David Brooks recites at length what went down during the health care reform debacle except he throws in a bunch of misleading statements, cites a firm that behaves as a front for an insurance company to bolster one of his claims, and then — why not? — fails to make a compelling statement or introduce any kind of noteworthy information.
In short, the column is representative of the very worst aspects of the health care debate: misleading half-truths that neither educate nor compel. If the Times is looking to boost revenues, it should rent out Brooks’s column space to an advertiser. At least they could then afford to fund more investigative journalism.
Much has gone wrong during the health care negotiations, so it’s downright odd Brooks willfully evades the fact that Obama met privately with the pharmaceutical companies, and agreed to oppose any congressional efforts to bargain for lower drug prices, import drugs from Canada, and not to pursue Medicare rebates or shift some drugs from Medicare Part B to Medicare Part D, which would cost Big Pharma billions in reduced reimbursements. That seems like a huge “uh-oh” moment to avoid if we’re making a list of Shit That Went Wrong during the reform process.
Brooks also skips right over how the private health insurance companies and drug makers bribed Congress to vote against reform, though he does get a shot in about trial lawyers. The rest of the back door negotiations and bribing is summarized as, “These were compromises, too. They were ugly, and they soiled everybody involved. But, again, they could be justified for reasons of political expediency.”
Oh. Well, as long as they can be justified. Moving on…
Brooks weirdly reminds his readers that they do not live in Plato’s Republic, and America is a democracy. Yet, polls continue to show that the public option has tremendous support, and is clearly supported by a majority of citizens. Brooks fails to mention this, of course. That’s not the breed of democracy he’s talking about.
He describes the Senate bill as having “some integrity” without mentioning the bill’s backdoor challenge to Roe v. Wade, the 2014 starter date, age-rating, the banishment of generic, less-expensive drugs from ever getting to the market, and also re-imported prescription drugs (that could save consumers $100 billion over 10 years), how the bill fails to address the rising cost of medical care, and taxes the middle class to pay for itself.
Apparently, what Brooks means by “some integrity” is that the Senate bill won’t add to the deficit. BTW: the deficit is that thing Republicans care about when discussing health care, but not the wars or the bailout of financial firms that destroyed the economy.
The single negative aspect of the Senate bill Brooks focuses on is the excise tax, which is Congress’s attempt to tax the middle class instead of the wealthy. It’s a very bad idea that a majority of Americans hate and will result in most people getting worse health insurance (that covers less), according to the CMS.
In reaction to the tax, many employers would reduce the scope of their health benefits. The resulting reductions in covered services and/or increases in employee cost-sharing requirements would induce workers to use fewer services. Because plan benefit values would generally increase faster than the threshold amounts for defining high-cost plans (which are indexed by the CPI plus 1 percent), over time additional plans would become subject to the excise tax,prompting those employers to scale back coverage.
Jon Walker translates:
your employer will reduce what your current insurance plan and put in place high co-pays and deductibles. The result is that many people with employer-provided health insurance will see their insurance get much worse. For younger, healthier employees, possibly getting less comprehensive insurance but maybe higher wages (I think it is very doubtful that there is a pure dollar for dollar passthrough), this might be a decent deal. For older, less healthy employees this is a very bad deal. They will be forced to pay much more out-of-pocket for their health care.
Brooks continues to portray the excise tax as a penalty for Cadillac health care plans, which is not true. Really expensive plans aren’t necessarily generous ones. A flat tax on all employer-provided benefit plans above a set dollar amount is extremely regressive, and potentially devastating for low or middle-income Americans.
Brooks argues that the tax would bring down healthcare costs (of course, without mentioning other ways to do this i.e. re-importing drugs). He then cites Republicans’ favorite firm, the Lewin Group, which is a wholly owned subsidiary of UnitedHealth. It’s interesting that the Lewin Group is never identified in this way.
Whenever Daily Kos, for example, is referenced in the news, the website is described as “the liberal Daily Kos.” Same goes with think tanks i.e. the liberal Center for American Progress. Such labeling is customary because it’s important to disclose the ideological bend of organizations. Except, the Lewin Group is never described as the “pro-insurance industry firm,” or linked to UnitedHealth, a health insurance company that makes tens of millions of dollars in revenue from a system it benefits from preserving, and does so by buying off the right Democrats and getting Republicans to cite polls from their Super Independent And Serious healthcare policy research and management consulting firm.
Of course, then Brooks goes into how unpopular all this reform business is. And that’s true. It is unpopular, but because he’s a good little beltway stenographer, Brooks portrays this unpopularity as a kind of backlash against reform, which isn’t the case. Citizens are reacting to gridlock and total surrender from the Democrats, who let’s remember, were overwhelming voted into power because Americans wanted major change. They also still support the public option by large margins. That indicates they wanted Democratic-led initiatives, including in the sphere of health care reform. What they got was pro-industry, pro-status quo legislation. No wonder they’re pissed.
Brooks describes the White House’s concession as “[catering] to every special-interest plea.” I have to assume the American people aren’t a special-interest group in that scenario. And Obama certainly hasn’t caved to any demand from Progressives or liberals, those much loathed special interest groups. In fact, the only special interest pleas I have seen Obama acquiesce to are the private health care and pharmaceutical special interest groups.
The latest news on the excise tax is that it won’t be implemented until 2018, a breathtaking display of kicking the can down the road if ever there was one. Brooks is skeptical the tax will ever be activated, and since that would adhere to Congress’s proud tradition of doing nothing, I’m inclined to agree with him on this single point.
He ends his column by praising the White House, which “has tried to think about the long term.” For whom? Certainly, not the benefit of the American people. The private health care industry and drug makers won this game, and tellingly, they’re the only missing players in Brooks’s diatribe against the reform process.