The Financial Times has published a bizarre column by Matt Miller, a former Clinton administration budget official, titled “right is wrong to attack Obama’s health plan” in which he lashes out at conservatives for criticizing what Obama is actually proposing rather than what Miller wants him to propose. This article is so misleading and poorly written, that it’s hard to know where to start, so I’ll just begin at the beginning.
The Republican charge that Barack Obama is seeking a “government takeover” of US healthcare is further proof that American political rhetoric has become detached from reality. In fact, once you take away the proposed public insurance option, which Mr Obama’s aides have signalled they will drop in final negotiations, the likely outcome is an affordable reform that embraces Mitt Romney’s blueprint from Massachusetts and funds it with John McCain’s best idea from the presidential campaign.
Only in America can you co-opt Republican thinking and have critics label you “socialist”.
Arguing that we should judge Obama’s health care effort assuming the absence of a “public option” is quite a caveat for Miller to just throw out there. This isn’t some minor feature of Democratic proposals, but is seen as the key to their efforts to overhaul the health care system. The provision was central to President Obama’s campaign proposal, he has maintained public support for it, Rahm Emanuel was forced to backtrack when he hinted that it was negotiable, Harry Reid has said the Senate Bill needs to have one and Nancy Pelosi has said the same on the House side.
Just because Mitt Romney is a Republican, doesn’t mean his health care plan wasn’t a step toward socialized medicine. Plenty of conservatives who weren’t shilling for Romney’s presidential campaign recognized the 2006 Massachusetts “reform” for what it was: a big government health care plan in which government forced people to obtain insurance and then provided them with government subsidies to purchase government-designed insurance on a government-run exchange.
Miller then writes:
Start with cost. It’s easy for foes to feign shock at Obamacare’s $1,000bn 10-year price tag, but a trillion dollars ain’t what it used to be. That is just over 0.5 per cent of gross domestic product over the same period, and barely 3 per cent of the roughly $35,000bn total healthcare spending during that time. If Mr Obama’s approach is otherwise sensible, the idea that America can’t afford it is preposterous.
Yes, it’s “preposterous” to say we can’t afford something when the Congressional Budget Office is already projecting $9.3 trillion in cumulative deficits over the next decade. It’s “preposterous” to argue that we can’t afford to create a new entitlement when the ones we have now are already driving a long-term entitlement deficit of $56 trillion. It’s “preposterous” to argue that we can’t afford to add 20 million beneficiaries to Medicaid when the current program is currently bankrupting state governments.
Of the Massachusetts plan, which has led to skyrocketing costs and longer waiting times in the state, Miller writes:
The results have been impressive. The ranks of the uninsured have been slashed; just 2.7 per cent of residents now lack coverage, the lowest of any state – against 15 per cent nationally. Costs, which overran as the programme was brought in more quickly than planned, are now on budget.
What he doesn’t say is that Taxachusetts just passed a 25 percent hike in the sales tax. And State Treasurer Timothy P. Cahill, a Democrat, criticized the health care legislation, telling the Boston Globe that : “Everyone wanted it to pass, to get it on their resume…Nobody asked the tough questions. It was expensive, even in good times. In tough times . . . it just doesn’t seem doable.’’ Later in the article, Cahill is quoted as saying, “We’re all still waiting for the savings….Universal healthcare was supposed to eventually save us money.’’ He added, “It’s a warning for the federal government as it looks to do something similar.”
Then, after having written that it’s “preposterous” to say that we can’t afford health care, Miller argues that the only way to do so is to tax employer-provided health benefits:
When it comes to financing expanded coverage there’s no way to get there without revisiting the current scheme, under which employees escape taxes on employer-provided health benefits. This subsidy is so massive, at $250bn a year, and regressive – reserving its biggest bounty for those with the most generous plans – that a phalanx of health economists from both political parties recently begged Congress to trim it.
As it turns out, scrapping this tax subsidy was the bold, if unappreciated, centrepiece of Mr McCain’s health plan during last year’s election. The fact that candidate Obama slammed it then as a tax hike on the middle class does not mean President Obama cannot embrace it as part of a deal that achieves his goals; his top advisers have long agreed it is the soundest way to fund reform. Moreover, union leaders who defend the tax exclusion because it bankrolls union plans tell me they are open to change to get to universal coverage.
The problem is that Harry Reid ordered Max Baucus to rule out the idea of taxing employer-based health care, especially given low polling numbers. Obama has also remained opposed. And as for the unions, I’m not sure who Miller spoke to, but unions have been fiercely opposed to the idea publicly. Last month, Gerald McEntee, President of the American Federation of State, County, and Municipal Employees (AFSCME), warned that any attempt to tax employee health benefits would “turn good people against great reform.”
Miller writes, “just because Obama is on a path to give America the Romney health plan with McCain-style financing does not mean the Republicans will embrace it, if it seems politically more attractive to scream ‘socialist.’ But the rest of us do not have to listen to them. Mr Obama can fairly claim to have championed a bipartisan health policy, even with few Republican votes.”
This is really weird. Normally, the way it’s supposed to work is that somebody defending an administration’s policies is supposed to defend its actual policies. Yet Miller is arguing that we must praise Obama for championing bipartisan health policy that neither he nor the relevant Democrats are supporting, and refrain from criticizing him for what he and most Democrats are actually proposing.