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Republicans want to make the insurance industry more like the credit card industry

"A House Republican health-care bill wouldn't seek to prevent health-insurance companies from denying sick people insurance," the first paragraph of the Wall Street Journal's preview of the latest Republican health-care reform alternative says. "Republicans also wouldn't prevent insurers from ending policies once an individual becomes seriously ill," reads the fifth. On the bright side, the Republican bill would allow insurers to base themselves in whichever state has the weakest regulatory standards and then sell policies built around those rules nationwide. If you've ever thought that your insurance was too comprehensive, too straightforward, and contained too few loopholes that you didn't learn about until you feel terribly ill, then this is the plan for you!

I'm tired of doing this. I'm tired of pretending that political documents are the same as policy documents. Republicans have not released a plan to reform the health-care system. They have released a plan (pdf) to have people stop bugging them about releasing a plan to reform the health-care system. The two are not the same thing.

The difference is clear from the first page. The bill released by House Democrats states that the legislation is meant "to provide affordable, quality health care for all Americans and reduce the growth in health care spending, and for other purposes." The "amendment in the nature of a substitute" by John Boehner says, "The purpose of this Act is to take meaningful steps to lower health care costs and increase access to health insurance coverage (especially for individuals with preexisting conditions) without --

(1) raising taxes;
(2) cutting Medicare benefits for seniors;
(3) adding to the national deficit;
(4) intervening in the doctor-patient relationship; or
(5) instituting a government takeover of health care."

The bill is framed in terms of Republican attacks on the Democratic bill, not in terms of its own aims or methods. Which is fine, and to be expected. If I were a Republican, I wouldn't spend my time crafting a health-care reform plan, either. Republicans don't have the votes to pass a bill, and they know it. As such, they're not particularly interested in spending months crafting a precise and detailed health-care reform alternative, as it wastes time that could be spent fighting the Democratic bill, raising money for 2010, and generally working on projects that have an actual chance to succeed.

But you don't get to have it both ways. You don't get to save time by producing a bill that wouldn't solve any problems and doesn't hang together and then also get to whine about how no one is covering the legislation you introduced on Nov. 3 when you can't even say how many people will be covered under your bill! This isn't serious legislation. It's a really long press release. And I don't cover really long press releases.

The irony is that the GOP is lucky that most of the press corps will react similarly. A serious investigation into what would happen if we let insurers cluster in the state with the least regulations and then sell that product nationwide would not go well for the Republicans. Nor will a sustained look at the world of "high-risk pools" be comforting to Americans. "Make the insurance industry more like the credit card industry!" is not a winning slogan.

By Ezra Klein  |  November 3, 2009; 12:30 PM ET
 
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Comments

And I don't cover really long press releases.

Well judging from this post, apparently you do!

Posted by: redwards95 | November 3, 2009 12:46 PM | Report abuse

"A serious investigation into what would happen if we let insurers cluster in the state with the least regulations and then sell that product nationwide would not go well for the Republicans."

So where is that piece of investigative journalism? I've been waiting to read a substantive analysis of the proposal to allow insurers to market across state lines ever since John McCain endorsed it during the presidential election ... and not a single "liberal" publication has taken up the gauntlet.

Journalists who understand why this is a bad idea arrogantly assume that anyone who doesn't appreciate the problems are just too stupid to talk with. As a result, the Republicans can keep claiming it would somehow help us in containing health care costs and it sounds good.

The Democrats set themselves up for this by
* Not refuting the supposed advantages of the national insurance market proposal from the outset
* Conflating insurance with care
* Allowing Republicans and journalists to set up the strawman of "socialized medicine" instead of starting with a sensible universal *care* proposal.

Posted by: Athena_news | November 3, 2009 1:17 PM | Report abuse

"I'm tired of doing this. I'm tired of pretending that political documents are the same as policy documents. Republicans have not released a plan to reform the health-care system. They have released a plan (pdf) to have people stop bugging them about releasing a plan to reform the health-care system. The two are not the same thing."

You are right here Ezra. Your time will be much more productively used than these useless press releases for 3rd graders.

That is our collective tragedy (that there is no viable, serious political opposition articulating good policy responses) and we Americans will pay for that. Blame for that is with Fox and other MSM who are reluctant to call the bluff.

And if you want to go after these foolish GOP politicians, the way you do is the way Frank Rich on NYT slammed their Pavlovian Afghan war policy. In particular the way he thrashed Sen. McCain about that policy; that was Royal.

Anyways. If not, you can continue to oblige us by telling:

- what is about MedPAC and iMAC in these bills? Any chance those would survive, strengthened?

- Megan McArdlee had a solid post critiquing the House bill "The True Cost of the House Health Care Bill". It will be a real addition to this debate, on top off what has been delivered on this blog; if we get some serious responses to Megan's post.

Posted by: umesh409 | November 3, 2009 1:32 PM | Report abuse

Sorry about these demands, I am shameless! My apologies there...

Posted by: umesh409 | November 3, 2009 1:36 PM | Report abuse

Ezra,
Why don't you just change the name of your blog to DNC Policy Statements and Lots of Them (and regurgitated material from TNR and Matt Yglesias)? It's a little long, but the change would just make official the fact that you have turned this section of the WaPo into what is essentially a PR arm for the Democrats.

Posted by: novalfter | November 3, 2009 1:39 PM | Report abuse

What are you talking about?! I love my credit card! The hidden fees are great. The fine print is a challenge to interpret, like the Di Vinci code! And who could live without arbitrary changes to their APR?

Every college student with no earning power or impulse control should have one. It teaches responsibility. If only health insurance could do that for the kids, maybe they wouldn't get so sick.

Posted by: itstrue | November 3, 2009 2:19 PM | Report abuse

This has been the problem all along as the Repubs have decided to oppose without an alternative. There are a lot of good ideas out there from conservative healthcare economists (and even conservative plans from liberals, like Brad DeLong and Ron Wyden) that lost their opportunity for debate and incorporation/compromise because of that nihilistic stance. The result is that one basic bill (of a few different flavors) is available right now that's certainly flawed, but preferable to the status quo and can be further refined as time goes on. Sure there are good points to be made about the benefits of consumers having more direct cost exposure or changing standards for malpractice, but we're well past the time for idle theoretical musing. The Republicans had to put up or shut up, and they've done neither.

Posted by: etdean1 | November 3, 2009 2:24 PM | Report abuse

"If I were a Republican, I wouldn't spend my time crafting a health-care reform plan, either." I appreciate your appreciating that.

"But you don't get to have it both ways. You don't get to save time by producing a bill that wouldn't solve any problems and doesn't hang together" - I get it. You don't agree with this bill so it doesn't count. Well, you could hardly be expected to agree, given your views. Let's see how conservatives feel about it instead. If they approve, you have already made all the admissions you need to, to remove your moral right to call them obstructionist.

Does someone expect conservatives to cooperate with bills that they disagree with strongly? Instead, just fly right past their view of what ought to be done, because it's not your view. That makes sense.

Posted by: MikeR4 | November 3, 2009 3:02 PM | Report abuse

""Make the insurance industry more like the credit card industry!" is not a winning slogan. "

For the Republicans, that is. But we'll add "the Republicans want to make the insurance industry more like the credit card industry!" to the long list of slogans and potential attack ads that a smarter Democratic Party would have used against them.

"What are you talking about?! I love my credit card! The hidden fees are great. The fine print is a challenge to interpret, like the Di Vinci code! And who could live without arbitrary changes to their APR?"

Thanks for reminding me. America just wouldn't feel like home without constant fighting over small print and arbitrary contract changes.

Posted by: guardsmanbass | November 3, 2009 3:18 PM | Report abuse

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