighted to hear Lindsey talk about the possibility of having something like a co-op and non-profits. I happen to support a public option, I don't think you can bring down costs without it. If there isn't some competition out there to drive down the overall cost -- costs have gone up 86 percent since '96, 1996. Forty-five percent might stay the loan, increase in health care cost. The American average working family can't afford this. A family of four now. it's $12,000. We're being told in 20 years, it could be half the gross income of a family spent on health care premiums. That is just unacceptable.

Now how we get those costs down -- you use a lot of these buzz words. No one I know is for socialized medicine. We're going to develop a U.S. plan, not a Canadian or a U.K. plan, one that meets our needs in our country. It's designed for Americans, by Americans, that isn't socialized medicine. But you've got to drive down these costs. We need quality, accessible health care in bringing down those costs are absolutely critical, or we're going to bankrupt the country. It's unsustainable. That's why we're at the table.

Now, let me make that even clearer: Dodd's right when he says the present situation is unsustainable. Borrowing money to fix this is rational, the same way borrowing to fix a major structural problem with your house is. As economist Brad DeLong pointed out this week:

America's long-run fiscal problems are caused by health care, and will not be appreciably made worse by this half-decade's federal fiscal stimulus. If restructuring the health care system can bend the curve on the rise in overall (and hence public as well as private) health care costs, then America has ample debt capacity to borrow whatever we wish in this crisis--and to borrow it at extraordinarily favorable rates as well.

If the curve of rising health-care costs is not bent, then the government's long-term finances are in trouble and so is the growth of private-sector non-health living standards: health care costs that rise as fast as CBO is projecting in the baseline cause lots of long-run economic problems, of which government fiscal bankruptcy is not the worst. Health care reform to bend the long-run curve of costs is now just what it was back in 1993: the most important issue for the American political system to deal with.

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