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Posted at 11:30 AM ET, 01/18/2011

Going after ObamaCare

By Jennifer Rubin

The House is set to vote on repeal of ObamaCare tomorrow. It will pass overwhelmingly, with more Democratic votes in favor of repeal than there were Republican votes to pass it originally. What then?

The conventional wisdom (i.e. the consensus of wishful-thinking, generally liberal elite opinion makers) is that it then goes nowhere. But don't be so sure. Senate leadership advisers tell me there is always a way, through amendments and other procedural efforts, to get votes. They point out that filibusters also can be mounted. That is precisely why filibuster reform is going nowhere.

The Republican Senate leadership does not expect any Senate Democrats to flip sides on the vote for an out-and-out repeal. The consolation prize is that Democratic senators such as Jim Webb, Claire McCaskill, Ben Nelson and Bill Nelson will have to defend those votes in 2012.

On votes on discrete issues, there is a high likelihood that some provisions -- e.g. the massive paperwork burdens on business -- will draw Democratic votes. Likewise, there may be difficult votes for Democrats on everything from Medicare Advantage to the individual mandate.

Red state Democrats up for re-election in 2012 will have a very tough time of it -- back the president or help their own re-election prospects? And as this goes on, the House will be holding hearing after hearing on ObamaCare to, in Nancy Pelosi's words, find out what is in it.

Finally, on the funding side of things Douglas Holtz-Eakin, Joseph Antos and James Capretta present another effective skewering of the "it will save money!" argument. They write in the Wall Street Journal that "legislative prescriptions were written to create deficit reduction only on paper -- not in reality." They list a few of the problems with the CBO calculations:

For starters, that $1 trillion price is a low-ball estimate, covering only six - not ten - years of subsidies that don't begin until 2014. The uninsured were clearly less of a priority than the deception of making the law look less expensive than it really is over its first decade. Over ten years of full implementation, it's more like $2.3 trillion.

Next up is the CLASS Act (for the Community Living Assistance Services and Supports Act) providing a new long-term care insurance entitlement. CLASS hitched a ride on the ACA for one reason only: premiums are collected in the first ten years, but no benefits are provided. Voila, it creates the perception of $70 billion in deficit reduction. In fact, CLASS is a bailout waiting to happen, as it will attract mainly sick enrollees. Only in Washington could the creation of a reckless entitlement program be used as "offset" to grease the way for another entitlement.

Then there are the "illusory cuts" in Medicare (i.e. it envisions unsustainable levels of reimbursement). And then there is the estimate that only 19 million Americans will wind up in the insurance exchanges for those who can't get insurance through their employers. In fact, Holtz-Eakin, Antos and Capretta write: "With such a large financial incentive, eventually those who would be better off in the exchanges will end up there, and costs will soar. If only the 35 million lowest wage-workers leave their job-based plans, federal spending will rise by another $1 trillion in just the first decade."

In sum, the House will vote to repeal ObamaCare. Red state senators will be forced to vote again and again on the deeply flawed legislation. And then the public will be shown just how flawed it is. No wonder Democrats don't relish "relitigating" ObamaCare.

By Jennifer Rubin  | January 18, 2011; 11:30 AM ET
Categories:  Obamacare  
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Comments

The conventional wisdom (i.e. the consensus of wishful-thinking, generally liberal elite opinion makers) is that it then goes nowhere.

*****************************************

As opposed to the conventional wisdom (i.e. the consensus of wishful-thinking, generally conservative elite opinion makers) that the law is going to be significantly undermined through budgetary tricks and Senate amendments.

Posted by: mustangs79 | January 18, 2011 11:43 AM | Report abuse

"Senate leadership advisers tell me there is always a way, through amendments and other procedural efforts, to get votes."

OK,so does this mean that,once passed in the house, the Repeal Process could get 60 votes in the Senate,and go to Obama,and he would sign the repeal? Or if he vetoes it,that there could be a 2/3ds vote to override. Or does this mean that if the bill dies,that the courts will repeal the bill. Or exactly what is the process of Repeal going to be? It doesn't seem like JR is very clear on that process.

Posted by: rcaruth | January 18, 2011 12:08 PM | Report abuse

As support for repeal continues to decline, look for rightwingers like Rubin to get shriller and shriller.

Posted by: Observer691 | January 18, 2011 12:21 PM | Report abuse

I have a big problem with what Rubin said here because of the slanted, disingenuous comments. If we wnat to compare passing of big unpopular bills, let's look at Bush's Medicare bill.

Bush rammed that bil through Congress, the Republican leadership even violated the 15 minute role call rule in order to scrape up/pressure enough Congressmen to pass the bill. Yet you didn't see any Democrats, not to mention any Republicans, work to repeal the bill once signed. Yet Obama passes a bill, without the heavy handed role call tactics and the resultant legislation is treated like a deadly virus.

I think your hypocritical rantings are a sign of creeping loss of democracy in this country. Through media pressure, political demonization, and spreading of lies about recent history conservatives are trying to demonize and marginalize Democrats in this country. Republican bills are treated like Gospel, Democratic bill can be overturned. Result, Democrats are disenfranchised. When elected Democrats aren't allowed to exercise power (witness the over the top attacks and obstructionism towards Obama), when the assumption is that no legislation that Democrats create is worthy of any consideration but repeal; when media and educational systems are used to make Democrats look like Martians, when Democratic politicians are physically assulted, the message is: "This is a free country, you can belong to any party you want - but you will rue the day you don't decide to be a Republican." This country begins to look more and more like a right-wing Argentina and less like a democracy.

Posted by: chuck2 | January 18, 2011 12:44 PM | Report abuse

Let's stop the pussyfooting around. Opinions do matter,and Obamacare is about the conflict of those opinions. My opinion is that there is an inalienable human right to healthcare which is related to the opinion that life,liberty,pursuit of happiness are inalienable rights. It's hard for me to imagine a citizen with leukemia or congestive heart failure to be free to pursue happiness. My opinion is consistent with FDR's 2ND Bill of Rights,and with many other individuals who live within what we call Western Civilization.
However,I respect an opposing Opinion which would argue that Healthcare is not a Right,but a privilage that must be paid for by the afflicted. Fine,but this discussion is not about political tactics,but a debate on the nature of our inalienable rights,with the full knowledge that the concept of any Human Rights is always about the clash of opinions. Rights are not facts. They are socially embedded opinions protected by law and tradition.
Therfore,before we agree that Obamacare has been an unholy mess from day one,we need to decide the underlying conflict,which is about healthcare rights. Once we decide that,the debate over Obamacare will be irrelevant. At that point,we will either retain a "private" system of some sort,or provide "equal" healthcare for all citizens.

Posted by: rcaruth | January 18, 2011 12:52 PM | Report abuse

My life force is draining out of me just thinking about it.

Posted by: danw1 | January 18, 2011 12:54 PM | Report abuse

If the Republicans in Congress have an alternative plan, and they say they do, then why are they demanding a repeal of ObamaCare before presenting it to the American people?

And don't point me to Ryan's Roadmap as the template for the future. Its assumptions about the availability and cost of health insurance on the open market are not realistic, and that's just for starters.

Posted by: MsJS | January 18, 2011 1:01 PM | Report abuse

I agree with rcaruth, and will gladly say that there cannot be a right that obliges others to pay for your exercise thereof, or to perform a service, in general, or for less money than they would have demanded otherwise. Hence, if there is a right to healthcare, it doesn't translate into a right to raise other people's taxes to pay for your health care, or to force doctors to work for the government, or a government approved union, or to charge prices dictated by the government. The same goes for insurance companies, for that matter. So, it's a pretty empty right.

I also agree with rcaruth that it's unfortunate that the issue doesn't get debated on these terms--if it were, we would never have gotten to this point, because a majority of Americans don't believe health care is a right, certainly not in any strong sense. And my proof of that is that politicians only use the "R" word in conjunction with health care when they are speaking to very sympathetic audiences.

Posted by: adam62 | January 18, 2011 1:33 PM | Report abuse

ADAM/ Hence, if there is a right to healthcare, it doesn't translate into a right to raise other people's taxes to pay for your health care, or to force doctors to work for the government, or a government approved union, or to charge prices dictated by the government.

Unless the Healthcare expense is related to war injuries,illness,right? Even in your opinion,the state has the right to collect taxes,and even Draft physicians,if necesary,to care for casulties of war,right? If wrong,my apologies. A small step from there to injured policemen,firemen,even social workers,maybe? Slippery slope?
First Responders? Do you have a problem with Health Insurance for Government employees? What about Medicare/Medicaid?
Good Luck,Adam

Posted by: rcaruth | January 18, 2011 2:07 PM | Report abuse


It's nice to read a column that provides a dissonant view of Obamacare and provides a few details, instead of just glossing over the details and spouting the company line.

Good job.

Posted by: postfan1 | January 18, 2011 2:11 PM | Report abuse

Jennifer- And the GOP will replace it with what, exactly? All the years the GOP had to do something with health care and what did they do? Nothing. It would be one thing if our system were humming along perfectly, but it's not. It's massively expensive and we are pitifully low on key rankings of population health.

I can't wait to hear your ideas. But these days, all you seem to write about is how everyone who disagrees with you is wrong and we certainly know a lot about what you oppose and want to do away with. And yes, you'd like to see spending cuts, so long as it's not defense. For the previous eight years under Bush it's funny how most didn't seem to mind much of the spending- at least not enough to really speak out against a GOP POTUS.

I keep waiting to see a post where Rubin actually distinguishes herself as an independent thinker as opposed to just spurting out GOP talking points. I guess I shouldn't hold my breath.

Posted by: Stacyx | January 18, 2011 2:20 PM | Report abuse

The survivors of the AZ massacre now have preexisting conditions.

Let's see Boehner cut their health insurance. Or Huckabee, he likes to ridicule preexisting conditions.

Posted by: BurfordHolly | January 18, 2011 2:21 PM | Report abuse

the simple fact is that there cannot be a "right" that imposes a "duty" on others. rcaruth says that he has a "right" to have others provide him (her?) (it?) goods and services at someone else's expense it seems. Since rcaruth has this "right" someone else has a concommitant "duty".

How, exactly does that make any sense at all? Will rcaruth select people at random upon whom he will impose the "duty" such that his "right" isn't violated?

As for the concern about those special groups he mentions, well it is already addressed. A first responder injured in the line of duty has the same recourse as any other employee so injured: worker's compensation as established in the state where the person is employed.

When we talk of our soldiers it is recognized that Americans do indeed have a duty to them. They afterall voluntarily assumed a duty on our behalf. that is they agree to put themselves in harm's way to protect the actual rights we currently enjoy (as opposed to the fake rights that FDR and the liberals dream up when they want to raid the taxpayers' pocket)

I see no reason to strive for "equal" healthcare. We don't strive to provide "equal" cars or "equal" homes or "equal" just about anything else one can name.

If it isn't a right (and it isn't) then we are free to consume as much of it as we are willing to pay for. I would expect to get much better treatment from a hospital were I to pay 100K than if I were to pay nothing. We get what we pay for.

What about Medicare and Medicaid? These are the nightmares from the LBJ war on poverty. Now the impoverished are the taxpayers. How well did that work out for us?

Let's turn medicaid into a block grant prepartory to eliminating it. Let's move medicare from defined benefit to defined contribution before it bankrupts us completely.

Any time you want to argue health care finance I'm here for you. I'll stack my thirty years of hospital financial management against your rote repitition of liberal talking points any time.

Posted by: skipsailing28 | January 18, 2011 2:30 PM | Report abuse

So, Ms. Rubin, I expect you'll issue a clarification regarding your creative editing of the interview you had with Hannah Rosenthal, right?

http://wonkroom.thinkprogress.org/2011/01/18/state-dept-anti-semitism-envoy-misrepresented/

You know, in the interest of your "journalism."

Posted by: Stacyx | January 18, 2011 2:36 PM | Report abuse

Okay, so what's your solution? Under this law, Obamacare or whatever you like to call it, millions of boomers ready to retire would. Why? Simple. When you're between retirement and 65, try buying health insurance that you can afford, especially with pre-conditions. So if the Republic Party wants to crush this certainty that boomers could actually afford real health insurance, millions and millions of people will hang on to their jobs, depriving the next generations of having those jobs.

The Republic Party is the party of crackpot thinking. They want to overturn anything that helps regular people and pass anything that makes rich people richer. It's a sick, twisted, sordid and degenerate way to think.

Posted by: mongolovesheriff | January 18, 2011 2:39 PM | Report abuse

chuck wrote"I have a big problem with what Rubin said here because of the slanted, disingenuous comments. If we wnat to compare passing of big unpopular bills, let's look at Bush's Medicare bill"

Rubin is a right wing shill. Intelligent people either read her for a laugh or don't read her smut at all.

Posted by: clintt5 | January 18, 2011 2:40 PM | Report abuse

It will be fun to watch the GOP try to convince people they should roll back health reform planks like requiring insurers to spend 80% of the amount they receive for premiums on actual health care, not on profits. It will also be fun to see the GOP tell parents they can no longer keep their children up to age 26 on their politices. And it will be even more fun to see them tell seniors that we are going to repeal the plank that gradually does away with the donut hole. And oh yes, I will enjoy watching them tell people with so-called "pre-existing illnesses" or who have been subject recission that now we are going back to letting health insurers continue cutting them out of coverage. The recent AP poll shows that only 25-30% polled are for repeal. And some who are for repeal want the bill repealed because they don't think it went far enough. Health care reform benefits many people. To repeal it will add billions to the deficit. It will be fun to watch the GOP posture about repealing health care reform.

Posted by: tinyjab40 | January 18, 2011 2:45 PM | Report abuse

Skipsailing&Adam/the simple fact is that there cannot be a "right" that imposes a "duty" on others.

OR,all rights impose duty on others
The inalienable right to Life imposes a duty on society to protect "Life" from Threats to Life(That's why we are required to have police,firemen,and emergency rooms),a category which reasonable people might include disease and injury.

The inalienable right to Liberty requires society to have a system of national defense to prevent threats to liberty from enslaving us. A reasonable person could include disease and illness as an obstacle to liberty.

The inalienable right to pursuit of happiness requires society to prevent anything that prevents that pursuit. Reasonable people could include illness and injury as obstacles to the pursuit of happiness.

Posted by: rcaruth | January 18, 2011 2:54 PM | Report abuse

@Stacyx, if you're concerned about Hannah Rosenthal being misrepresented, forward the link in your comment above to the ombudsman: ombudsman@washpost.com

Posted by: MsJS | January 18, 2011 3:05 PM | Report abuse

The loony Republicans want to repeal ObamaCare, but their rank & file refuse to use private hospitals and insist upon using government run hospitals because of the quality of care. Namely Mitch McConnell clown face from KY.

Posted by: Maddogg | January 18, 2011 3:12 PM | Report abuse

The health care law is flawed, but it was a start and needs to be improved on. In that regard it is similar to every piece of major legislation ever passed. Republicans controlled all of government for six of Dubya's eight years. I must have fell asleep and missed their health care proposal.

Posted by: wrw01011 | January 18, 2011 3:13 PM | Report abuse

Do conservatives even know the definition of "elite"? Apparently not.

Posted by: jckdoors | January 18, 2011 3:14 PM | Report abuse

Do liberals even know the definition of "elitist"?

They define the term.

Posted by: postfan1 | January 18, 2011 3:17 PM | Report abuse

Perhaps it might be useful to mention the 40,000 or so Americans between 18-64 that die yearly because of the inability to access health care.

The idea that losing the same number of people lost on 9-11, EVERY MONTH, is meaningful.

Really, in as civil a tome as possible, why do the Republicans favor killing off 40,000 people a month?

Posted by: zcezcest1 | January 18, 2011 3:17 PM | Report abuse

What we know for sure:

Republicans are bent on keeping the health care system in the US the most expensive in the world and one of the worst.

Posted by: Maddogg | January 18, 2011 3:20 PM | Report abuse

Keep up the wishful thinking, Rubin - while you are busy admiring the underhanded b.s. that GOP engages in, the reality is that they do not have the votes to repeal the act and their attempts to undermine it is transparent and will backfire.

Posted by: LABC | January 18, 2011 3:24 PM | Report abuse

I see no reason to strive for "equal" healthcare. We don't strive to provide "equal" cars or "equal" homes or "equal" just about anything else one can name.

Posted by: skipsailing28 | January 18, 2011 2:30 PM | Report abuse

How about "equal education"? In our zeal to privatize, should we include education? If poor kids can't go to school, why then that's just the parent's fault I guess.

Heck, even vouchers (which I support) strive for some "equality" in educational opportunities, right?

Why is public access to healthcare different than public access to education?

Posted by: mikem1 | January 18, 2011 3:24 PM | Report abuse

Ms, Rubin your argument is weak at best. You surly must know that the health care repeal show is a smoke screen designed by the health insurance monopoly. Like it or not one of these days we eliminate the middle man and get a Public Option!

Posted by: Hawkestreet1 | January 18, 2011 3:27 PM | Report abuse

It is all about personal responsibility. Infants and children of the poor should never have been born into families that cannot pay the insurance premiums the the health care executives need to charge to maintain their multi-million dollar salaries. The republicans understand the plight of the rich and powerful, and merely want to help. Let the little people pay taxes, and find a way to pay for children and infants, or just let them die. That is the Republican, conservative way.

Posted by: billaldridge | January 18, 2011 3:28 PM | Report abuse

dear skipsailing:

I imagine your knowledge will never be tapped by the trolls here.

A liberal troll, on these boards, has marching orders that will not permit a reasonable discourse on topics like "healthcare is a right" or different levels of care given to different people.

Such concepts are "inherently" unfair according to libs, and thus, logical people are not even permitted to discuss such things in their presence.

If you can teach one person one thing, congrats.

Posted by: docwhocuts | January 18, 2011 3:30 PM | Report abuse

Jennifer what does the Weekly Standard have to say to the millions of uninsured? Ohh I know tax cut to buy your own insurance that is if you can afford it. And if you can't too bad.

Posted by: sargon20 | January 18, 2011 3:32 PM | Report abuse

This is ridiculous. Ms. Rubin is living in another world. The vote is a gimmick. And it will be exposed to the American public as a gimmick.

Perhaps if the Republican Party had produced their own healthcare reform plan they wouldn't look so ridiculous today. But they didn't. And now they do indeed look ridiculous.

Posted by: wkristol | January 18, 2011 3:36 PM | Report abuse

Do liberals even know the definition of "elitist"?
They define the term.
Posted by: postfan1
===============================

I doubt it..

They just Work for a Living and have Fun doing it..

Posted by: pdq5 | January 18, 2011 3:37 PM | Report abuse

Every industrial nation in the world, except us, has some sort of universal health care network. We spend twice as much per capita as some nations (whose populations are generally more healthy), yet we still have millions under-insured, or uninsured.

So, Mr. Rubin, how do you propose to solve the problem? What? Can't hear yoouuuu...

I have a close friend dying of a brain tumor. Her insurance company has ruled that it is a "prior condition." So there are "death panels" -- they are located at the private insurance companies who deny life-saving care. (Of course, it also appears there is a death panel in Arizona, where at least two people have died after being denied state funding for transplants.)

I have not heard one Republican explain a viable alternative to the present plan. And I don't expect to any time soon.

Posted by: okiedeadhead | January 18, 2011 3:38 PM | Report abuse

The Republicans should just change their name to the Anal Retentive Party. Fits them to a t.

Posted by: netwitone | January 18, 2011 3:38 PM | Report abuse

An excellent post and it very well illustrates that ObamaCare is a poor piece of legislation. While Democrats may believe that they had good intentions behind the legislation that does not take away from the fact that it is poorly conceived and executed. Intent matters but execution means a whole heck of a lot more.

Many people are right to be dismissive of gargantuan legislation like ObamaCare, especially considering that members of Congress are notoriously ignorant of the contents of the bills for which they are voting for.

If content was of primary concern to Democrats then they would've scrapped the bill or put it though a major overhaul, because the existing legislation is unsustainable. No one reasonable would ever recommend that an individual or family put together a budget that only accounts for spending 60% of the time, so why is that alright for major pieces of legislation?

Posted by: Fitz157 | January 18, 2011 3:39 PM | Report abuse

A liberal troll, on these boards, has marching orders that will not permit a reasonable discourse ...

Posted by: docwhocuts | January 18, 2011 3:30 PM | Report abuse


LOL, and "reasonable discourse" is always enhanced when you characterize those who disagree with you as "liberal trolls".

Posted by: mikem1 | January 18, 2011 3:40 PM | Report abuse

Actually if Obamacare was so bad Boehner would have scheduled far more than 7 hrs. debate. This is nothing other than grandstanding as the Republicans have yet to present any viable alternative. Just like on the deficit, big talk and no action. The Republicans have a 40 year record of only being able to spend and cut taxes. Why expect anything different now. Bush expanded Medicare Part D and Medicare Advantage. The Republicans first should pay for that.

Posted by: chucko2 | January 18, 2011 3:41 PM | Report abuse

I don't buy into Ms. Rubin's theories on this issue, and citing a Wall Street Journal column is somewhat akin to saying Rush Limbaugh endorses the repeal. As has been noted before, many Republicans have supported similar health care measures in the past -- why did they all have a change of heart?

Note to the Post webmasters: it might help to more clearly identify the columnist on your headline. My first reaction when I saw this on the home page was "Robert Rubin is for health care repeal?"

Posted by: calliaume | January 18, 2011 3:41 PM | Report abuse

If you are a conservative and you don't care that health care is denied to people with pre-existing conditions (including children) nor do you want anything done about it then you deserve every despicable thing anybody can say about you. This issue isn't political. This issue is moral. I understand the argument concerning the mandate but not pre-existing conditions. The health insurance industry has maintained these death panels for far too long (which denial of coverage undisputably is).

Posted by: hateisnotafamilyvalue | January 18, 2011 3:42 PM | Report abuse

Though I agree in principle with rcaruth, I disagree with the phrasing used.

For social services like education, health care, etc. - there is no reason (and, frankly, no way) to try and create some kind of "equal" criteria. But I do believe we should be setting minimum levels that we feel that our society wants to see for any social service.

The debate mentioned imn the post is still valid, though. Do we, as a society, have any responsibility to the marginalized living with us, other than to ensure that they aren't deliberately persecuted, either from within or without? The conservative says no - any assistance should come from individual acts of charity alone and not be forced by government, the liberal says yes, a civilized society should not be taking care of those on its peripheries - and, frankly, it's an issue that will never be "answered" because it's based solely on philosophical differences that can't be proven.

The trick is living together in a society that makes majority-consensus decisions and moves forward, and unless we want to continue to accrete liberal decisions, sometimes, conservative majorities will have to face the task of pruning back. Historically, we don't seem very good at that...

Posted by: iamweaver | January 18, 2011 3:43 PM | Report abuse

Any time you want to argue health care finance I'm here for you. I'll stack my thirty years of hospital financial management against your rote repitition of liberal talking points any time.
_______________________

Just imagine: Skip has brillance and situational awareness unmacthed by any liberal on top of 30 years experience yet still can't think of a coherent plan to elevate our health care system from the most expensive and 16th* best performing on the planet. Must be impossible!

Posted by: bob29 | January 18, 2011 3:45 PM | Report abuse


The repeal Bill from the House will also serve another purpose.

In some cases reviewed by the Supreme Court, when there is some 'ambiguity' in the Constitution, they give deference to the Legislative Branch when bipartisan support for a Law exists.

The repeal Bill will demonstrate that ObamaCare is a VERY partisan Law passed over the wishes of the opposition party and a majority of Americans. Deference to the Legislative Branch will be GONE. Hard core reading or the Constitution will prevail and the personal mandate (via commerce clause authority) will be struck down!

So pass your repeal Bill House Republicans and let’s see what happens when the pot starts to boil!

2011 and 2012 should be FUN (except for the ad nausea whining and wailing by the liberal left)!


Posted by: bcarte1 | January 18, 2011 3:47 PM | Report abuse

Given her clear partisan bias and her inabiltiy (or courtesy) to give H.R. 4872, THE HEALTH CARE & EDUCATION AFFORDABILITY RECONCILIATION ACT of 2010 its proper title, Rubin has very little or no credibility as a journalist or contribution as a columnist.

By the way, the term "Obamacare," intended to be dismissive and derogatory is, oddly, right on target. Obama (that's President Obama, by the way) does care.

Rubin does not. Too bad. Her loss.

Posted by: castleb | January 18, 2011 3:52 PM | Report abuse

iamweaver,

Seriously? Denial of coverage due to pre-existing conditions has nothing to do with your ability to pay your bills. I know several people with very lucrative jobs that don't have health insurance simply because they have a pre-exisiting condition. This naive conservative opinion that this is all about government welfare is astounding. Unfortunately, I believe there are millions out there that mistakenly have this uneducated opinion.

Posted by: hateisnotafamilyvalue | January 18, 2011 3:58 PM | Report abuse

I'm a liberal. I don't like Obamacare and I hope the Republicans can kill it. There are a dozen or more countries in the world that have universal health care plans that work, and we could have examined the and picked the one that fit us best, but, no, we had to cobble something together that may or may not work. Screw that.

But here's what gets me about the Republicans. They don't believe the government has the right to tax us to pay for poor people's health care. In other words, decent health care should only be available to those who can afford it.

This is what they are turning our country into, survival of the fittest. You make a bad investment, you make a bad career choice, you get sick? You lose. The rich of course can afford to make bad choices, they can afford to get sick, they can recover from a bad investment.

No. I refuse to stand by and watch the poor suffer and die so the rich can increase their wealth by another $700 a year. I grew up in a foreign country that cared for each other, who took care of each other. That country was called the United States.

Posted by: Trakker | January 18, 2011 3:59 PM | Report abuse

Adam,
My argument was to link healthcare to the three inalieable rights. I would be very interested in the best Conservative argument showing that linkage is fallacious. Say Buckley were around to guide us,how would he use Buckleyian logic to deconstruct my construction.

Posted by: rcaruth | January 18, 2011 3:59 PM | Report abuse

Right Turn Jennifer? I think its a predictable turn

Posted by: puzzelbear | January 18, 2011 4:02 PM | Report abuse

I do think that this OpEd piece requires some clarification, though.

Let's take a look at Health Care Insurance legislation for a sec:

ROUND ONE:
libs: "Look! Universal health care with a government plan if you can't find a commercial one! And we'll build in funding, to be fiscally responsible!"
cons: "Just no. Socialist plans we aren't voting for. Oh, and stuff about Big Government and death panels"

ROUND TWO:
libs:"OK. Scratch the whole government intrusion thing. Lets just focus on the minimum services deal."
cons:"Still not thrilled - but at least CBO info says it won't cost our constituents too much - and it's great ammo for midterm elections."

So what we are aguing about nowadays isn't really the substance of the bill. Current complaints seem purely fiscal in nature, like this and the WSG piece, or are specious (the length of the bill? *Length*? What kind of a silly argument is that? I can read the bill. So can my rep). No one is arguing too much about the usefulness of the bill, or its ability to allow folks of all stripes to get health care insurance (emergency health care we all already get - EMTALA - but we don't all have to *pay* for it at the present).

SO articles like this *aren't* aimed at us libs. There's no reason for us to get all huffy or defensive, or anything. Basing any real argument purely on the fiscal side doesn't address issues that would bring libs to the table, because they haven't yet hit the bill in the place that matters to us - namely, "is it an effective tool"? As a lib, I was cautiously optimistic that it would be possible to extend health insurance a bit farther without costing me much - but its the extension of health insurance that really concerns me.

I'm more worried about the 750,000 families a year bankrupted by health issues, and the 15/20/30/40 million (pick a number) who are uninsured and rely purely on EMTALA and my tax dollar. If you can show the bill doesn't work, I'll be listening - otherwise, I'll be rooting for representatives of my philosophy to win the day.

Posted by: iamweaver | January 18, 2011 4:08 PM | Report abuse

Right on, Ms. Rubin!!! Why should the wealthy of America have to share their slice of the apple pie with stinky poor people? What's the advantage of being rich if you can't buy a hip replacement when the mechanic who fixes your BMW can't afford one? Oh, and hey; preexisting conditions!!! See that study, in this very issue, that says as many as 129 million Americans may have medical conditions that either disqualify them from receiving an insurance payout (doesn't prohibit them from paying, though; my, no!) or force them to pay higher premiums? The healthcare plan would spoil many opportunities for American Insurance executives to get rich(er) - good Americans who pay their taxes and vote and everything. In fact, instead of trying to make things "fair" for people who aren't rich, wouldn't it make more sense to just make all Americans rich?

Posted by: marknesop | January 18, 2011 4:09 PM | Report abuse

Perhaps it might be useful to mention the 40,000 or so Americans between 18-64 that die yearly because of the inability to access health care.

The idea that losing the same number of people lost on 9-11, EVERY MONTH, is meaningful.

Really, in as civil a tome as possible, why do the Republicans favor killing off 40,000 people a month?

Posted by: zcezcest1 | January 18, 2011 3:17 PM | Report abuse

-----------------------------

Wow, really? Can you substantiate your claim? That is a huge number. 40K is a big number. I'd be astonished if you are even remotely close to accurate.

Posted by: lingering_lead | January 18, 2011 4:09 PM | Report abuse

What I see as really flawed is doing nothing. What I see as really flawed is a world without compassion or fair play. Republicans should think long and hard about relitigating this. If my gerrymandered poor excuse for a representative (R) Congressman ever holds a Town Hall meeting I'll show up and tell him I want better health care for less money and I don't want to see people going without nor do I want tax money paying fat cats. Not sure that is in this plan so go ahead and repeal this plan. It was the compromise Republicans wanted and then they pretended not to know it. Fix our broken down health care system and do it right this time.

Posted by: SarahBB | January 18, 2011 4:16 PM | Report abuse

"...with more Democratic votes in favor of repeal than there were Republican votes to pass it originally."

What an asinine, misleading statement! There were 0 votes. The author of this series has a repeated pattern of making statements like this, which seriously undermines her credibility. Surely the Post can find someone who can represent the "right" better.

Posted by: johnhunsaker4 | January 18, 2011 4:21 PM | Report abuse

And, the first order of business should have been jobs, if they cared.

Posted by: SarahBB | January 18, 2011 4:21 PM | Report abuse

@lingering_lead:
Sorry that this link is from Harvard, but it does substantiate zcezcest1's claim.
http://news.harvard.edu/gazette/story/2009/09/new-study-finds-45000-deaths-annually-linked-to-lack-of-health-coverage/

Except the figure is closer to 45,000.

Posted by: MsJS | January 18, 2011 4:22 PM | Report abuse

It might be a good thing to mention that it won't be the rich who are subsidizing Obamacare, but the middle class, who are already paying way too much for health care.

Obama's solution is to have them subsidize someone else's overpriced care as well.

Posted by: postfan1 | January 18, 2011 4:24 PM | Report abuse

If repeal of health care reform is so damn popular and inevitable then why did some bozos enlist Mike Huckabee to beg folks to sign a petition? You would have thought the anti-health care crowd could push repeal without the involvement by another "grass roots" effort. This smells like a Dick Armey operation.

Posted by: army164 | January 18, 2011 4:27 PM | Report abuse

Couldn't be more wrong. The repeal vote is an embarassment to the Congress. That's how it will die.

Posted by: dudh | January 18, 2011 4:31 PM | Report abuse

Healthcare aside, that drawing of Jennifer Rubin doesn't do her justice. She's just as ugly as her prose in real life.

Posted by: kenshabby | January 18, 2011 4:33 PM | Report abuse


So if this repeal Bill is such a dead-ender that only takes two days to pass, then why are the oxymoron liberals whining so much about it?


Posted by: bcarte1 | January 18, 2011 4:42 PM | Report abuse

First of all, let's discount anybody who calls national health care "Obamacare." It's an obvious tip-off that the user has no sympathy or empathy for those Americans who suffered and died owing to our lack of national health care -- before this law.
Why can't our USA rise to the level of Ireland or Italy in the level of our citizens' medical care?

Posted by: jimsteinberg1 | January 18, 2011 4:42 PM | Report abuse

All for not! Unless millions of new well-paying jobs are created anything Congress does be it Republicans or Democrats will be meaningless. The US is in a huge downward spiral that pep talks won't correct.

Posted by: Maddogg | January 18, 2011 4:44 PM | Report abuse

"Senate leadership advisers tell me there is always a way, through amendments and other procedural efforts, to get votes. They point out that filibusters also can be mounted."

Okay, I think we all know that those tools exist to advance a biil. If you're writing for the Washington Post you're expected to provide some insight into how those tools will be used in this particular instance.

What are you saying, a particular Senator will be given some pork to vote for reform? And what about the fact that it was the "Blue Dog" type Democrats who were voted out of office showing that the people didn't appreciate middle of the road politicians? Doesn't that mean that some senators will take that into account in voting and go the left of their base?

This is weak and shallow analysis.

Posted by: DatMel | January 18, 2011 4:49 PM | Report abuse

The right doesn't have a alternative plan. We can talk about about "rights" and "duties" all we want, but at the end of the day, the rubber has to meet the road. Where is the Constitutional authority for the military draft? For VA hospitals? For Medicare? For Social Security? We can talk about "rights" and "duties," but all that truly matters at the end of the day is creating a society where one generation is better off than the last generation. The problem I have with republicans is that their full of what they don't like, but they can't articulate anything to improve "the general welfare" of the populace. Ideology has to meet reality at some point and that's where republican "laissez faire, trickle down, boot strap" politics falls apart. Their ideology doesn't produce anything but social and economic stratification. "Elitism/elites" simply means "they got an education and you didn't so you should hate them because they will be leading and you'll be following so you should hate them."

Posted by: nsu1203 | January 18, 2011 4:50 PM | Report abuse

Republicans in Congress continue to make fools of themselves while 28,000,000 Americans are out of work!

OMG!

Posted by: Maddogg | January 18, 2011 4:51 PM | Report abuse

Utter claptrap. Look, be partisan if you want to, but for God's sake, if what you're partisan about is an earnest belief that the Earth is flat ... (psst - keep it to yourself ...!!!) Come on, Jennifer. The repeal will go nowhere. The bill is good for America. Its opponents are either liars or lunatics trying to appeal to a very ignorant base. Conservatism has utterly failed. Try being objective for once in your life. i.e.: try not to be a right-winger.

Posted by: chert | January 18, 2011 4:54 PM | Report abuse

A bit of a double standard here. Republican Congress' passed some really unpopular bills, and Dems didn't immediately spend all their time trying to repeal them the second they came to power.

And by 2012 a good number of voters will see the effect of some of the popular parts of the bill start to become reality.

By then public opinion will likely be on the side of the bill, albeit not strongly.

This author would have had more credibility if she was willing to mention 'death panels' and other outright lies after she mentioned the Dems somewhat selectively rosy financial forecasts.

It's one thing to cherry pick financial forecasts that may or may not happen.

It's quite another to lie and claim Obama is going to kill your grandmother.

Odd how the author fails to realize that.

Posted by: TheHillman | January 18, 2011 5:00 PM | Report abuse

"No wonder Democrats don't relish "relitigating" ObamaCare. "

There's a reason the new in-power party doesn't 'relitigate' new legislation the previous Congress just passed.

It's because if we do that then we never ever get anything done, and the work of the country grinds to a halt.

Posted by: TheHillman | January 18, 2011 5:03 PM | Report abuse

Great column! Thanks for continuing to take on the left. Why didn't we just start with the people who didn't have healthcare? Here's the problem: I'm perfectly happy with my healthcare. I'm 68 and still very active in my profession. I hope it stays that way because I don't want to deal with the little-minded government bureaucrats at social security or medicare, thank you! The left thinks we're terrible. The left just wants us all to be equal. Hey! Didn't they try that in some other countries several decades ago? Why do government bureaucrats think you always have to reinvent the wheel?

Posted by: georges2 | January 18, 2011 5:07 PM | Report abuse

No Jen, what's "ultimately" going to happen is that Mitt Romney is going to doubletalk your rank and file till they get dizzy, they're going to annoint him their nominee for 2012, and every darn one of you is going to forget why you opposed this plan within a few years.

Just like you've all forgotten that Medicare was "socialized medicine", according to Saint Ronald. Conservatives are the road kill of history. They slow down traffic sometimes, and the big ones cause society to swerve slightly, but a few miles later the obstructions they presented to the journey are long forgotten.

Posted by: B2O2 | January 18, 2011 5:24 PM | Report abuse

Georges2 writes:
"Great column! Thanks for continuing to take on the left."
-------------------------------------------------------

This column didn't take on the left. it's taking on a purely intra-conservative issue, because it only addresses potential fiscal issues that are really only important for Republican horse-trading. Most liberals I know expected the bill to cost society something, even given the potential to push some of EMTALA's costs back on those who utilize it. The CBO studies were icing on the cake - useful for inter-party negotiations.

But you're completely wrong about the whole "equal" thing. The health care insurance bill addresses societal *minimums* only. If someone can afford more and better health care, then go for it.

The "wheel" that you claim government is reinventing lets 750,000 Americans go into bankruptcy every year due to health care insurance issues (and over 2/3 of those folks *were* insured). That's your idea of a working system?

Posted by: iamweaver | January 18, 2011 5:29 PM | Report abuse

I do not understand this obsession with removal of health care. If anyone has a good plan (GOP or democrat), I am fine with it. I do not want a plan removed as it is perceived to be a bad one without an alternate good one proposed. As a person with a pre-existing condition, I do not like this repeal. The minute I lose my job, I have a big problem getting a good plan. People who say that they have good healthcare currently must look at the circumstances that guarantee it. Forget the liberal vs conservative, elite vs common etc. The truth is that we need health care rights as we need civil rights. No developed country must have a system that says that we should have tax for defense and nothing else. Saying that we should not have social security, medicare etc means that you must have a lot of money when you are older or die suffering.

Posted by: parunach | January 18, 2011 5:31 PM | Report abuse

The Party of No has become the Party of can't deliver won't deliver.

The GOP is just a lame duck congress with no power and lots of hot air.

Posted by: walker1 | January 18, 2011 5:59 PM | Report abuse

I propose that they insert a few pages into the Republicans bill that would end all Federally funded health care for Congress members and their families. This would force members to have to actually go out and get their own insurance, thus finding out what it is really like for most Americans. It would also put a dent in the deficit, albeit tiny. Don't get me wrong though, I believe they should have health care as part of your job representing us. But until others realize what millions face, they will be incredulous to change.

Posted by: kookmeyer111 | January 18, 2011 6:00 PM | Report abuse

It might be a good thing to mention that it won't be the rich who are subsidizing Obamacare, but the middle class, who are already paying way too much for health care.

Obama's solution is to have them subsidize someone else's overpriced care as well.

Posted by: postfan1
_______________________
just the opposite. the free care the uninsured get in ERs now is subsidized by the middle class because it's passed on by hospitals to insurers and then evenly in the form of increased premiums for the insured.

under reform, the uninsured have to pay what they can afford, with only the difference being subsidized (before reform, it's all or nothing, you can't get half insurance for half a premium) and the subsidy is paid for in general revenues, which are born progressively.

aside from the fussing over whether reform saves money, which will go nowhere, there's nothing to repeal that makes any political sense, and to repeal it all is even dumber, because the republicans don't have a backup plan.

which is no surprise, because Obama's reform plan was the Republican plan before he borrowed it, which caused Republicans to be against it. you can look it up. It was the republican alternative to HillaryCare, courtesy of the Heritage Foundation, Nixon, and Dole.

Posted by: JoeT1 | January 18, 2011 6:06 PM | Report abuse

This act by republicans is just an introduction. More is to follow. This is because the budget is adding debt. Oddly, Louis XVI had the same problem and things did not workout to well for him. And he lost his head over the problem.

The big problem when you are living beyond your means is that bankruptcy occurs. This distroys the banking system that has been claimed to be saved. The fact of the matter nothing has been saved but alot has been spent.

Now there will be a cut in entitlements as these start to become impossible. And the main entitlement is in health care. So all that insurance will go down in cost to the government while the cost goes up to the public. And the government will tell people no more free lunch. All this will come as a shock to the free loaders. If the people no longer have bread feed them cake! And there will be blood. It all comes in good time which is really a bad time.

Posted by: artg | January 18, 2011 6:09 PM | Report abuse

Rex, death is the greatest of all obstacles to freedom. Do we all have the right to eternal life?

What we should have, which is to say, what we should arrange through voluntary agreements with one another, is very different from what we have a right to. The right to free speech, or to freedom of movement, or worship, or guns, only require that others not use violence to shut me up or take my means of self-defense; and, yes, the basic liberal (in the classical sense) justification of government was to protect those rights. But, note, that no one defending those rights considered canonizing, say, the right to eat. Why not--the starving man can't be very free either. Or the man (or woman) without a home. To see these equally (if not more urgent) ingredients of life implies a duty on the government's part not just to protect us from those who would violate our lives, but to put food on our tables, roofs over our heads and, in the case of health, our medicine cabinets well stocked with the latest, FDA approved drugs. But all this would require, in a way that the rights to speech, worship, etc., don't, that the government also have the power to tell the farmer what food to grow, the store what to stock, the drug company what to develop and all of the above what to charge, etc. In other words, rights that imply unlimited power can't really be rights--indeed, they turn into the opposite, because if the government can decide all this, it can also decide that you are consuming too many health care resources, are living in to big a house, are eating too much or the wrong kinds of food, etc.

Now, having said all that, I don't necessarily exclude any particular policy--I'm just against inflating the value of a particular policy (and ensuring that the policy in question will ultimately be administered by the courts) by claiming it is necessary to fulfill some "right."

Of course, I don't know whether Buckley would have argued thusly.

Posted by: adam62 | January 18, 2011 6:09 PM | Report abuse

All I have to say to Republicans is, good luck. You'll have to wait till at least 2013 to repeal, and a majority of the country is not going to like it as more benefits kick in. The 650,000 people who would have had the opportunity to retire or take a part-time will instead have to hold onto their jobs and keep others from rising up.

And if your repeal does go through, you can celebrate by watching the deficit kick off like fireworks -- even assuming the CBO's projections are indeed as far off as Jennifer Rubin fantasizes.

Posted by: DAK4Blizzard | January 18, 2011 6:19 PM | Report abuse

Americans deserve what the citizens of every other industrialized nation on earth have and that's affordable health care. The Republicans won't repeal Obamacare, but if they were serious about "fixing" it, they'd have something to replace it with. They don't. They are still the party of no ideas except where it comes to their corporate sponsors.

Posted by: MNUSA | January 18, 2011 6:26 PM | Report abuse

The sooner it's repealed the sooner Congress can start working on Health Care Reform that works FOR Americans rather than against them.

There isn't a single page in the Obamasham law that doesn't have a reference to some bribe, payoff, kick back or quid pro quo.

Repeal it over and start again.

Posted by: asmith1 | January 18, 2011 6:43 PM | Report abuse

This legislation is the only thing standing between me and my not receiving treatment for my cancer.

I have worked and paid health care premiums all my life. The insurance company sent me a letter wanting to cancel my policy. Only this legislation kept it from happening.

Thank you, Jennifer Rubin for sitting on my Death Panel.

Posted by: colonelpanic | January 18, 2011 6:46 PM | Report abuse

I agree, adam62 - it's why the whole government action issue simply has no logical resolution - because it's simply a matter of personal ideology. If you believe that the only responsibility that society has is prevention of deliberate oppression, than that's your belief. If you believe that society should provide some minimal level of support for its disenfranchised, then that's your opinion. The US Constitution pretty much stays away from this, other than the "general welfare" mentioned in the preamble, which leaves lots of wiggle room for whatever we decide.

My quibble here is twofold.

First - with those willing to accept Medicare and Social Security, but don't want to accept health care insurance regulation because of "big government". That seems simply selfish, and shows that these folks aren't against governmental social activism - just activism that they don't receive.

Second- the "personal responsibility" people who are willing to let US citizens get a free ride (as they now do). EMTALA guarantees emergency medical care to everyone, regardless of US citizenship, etc. - and if the recipient cannot pay, we all do in the form of higher insurance premiums. This should strike a deep, sympathetic chord in a fiscal conservative - but instead, I keep hearing about how the government will force folks to pay for insurance if they can afford it. Darn straight, skippy. If everyone has access to emergency health care, then I see no reason why I should pay for someone else's gamble that they won't get a health care bill that they cannot afford. Though I guess there could be a rider that says that if you can prove, say, a million and a half in fungible assets, then you don't have to purchase health care insurance.

Posted by: iamweaver | January 18, 2011 6:46 PM | Report abuse

You Republicans have no concept of fiscal responsibility. Long story short your math is bad and its purposely flawed to say what you want to say.

I find it extremely laughable that the Republicans had to put in an exception for Healthcare Reform repeal in their list of not adding to the deficit. Why is that? Because repealing this Healthcare & Insurance reform actually ADDS to the deficit. While its true it costs money, its paid for.

If Republicans really wanted to save money, they would allow the government to negotiate down drug prices to pay for the unfunded Medicare Part D entitlement Bush passed.

Or how about the $700 million dollar tax cuts for those making over $250,000 a year. While its true that money provides some economic stimulus, the economic activity per dollar ratio is very low. The same money used for building roads would be 3x as effective.

Hell ALL the Bush tax cuts were unpaid for. Between the Bush Tax Cuts and wars in Iraq and Afghanistan that is about 6 trillion of our debt right there.

I am not happy with Obama. I don't even like how the health reform bill turned out. One thing is for sure and I don't think the Republicans get it... its better than it was before.

Letting Health Insurance Cos sell across state lines is the Repubs big talking point right now. Translation: "We want to find the state with the most lenient laws and we'll all sell insurance out of that state." This is not more choice for the consumer, it is circumventing the states right to regulate the industry.

When we let the credit card companies do this we had companies offering "credit" with 33% interest rates.

I really don't think anyone really cares who pays for their health care. They care that when they are sick, they don't have to pay for it out of pocket. They care that they are covered for the care they need, that they can go to the doctor they want to go to and that they don't pay too much each month and especially they don't want to pay more than they can afford.

The solution is:

- Government provided Single Payer Basic Health Insurance for every American

- Optional Private Additional Coverage

- Keep our current Private and Public Health _Care_

Posted by: pdxgeek | January 18, 2011 6:52 PM | Report abuse

Americans deserve what the citizens of every other industrialized nation on earth have and that's affordable health care.
Posted by: MNUSA | January 18, 2011 6:26 PM
=======

You got that right. To accomplish this, they rescinded Birthright Citizenship and kick illegal aliens to the curb in a heartbeat rather than allow them to use and abuse their health care system.

We certainly do deserve what the other nations have - a government that enforces it's immigration and employment laws. If the government did that, we wouldn't have health care costs running amok.

To take control of our health care and insurance costs, we have to work on the whole package, and neither the Democrats nor Republicans are willing to do that.

Posted by: asmith1 | January 18, 2011 6:53 PM | Report abuse

Hmmmm I long ago gave up trying to figure what was right in this argument. To call the various numbers and positions Byzantine, would be to understate the case. I do know this however, it's not going to be repealed, not before January 2013 anyway.

So much like the Palin for president that will never happen, or the Hillary to challenge Obama that will never happen, or the deficit reduction that will never happen, can we give it a rest? LOL

Posted by: johnmarshall5446 | January 18, 2011 6:53 PM | Report abuse

I think one of the issues we (Americans) have to deal with is that there is no such thing as a free lunch.

So, ideas of reforming healthcare provisions which don't balance the books without dealing with those costs (to individuals directly, to individuals collectively via taxes, to corporations - including those corporations profiting from the insurance business currently structured, etc.) just don't add up.

Unless and until healthcare costs are gotten under control (17% of current GDP and slated to rise as we age), NO plan (Republican or Democrat) is going to pass the economic smell test.

Unfortunately, and Barnum stated over a century ago, there is a sucker born every second, and the American polity still is inclined to believe the 'I want it all and don't have to pay for it' hustle that seemingly both Democrats and Republicans play to.

Posted by: Barry8 | January 18, 2011 6:59 PM | Report abuse

Ms Rubin:

You no longer have the luxury of being official spokeswoman for the party of "Nothing but NO!"

Your ilk wrestled away control of the United States House of Representatives from those with constructive ideas -- so you better darn well come up with positive solutions of your own to this country's problems.

It is no longer permissible for you to sit and throw your mud from the slidelines. You are in the game, lady! So what's your game plan? Nothing but continued defense for the next two years?

Posted by: PeterIII | January 18, 2011 7:04 PM | Report abuse

In their eagerness to demonstrate anti-administration passion, the Republicans have overlooked that there are tripwires laced throughout the health care law. These are the Republican ideas that went into the bill.

The Republicans cleverly named this the job-killing health care reform repeal act. Of course, the Republicans were sure that the tax cuts Bush asked for would create jobs. This shows how much they know about creating jobs.

The Republicans know they can't repeal the health care law, and they really don't want to. They want it around so that they can tell their lemmings that all of their problems stem from this law and those nasty Democrats wouldn't allow its repeal.

Posted by: amstphd | January 18, 2011 7:17 PM | Report abuse

As usual, Rubin writes circles around herself.

Conventional wisdom says the repeal goes nowhere, but don't be so sure because filibusters can be mounted?

Um . . . . ok.

But hey, at least she does lift a partisan and unsubstantiated claim from another opinion page (WSJ) to fill in where her logic fails.

At least that's something . . . isn't it?

Posted by: russellglee | January 18, 2011 7:20 PM | Report abuse

Maybe we can all win. We keep HCR and pay for it by having all Republicans use non-elite doctors who did poorly in school and never heard of the Ivy League.

Posted by: Keesvan | January 18, 2011 7:27 PM | Report abuse

"First - with those willing to accept Medicare and Social Security, but don't want to accept health care insurance regulation because of "big government". That seems simply selfish, and shows that these folks aren't against governmental social activism - just activism that they don't receive."

It seems to me that opposition to Obamacare is primarily defense of the status quo in which about 2/3 of Americans seem to be satisfied with their healthcare--they obviously believe, I think correctly, that Obamacare will take away what they have now and give them something worse. So, it may be selfish to defend their interests at the expense of the other 35% (if we imagine, for the sake of argument, that things will get better for them); and, I will add, even Medicare and Social Security are unsustainable and we have a much bigger reckoning ahead, making the opposition to Obamacare naive in most cases--nevertheless, I'm with all those people in not wanting to make things worse, much worse in my view. The question of rolling back the welfare state is obviously not on the agenda now, just preventing it from metastasizing further.

Posted by: adam62 | January 18, 2011 7:31 PM | Report abuse

"Second- the "personal responsibility" people who are willing to let US citizens get a free ride (as they now do). EMTALA guarantees emergency medical care to everyone, regardless of US citizenship, etc. - and if the recipient cannot pay, we all do in the form of higher insurance premiums. This should strike a deep, sympathetic chord in a fiscal conservative - but instead, I keep hearing about how the government will force folks to pay for insurance if they can afford it. Darn straight, skippy. If everyone has access to emergency health care, then I see no reason why I should pay for someone else's gamble that they won't get a health care bill that they cannot afford. Though I guess there could be a rider that says that if you can prove, say, a million and a half in fungible assets, then you don't have to purchase health care insurance."

It may be legitimate to require hopsitals to treat genuine emergencies, but I don't see what prevents hospitals from collecting their fees afterward. I imagine the laws vary here from state to state and community to community, but why not give hospitals the right to garnish paychecks, take over property, etc., until they are paid? The flip side of this, of course, is that high deductible insurance must be available on a national (or even international) marketplace--if such insurance is available, then the knowledge that you will be paying for the rest of your life for an emergency room visit might encourage many more people to buy it.

Posted by: adam62 | January 18, 2011 7:36 PM | Report abuse

The House will vote to repeal health legislation and ultimately, the public will see just how flawed it is.
~~~

The only reason it would be flawed, as Rubin tries to suggest, is because of the lies (death panels) told by "unhinged" Sarah Palin, GOP obstructionism, filibusters, and other right-wing low down dirty tricks by the Republican Party and that tantrum throwing Senator Joe Lieberman, who demanded that the Public Option be taken out.

Those are the only reasons why it would be flawed and non other.

So, tell us again Rubin why you think it's flawed?

Posted by: lcarter0311 | January 18, 2011 7:41 PM | Report abuse

What? Who? "Wishful-thinking, generally liberal elite opinion makers." I guess that's supposed to be an insult or sneer, but frankly it comes off as a rude expression of disgust -- the result of being badly pummeled in a debate over health care reform. What comes to mind: sour grapes, sore loser, whiner, griper, malcontent or perhaps just a frustrated Republican. From the tone of this, I you also seem intent upon "getting even." What a waste of time. Find something constructive to do.

Posted by: dparks2 | January 18, 2011 7:41 PM | Report abuse

"Letting Health Insurance Cos sell across state lines is the Repubs big talking point right now. Translation: "We want to find the state with the most lenient laws and we'll all sell insurance out of that state." This is not more choice for the consumer, it is circumventing the states right to regulate the industry."

I just noticed this comment. This is an excellent talking point--"circumventing the states right to regulate the industry" is a great way to put it. Circumvent away! Why doing so doesn't mean more choice for the consumer--as far as I can see, it does mean that, pretty self-evidently--is a mystery.

Posted by: adam62 | January 18, 2011 7:48 PM | Report abuse

Jennifer: Look what you've done. The self described progressives are coming out of the woodwork with their panties in a knot. I've never seen so many knotted up panties in my life.

Here they are designing a magnificent paradise on earth for us, and do you appreciate their wonderful plans? No you do not, you ungrateful wretch.

Posted by: ZoltanNewberry | January 18, 2011 7:54 PM | Report abuse

If life were a thing that money could buy
the rich would live and the poor would die . . . oh, wait.

Hey, Rubin,why don't you address the fact that the individual mandate was thought up as a replacement for single payer, as a way to get all the freeloaders paying into the system?

Posted by: scientist1 | January 18, 2011 7:55 PM | Report abuse

I enjoy the posters who wish to debate the "right" aspect of the bill. With their view the pacifist would not be obliged to pay for defense spending, childless couples would not pay taxes for schools, and young people would not be taxed for social security. Pay attention. Ignoring the common good/greater good aspect of the constitutional imperative of the US government, or providing for the common defense aspect, is a trip down fantasy lane. The purpose of our government is to express our collective will within that constitutional framework. There is no doubt that the bill could be better. There is also no doubt that it is perfectly constitutional.

Posted by: heveymana | January 18, 2011 7:55 PM | Report abuse

Tens of millions of Americans are chain-smoking drunks with posteriors made of lard. Then throw drug addiction and HIV infection into the mix, and it's no wonder our health care costs have skyrocketed over the past 30 years. A disproportionate number of the previously described characteristics belong to African Americans, Latinos, and poor whites (a.k.a. rednecks) who live in southern states; this is one reason why many middle-class southerners are opposed to health care reform because their costs are going to go through the roof if they have to cover such people through their private policies.

Health care reform needs to figure out how to spread out such costs in a more equitable manner across the entire nation. Until it does, many white middle-class Southerners will continue to oppose it. They're being asked to shoulder 75% of the costs of the health care reform, while people in mostly European-American ancestry areas like Maine or Minnesota don't get hit with the same level of costs. Is it any wonder they voted Republican?

Posted by: armyofone | January 18, 2011 7:59 PM | Report abuse

If Republicans are sincere that "Obamacare" (aren't they great at making up pejorative labels?) is going to be replaced by something better, then I'm all ears.

I might even support it - provided it covers everyone who wasn't insured before, addresses pre-existing conditions and allows families to carry their children until age 26.

I would just note that Republicans had six years under Bush to propose a health care bill and no one recalls seeing one.

Well, maybe it's a New Day.

I'm afraid this might be just like the pledge to balance the budget - while rubber stamping every George Bush budget, financing two wars and a massive tax give-away to the wealthy, all on a government Master Card.

We'll see...

Posted by: MidwaySailor76 | January 18, 2011 8:10 PM | Report abuse

"Health care reform needs to figure out how to spread out such costs in a more equitable manner across the entire nation. Until it does, many white middle-class Southerners will continue to oppose it. They're being asked to shoulder 75% of the costs of the health care reform, while people in mostly European-American ancestry areas like Maine or Minnesota don't get hit with the same level of costs. Is it any wonder they voted Republican?"

This is a brilliant strategy for turning the Northeast red and further reddening the Midwest. Go for it!

Posted by: adam62 | January 18, 2011 8:24 PM | Report abuse

"Hey, Rubin,why don't you address the fact that the individual mandate was thought up as a replacement for single payer, as a way to get all the freeloaders paying into the system?"

Yes we managed to prevent you from directly socializing medicine--why do you think that should mean we won't try and prevent its gradual, piecemeal socialization?

Posted by: adam62 | January 18, 2011 8:26 PM | Report abuse

"There is also no doubt that it is perfectly constitutional."

I admire your certainty. And yet I still doubt, and look forward to many years of lawsuits by states and individuals.

Posted by: adam62 | January 18, 2011 8:29 PM | Report abuse

Every other industrialized nation has found a way to provide health care to its citizens - at less cost. Americans, meanwhile, pay the most and receive the least effective care. Something is wrong with that picture.

Obama tried to do something about it - he gets his props for that.

Could it be better? Absolutely. We could have covered everyone under the Medicare program.

But, because of irrational and disingenuous arguments from the right about "death panels" and "socialism" (do you Tea Partiers like getting Social Security and Medicare? Hello??), the bill that was ultimately signed was a hollow version of what it could have been.

It didn't control costs & it ensured windfall profits for the insurance companies with all the newly required participants. But it will insure everyone - that's the important point.

Republicans don't like that idea, of course. The "Pay As You Go" philosophy has deep roots; and, apparently, they would rather see some (unworthy) people die from neglect than pay a little extra to cover them.

Posted by: MidwaySailor76 | January 18, 2011 8:39 PM | Report abuse

- Ten years of taxes for seven years of benefits to cook the CBO books.
- Thousands of new IRS agents for enforcement.
I can hardly wait for all the young healthy ones that thought this was "free" like Medicare to get forced to buy or pay the fines.

Posted by: TominColorado | January 18, 2011 8:49 PM | Report abuse

An observation that is only tangential to the current health care debate: I hear the term "socialism" all the time - how bad it is and how we should avoid it. But, interestingly, no one - and I mean NO ONE (at least so far) on these posts - has articulated WHY socialism would necessarily be a bad thing.

Social Security, Medicare and Medicaid are all 'socialist' programs. As are Veterans' benefits. And yet I don't hear anyone saying they will give up their government checks in the interest of being true to their ideology.

If you're out there, and you really hate the idea of "socialism", then this is your chance to make a statement. Tell us you'll send back your Social Security check; tell us you'll turn down Medicare or Veterans' benefits; tell us, when you have nowhere else to turn, that you'll turn down Medicaid.

I await your principled response.

Or (I'll make it easy for you) an explanation - a cogent one - about why socialism is 'bad'.

Posted by: MidwaySailor76 | January 18, 2011 9:00 PM | Report abuse

Crickets chirping...as I suspected.

Still waiting...

Posted by: MidwaySailor76 | January 18, 2011 9:07 PM | Report abuse

I told you Jen, we're going to find out that it saves $$$ and covers EVERYBODY.

The answer to defenders of Obamacare, of course is that we have ... er ... had ... a healthcare system that provided more high quality care to a larger percentage of the population than any other large western nation. Obamacare is currently eviscerating that system (with great alacrity) in exchange for nominal "health insurance" to "more" people and inducing a massive and immediate crisis that would be even worse had there not been over 200 exemptions for politically connected entities. REPEALING OBAMCARE, IN ITS ENTIRETY WILL LIMIT LIMIT THE DAMAGE AND RESTORE A MUCH SUPERIOR SYSTEM. That system was not perfect prior to the ravages of Obamacare and it will not be perfect even if this nation is savvy enough to vote in such a way as to have it repealed early in 2013. Improvements in the system through expanding consumer choice, limiting abusive law suits and other means will make it even better but the first step is for now limiting and when politically feasible repealing Obamacare.

Posted by: cavalier4 | January 18, 2011 9:11 PM | Report abuse

"The answer to defenders of Obamacare, of course is that we have ... er ... had ... a healthcare system that provided more high quality care to a larger percentage of the population than any other large western nation."
=======================
Well, I don't know what your source is; but, according to the U.N., the world's recognized health authority (I know, it must break your heart), it breaks down this way:

(From Wikipedia) Starting with the 2010 report, the Health Development Index (HDI) combines three dimensions:

* A long and healthy life: Life expectancy at birth
* Access to knowledge: Mean years of schooling and Expected years of schooling
* A decent standard of living: GNI per capita (PPP US$)

The HDI combined three dimensions up until its 2009 report:

* Life expectancy at birth, as an index of population health and longevity
* Knowledge and education, as measured by the adult literacy rate (with two-thirds weighting) and the combined primary, secondary, and tertiary gross enrollment ratio (with one-third weighting).
* Standard of living, as indicated by the natural logarithm of gross domestic product per capita at purchasing power parity.

The United States is ranked anywhere from number 9 to number 13 on these scales, depending on the index being measured.

Not exactly number one. Not Somalia, by any stretch, but there is definitely room for improvement. We are far behind most industrialized countries - not what you'd expect if we had the best system in place.


Posted by: MidwaySailor76 | January 18, 2011 9:27 PM | Report abuse

"Or (I'll make it easy for you) an explanation - a cogent one - about why socialism is 'bad'."

Is this really your idea of a "gotcha!" question? Could it be that you have never considered that the government can't possibly make decisions regarding the needs, wants and abilities of hundreds of millions of people nearly as well as can those hundreds of millions of people engaging in voluntary exchanges with each other?

As always, I am very ambivalent about making making these arguments, because I would be ecstatic if the Left's next move was to come right out and say "Well, what's wrong with socialism?" But my ambivalence is overcome by the imperviousness of the Left to arguments on these questions--another logic determines the arguments of the Left.

Posted by: adam62 | January 18, 2011 9:32 PM | Report abuse

Skippy writes:

Any time you want to argue health care finance I'm here for you. I'll stack my thirty years of hospital financial management against your rote repitition of liberal talking points any time.

----

Oh Skippy, let's get real conservative.

Back before we had mid-six figure geniuses cooking the health care books, medical costs were 5% of US expenditures. During your career they've risen above 15%. Thanks to you, health care costs are skyrocketing past every sector in the economy. That's some management skill, Skippy.

Before you got your job, financial guys made a small percentage of what M.D.s make, now the average M.D. make a lot less than you, genius.

Finance? My last hospital stay I paid $35 for an aspirin. It cost me a penny at Walgreens. That's marked up 3,500 times!

Let's compare that to the paradigm of government waste: the $700 toilet seat. I can find a cheap one at the big box store for $10. Thats only marked up 70 times. You're a 50 times bigger waste than the U.S. government, Skippy! That's hard to do.

The markups aren't going to Doctors and Nurses who try to save lives and who are taking pay cuts, Skippy; they are going to parasites like you who feed off human misery. and only care about their Ferraris, Beach Homes, Trips to Vegas and Call Girls.

Inside the hospital, the only thingl your care about is your own gluteus maximus. We could cut your wages down to half of that of a Wal-Mart greeter and we'd cut out the biggest waste of all.

Posted by: colonelpanic | January 18, 2011 10:23 PM | Report abuse

"Or (I'll make it easy for you) an explanation - a cogent one - about why socialism is 'bad'."

Is this really your idea of a "gotcha!" question? Could it be that you have never considered that the government can't possibly make decisions regarding the needs, wants and abilities of hundreds of millions of people nearly as well as can those hundreds of millions of people engaging in voluntary exchanges with each other?
-----------------------
Well, apparently not, since every other modern nation has found a way to answer this question and we still can't get health care to millions - let me repeat that - millions of Americans.

If there was a free market solution to this, don't you think we would have found it by now?

Maybe denying access to millions is your idea of the ideal health care system. I would venture to say that if it came down to covering everyone and calling it "socialism", the ones not covered would gladly call it that and accept the coverage.

One man's opinion.

Peace.

Posted by: MidwaySailor76 | January 18, 2011 10:48 PM | Report abuse

Adam62 writes:

It may be legitimate to require hopsitals to treat genuine emergencies, but I don't see what prevents hospitals from collecting their fees afterward. I imagine the laws vary here from state to state and community to community, but why not give hospitals the right to garnish paychecks, take over property, etc., until they are paid?
---------------------------------------------------

Hospitals do try to collect from the uninsured - it's just often unsuccessful.

You know what a good result would be? To offer health care insurance to everyone - but pre-charge those that can afford to pay, so that hospitals bearing the brunt of the currently-uninsured ER patients don't have to fold, leaving a critical shortage of hospitals in the inner cities, for example. Personally, that seems to make sense - because leaving the health industry solely in the hands of capitalism, while simultaneously burdening it with unbalanced and unfunded social responsibilities, is a sure recipe for disaster.

Posted by: iamweaver | January 18, 2011 11:00 PM | Report abuse

"If there was a free market solution to this, don't you think we would have found it by now?"

There are all kinds of free market solutions yet to be discovered--the market is intrinsically open-ended and unpredictable. Most government solutions are attempts to solve the problems created by the latest government solution--in this case, tying health care so closely to employment rather than privileging its purchase on the open market.

"Hospitals do try to collect from the uninsured - it's just often unsuccessful."

No doubt--was I was wondering why. I'm sure some people just can't pay, but I'll bet plenty can, at least some.

"You know what a good result would be? To offer health care insurance to everyone - but pre-charge those that can afford to pay, so that hospitals bearing the brunt of the currently-uninsured ER patients don't have to fold, leaving a critical shortage of hospitals in the inner cities, for example"

Who is doing the offering here?

Posted by: adam62 | January 18, 2011 11:08 PM | Report abuse

"I would venture to say that if it came down to covering everyone and calling it "socialism", the ones not covered would gladly call it that and accept the coverage."

And the ones who lose their present coverage and get forced into government subsidized health care will also call it socialism--maybe they'll be able to explain to you what's wrong with it.

Posted by: adam62 | January 18, 2011 11:11 PM | Report abuse

Skipsailing&Adam/the simple fact is that there cannot be a "right" that imposes a "duty" on others.

OR,all rights impose duty on others
The inalienable right to Life imposes a duty on society to protect "Life" from Threats to Life(That's why we are required to have police,firemen,and emergency rooms),a category which reasonable people might include disease and injury.

The inalienable right to Liberty requires society to have a system of national defense to prevent threats to liberty from enslaving us. A reasonable person could include disease and illness as an obstacle to liberty.

The inalienable right to pursuit of happiness requires society to prevent anything that prevents that pursuit. Reasonable people could include illness and injury as obstacles to the pursuit of happiness.
+++++++++++++++++++++++++++++++++++++++++++

No one is compelled by government to work for the police or fire department, and those who do are compensated for it.

As to your second "right," the Constitution specifically enumerates the authority to raise armies and maintain a navy to that purpose.

Your last one, well, it's so unreasonable it's hard to respond. It presumes such an open-ended scope that it would impose no limit on government. The pursuit of happiness for most includes use of a decent car, does that empower the government to confiscate my property to buy you a car if you don't have one? How about a house? The founders' meaning in the pursuit of happiness is the freedom to pursue it though the fruits of your own labor, not to impose obligations on others to obtain it for you.

Nowhere in the Constitution is the federal government authorized to confiscate wealth to establish a national healthcare system.

Posted by: alexandria6351 | January 19, 2011 8:15 AM | Report abuse

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