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The Fox News/David Brooks tag team

Jon Chait points out an important dynamic here:

Obviously, delaying the Cadillac tax increases its political vulnerability to some degree. But I wonder why Brooks and Douthat can so casually blame Obama for this change. Unions argued against the tax on the grounds that their members had foregone wage hikes in order to obtain expensive health insurance. Providing a short-term reprieve for health plans obtained through collective bargaining was a reasonable way to keep most of the bite of the tax in place while accommodating those concerns. Alternatively, Democrats could have stiffed the unions if a few Republicans stepped forward to support the bill in exchange for tough cost control measures that Obama clearly wanted. But none would do that. It's impossible to pass health care reform without the support of labor unions or any Republican member of Congress.

The saga of the Cadillac tax is a useful example of the ways conservatives have attacked health care reform with mutually reinforcing highbrow-lowbrow attacks. Conservative politicians attack death panels and rationing and higher taxes. The conservative pundits who recognize the dishonesty of these claims may cluck their tongues a bit, but they don't put any meaningful pressure on Republican politicians to cut it out. Then the Democrats have to reduce their exposure to the lowbrow conservative attacks, which hit home with the public, by cutting back on the sacrifice in the bill. This in turn makes them vulnerable to the highbrow attacks.

To make a related point, this is one of those legislative problems that ending the filibuster won't fix. Neither party is really able to vote for the other party's major initiatives. That means you lose the biggest advantage of bipartisan deals: votes that are in hock to totally different special interest groups and constituencies. For instance: The Civil Rights Act was a compromise between Northern Republicans and non-Southern Democrats. But if it was passed today, it'd be a compromise between Democrats and Southern Democrats, and the bill would be terrible.

As for the broader political point, David Brooks is having a weird year. If you read his columns, it really is the case that he is much more in agreement with the Obama White House than with most members of his party or most members of the Democratic Party. But he's still got his tribal loyalties, as we all do. He's handled that tension by attacking Obama for deviating from the conservative things Obama wants to do and Brooks wants him to do but that Obama can't find any conservative votes for.

The excise tax is a good example. Rather than praising Obama for protecting the excise tax against unions, House Democrats, and Senate liberals and hammering Republicans for refusing to give Obama the three or four or five votes he'd need to keep that tax strong (or better yet, replace it with a cap on the employer exclusion for health-care benefits), Brooks attacked Obama for making the concessions that kept the excise tax in the bill. That doesn't make much sense, given that Brooks supports the excise tax and Obama is protecting the excise tax. But it makes a lot of sense if Brooks is groping for a way to disagree with a White House that he inconveniently agrees with.

By Ezra Klein  |  February 24, 2010; 10:27 AM ET
 
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Comments

This reminds me of Andrew Sullivan in the mid '00s. His heart wants to be conservative but his head can see them leaving him behind. Every once in a while Brooks breaks through the noise with good point that have recently agreed more with the WH than not, then I think he gets some guff from the Right, or maybe he feels guilty, and writes some incoherent mess.

Posted by: MosBen | February 24, 2010 10:48 AM | Report abuse

I nurtered some hope that Obama would blow up the logjam by aiming straight for Paul Ryan and fiscal conservatives with a proposal to reduce the exclusion to provide money for subsidies. It would have been the responsible thing to do from a policy standpoint, and might have changed the game entirely.

Posted by: bgmma50 | February 24, 2010 10:50 AM | Report abuse

Obama gave away a chance at a second term, you'd think Brooks would be happy about that.

Posted by: obrier2 | February 24, 2010 10:51 AM | Report abuse

Ezra said : Neither party is really able to vote for the other party's major initiatives."

WRONG WRONG WRONG

Many major GOP ideological-based initiatives have received Democratic votes. Dems are spineless and are often dared to not vote for something important to the GOP (Bush tax cuts, Iraq War, Nafta, etc). Also, a handful of Dems are actually conservatives who would rather be a Republican (if they could only defeat the GOP candidate in a primary). As a result, a handful of Dems usually can be counted on to vote with the GOP on their major initiatives.

You posted an article yesterday suggesting George W Bush was a bipartisan president. That post contradicts your statement above.

Posted by: Lomillialor | February 24, 2010 10:52 AM | Report abuse

Ezra,

I think Republicans would have to give a lot more than what you suggest to keep the excise tax. I think to get Democratic votes for the excise tax, you still have to do something to eliminate -- or at least substantially mitigate -- the unfair age, gender, occupational, etc. effects of the tax. That means the House should get its version of the following provisions:

1. Five-year grace period of grandfathered plans (subjecting the self-insured to the minimum benefit packages in the bill)
2. The 2:1 age rating and no smoker rating
3. The elimination of the 8 percent income exemption from the individual mandate so those 20-sumpin' bachelors aren't exempt from the individual mandate, choose to go bare, and blunt a good deal of the benefits to older adults from the tighter community rating
4. The application of the community rating to all markets and provision making it very difficult to self-insuring so those firms with good claims experience don't self-insure, and muck up the community rating.

But yeah, I strongly prefer capping the employer tax exclusion to the excise tax. It's a little bit more progressive, and it doesn't have the problem of the taxing businesses who self-insure.

Posted by: moronjim | February 24, 2010 10:53 AM | Report abuse

Democrats started the healthcare debate from Jacob Hacker's Single-Payer Trojan Horse plan.

As Americans became aware to the cynicism of the Democrats' duplicitous plan to craft legislation that regulates private insurance out of business and leaves a Public Option to morph into Single-Payer, they've been forced to retreat.

They first retreated into giving up the Public Option, and instead focused primarily on the simple goal of regulating Private insurance out of business. They've also retreated into finding ways to pay for this bill under the guise that they're conscious of how the economy will be effected by more spending....hence the emergence of this excise tax.

But having been in retreat from Day 1 from their radical position, they now seem so suddenly shocked that people do not believe they are bargaining honestly? Espcially in light of how someone like Ezra Klein, who pretends to be fair, spins giving special interest Unions a 4-year exemption on the cost increases they've chosen to pay for his plan!!!

Remarkable Chutzpah!

Posted by: FastEddieO007 | February 24, 2010 10:54 AM | Report abuse

Ezra,

The irony is our continuing use of the term "Cadillac" to mean expensive and luxurious. In both real and figurative terms for this debate, "Cadillac" means overpriced and more memory than reality.

The sad reality is we're calling an insurance plan 'luxurious' simply because it won't bankrupt you when you have a life-threatening illness.

Posted by: Jaycal | February 24, 2010 10:55 AM | Report abuse

That's what I like about David Brooks.
He works so hard at justifying his wrongs.
The typical "conservative" just makes up whatever they need to undermine Obama, even if it means trashing their own values, policies, etc. Brooks on the other hand tries to reconcile his partisan affiliation with goofiness with what he knows to be right. It doesn't work at all but it's much less irritating.

Posted by: jefft1225 | February 24, 2010 10:57 AM | Report abuse

****Brooks attacked Obama for making the concessions that kept the excise tax in the bill.****

In his most recent column, Brooks falsely charges Obama and the Democrats with "exempting" unions from the tax. Neither the Senate bill nor Obama's side-car proposal does any such thing (it merely delays implementation of the tax). I tried to make a comment on the discussion board to point this out, but I notice NY Times.com cuts off discussion at around 150 comments (what's up with that?).

Posted by: Jasper999 | February 24, 2010 11:14 AM | Report abuse

"The sad reality is we're calling an insurance plan 'luxurious' simply because it won't bankrupt you when you have a life-threatening illness.

Posted by: Jaycal"

Speak for yourself. I'm calling an insurance plan luxurious when it provides all of the things Nancy Pelosi has committed to providing, including low copays, low deductibles, preventative care, no limits on lifetime and annual expenditures. That's not insurance designed to prevent bankruptcy in the case of life-threatening illness, that's gold plated luxurious cradle to grave health service subsidized by taxpayers. It's inefficient, it's expensive, it drives overconsumption and increases costs. And not only do the Dem's plans not even begin to repair this hydra, they reproduce it and multiply it.

Posted by: bgmma50 | February 24, 2010 11:18 AM | Report abuse

Lomillialor,

I don't think you can compare the Bush tax cuts and the Iraq War to health care reform -- or for a more relevant item, Social Security. When you're voting to cut taxes, you're being Santa Claus. When you're voting for health care reform or phasing out Social Security, it's cold showers and root canals for the next five years!

Voting to start a war is another politically easy vote: There's this sense with foreign policy that the President has access to intelligence that we don't. That isn't the case with domestic policy. The public, therefore, is willing to give deference to their President in a way they don't for domestic policy.

As for NAFTA and other trade bills, I believe even those rabid right-wing economists like Paul Krugman and some at Brookings and Economic Policy Institute support such a policy.

Posted by: moronjim | February 24, 2010 11:20 AM | Report abuse

bgmma50, insurance that doesn't deny you for pre-existing conditions and doesn't have lifetime payout limits is not "gold plated insurance." It is called "insurance." Insurance that does not provide preventative care is the very definition of inefficient.

FastEddie, meanwhile, believes simultaneously that government doesn't work and that a public option will run insurance companies out of business because it is supposed to be much better than the private insurance companies who can't hope to compete with it, because people will like it so much. So we have to stop it.

Posted by: constans | February 24, 2010 11:53 AM | Report abuse

FE007: "But having been in retreat from Day 1 from their radical position, they now seem so suddenly shocked that people do not believe they are bargaining honestly? "

So many dishonest things, so little time.

The way repiglicans have reversed themselves to oppose this very repiglican influenced bill would be funny if it wasn't so tragic.
1. Any thought of single payer for everyone (seniors already have this through medicare) was never in the bill, even though it is the most cost effective to deliver health insurance (I thought repiglicans were for fiscal responsibility).
2. There are 4 major parts of this bill that are basically the same as the bill drawn up by Dole, Baker, and Daschle last year...That doesn't make it good, but it sure makes it a centrist, incremental bill, not a "radical position". These are
-insurance exchanges
-buying insurance across state lines
-insurance provided exclusively by private insurers.
-ability for groups to form their own risk pools to improve bargaining position with insurers.
-individual mandate

So it is the repiglicans that are bargaining in bad faith, rejecting ideas that they used to support. Just like Paygo, deficit commission, etc.

Posted by: srw3 | February 24, 2010 12:04 PM | Report abuse

"low copays, low deductibles, preventative care, no limits on lifetime and annual expenditures. That's not insurance designed to prevent bankruptcy in the case of life-threatening illness, that's gold plated luxurious cradle to grave health service subsidized by taxpayers."
@ bgmma50: A few things.

Which of these things would you like to remove from this list to make reform less Cadillac?

All of these things, to a greater or lesser extent are a part of medicare. Again, what kind of medicare cuts are you suggesting be eliminated?

If plans have yearly and lifetime caps, doesn't that mean that an expensive illness will put a severe strain (ie bankruptcy) on the 80% of families making less than 100K per year? Isn't this basically an insurance company death panel?


Posted by: srw3 | February 24, 2010 12:21 PM | Report abuse

moron

A majority of elected Dems voted against Nafta. Look it up. The reason it passed was that almost all Repubs voted for it with just enough Dems to pass it. Of course, Clinton naively believed (as does Obama) that if he played nice with the Repubs, they would treat him good.

Most Dems were publicly against the Bush Tax cuts and Iraq War, yet many switched to voting with Bush when the time counted because they were spineless. Same thing happened with the patriot act and other major Republican initiatives.

Posted by: Lomillialor | February 24, 2010 1:39 PM | Report abuse

"Which of these things would you like to remove from this list to make reform less Cadillac?"

I've purchased various forms of coverage for my children when they ceased to be dependents. For $75 per month, I could get $5000 deductible with 20% coinsurance and no copays. For $120 per month, I could get $1000 deductible with 20%coinsurance and $35 copays. Roughly in the vicinity of an iphone plan, and about 25% of the cost of the plan proposed by the House dems. Why should I pay for somebody else to have better insurance than I would be willing to purchase for my own kid?

I understand perfectly well that most Amercians have been conditioned to expect that somebody else is going to pay for their routine medical expenses. Some guy was on this blog the other day flailing away at his insurance company because it wouldn't pay for toe fungus medication that is available at a cost of about $1-$2 per day for 12 weeks. Women were up in arms because some advisory group recommended biannual instead of annual mammograms and it never occurred to them that they might pay for their own mammograms every other year if they want them. My annual mammogram costs $50.

All you folks who want insurance that will pay for your toe fungus medicine and your $50 annual mammograms should expect to pay the additional thousands of dollars a year it costs per person to provide such coverage out of your own pockets.

"All of these things, to a greater or lesser extent are a part of medicare.

Yeah. And Medicare is broke.


"If plans have yearly and lifetime caps, doesn't that mean that an expensive illness will put a severe strain (ie bankruptcy) on the 80% of families making less than 100K per year? Isn't this basically an insurance company death panel?"

The cost of catastrophic coverage is the cheap part, it's the low copays, low deductibles, low out of pocket, preventitive care, etc. that cost a lot. Put it all together and it really costs a lot. Are you willing to give up any of it or do you want taxpayers to subsidize the whole ball of wax? Don't you at least think that people who want coverage with all the bells and whistles ought to pay more for it? Out of their own pockets?


Again, what kind of medicare cuts are you suggesting be eliminated?"

The subject is avoiding making the same mistakes we made in Medicare, not fixing Medicare, which is a whole other ball game.

Posted by: bgmma50 | February 24, 2010 3:07 PM | Report abuse

"bgmma50, insurance that doesn't deny you for pre-existing conditions and doesn't have lifetime payout limits is not "gold plated insurance." It is called "insurance."

Did I say anything about pre-existing conditions? Nope.

My insurance has a 1 million lifetime payout limit. I have no problem with that, so why should I pay for you to have insurance with no limit? If you want unlimited payout limits, why shouldn't you have to pay more for it?

"Insurance that does not provide preventative care is the very definition of inefficient."

If that's a variation on the old, it's cheaper to pay for everyone to have preventitive care than it is to pay for them when they get sick, I suggest you do some research. But again, if you want coverage that includes preventitive care, I've got no problem with that as long as I don't have to subsidize it for you.

Posted by: bgmma50 | February 24, 2010 3:15 PM | Report abuse

Good analysis of Brooks's predicament, but I think you are being charitable and polite. It is possible that he won't admit that he agrees with Obama because of tribal loyalties. It is also possible that he is acting from self interest.

Consider the following hypothesis. Brooks has noticed that there is a terrible shortage of rational reality based Republican commentators, so he can get what he wants by claiming to be a Republican. If he admits he agrees with Obama on most issues, he'll be just another sane reality based centrist who agrees with Obama on most issues.

The New York Times won't fire him (they don't do that to members of the club) but he won't appear on TV anymore.

I am not really speculating about his integrity, but I notice the fact that Brooks has done very well by presenting himself as a sane reality based Republican and will lose things that he wants if he decides to be (or admits he is) an Obama supporter.

Posted by: rjw88 | February 25, 2010 6:29 AM | Report abuse

Americans are angry at insurance companies...we all have our stories. The problem is that insurance IS tied to employers generally and that the pool for "individual policies" is prohibitively expensive.

But even with this bill, health insurance companies will continue to increase the premiums...and we will ultimately pay anyway - except for the fact that we will be funding a layered new bureaucracy.

We can't win in any case. But the government can offer subsidies to pay a percentage of our premiums...and tax credits for the premiums we pay.

Obama simply wants a way into our pockets...and has found the way in.

Posted by: easttxisfreaky | February 25, 2010 6:33 PM | Report abuse

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