Distortions in the healthcare debate

Bob Herbert explains the substantive progressive case against the Democrats' plan.

By Glenn Greenwald
December 29, 2009 4:30PM (UTC)
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As I've documented before, the "debate" over the President's health care reform bill has come to resemble most political debates in the U.S.:  dominated by ludicrous, obvious strawmen and bullying, manipulative tactics in lieu of substantive debate.  Proponents of the bill have continuously claimed -- falsely -- that progressive opponents object to the bill because they're petulant purists who didn't get everything they want and are therefore willing to sacrifice expanded access to health care in pursuit of ideological dogma.  We like to think we've come a long way since 2003, yet the health care "debate" is being shaped by the likes of The New Republic's Jonathan Chait and his fellow Beltway Democratic comrades reprising their standard, typical role of deriding anyone "to their Left" who opposes their President's plan as unSerious, unhinged losers who don't care about serious policy matters or progressive goals.  When it's The New Republic -- whose self-proclaimed editorial mission is to re-make the Democratic Party in Joe Lieberman's image -- taking the lead in dictating what every Good, Serious Progressive must affirm (this "bill is the greatest social achievement of our time"), you know the debate has gone seriously awry.

Today, The New York Times' Bob Herbert has an excellent column giving the lie to those tactics from the President's most loyal supporters.  Herbert explains why the health care bill -- with its reliance on taxes on so-called "Cadillac" plans -- is far more likely to end up burdening the middle class and reducing health insurance coverage for tens of millions of people:


In fact, it’s a tax that in a few years will hammer millions of middle-class policyholders, forcing them to scale back their access to medical care. Which is exactly what the tax is designed to do. . . .

Within three years of its implementation, according to the Congressional Budget Office, the tax would apply to nearly 20 percent of all workers with employer-provided health coverage in the country, affecting some 31 million people. Within six years, according to Congress’s Joint Committee on Taxation, the tax would reach a fifth of all households earning between $50,000 and $75,000 annually. Those families can hardly be considered very wealthy. . . .

The idea is that rather than fork over 40 percent in taxes on the amount by which policies exceed the threshold, employers (and individuals who purchase health insurance on their own) will have little choice but to ratchet down the quality of their health plans. . . . These lower-value plans would have higher out-of-pocket costs, thus increasing the very things that are so maddening to so many policyholders right now: higher and higher co-payments, soaring deductibles and so forth. . . .

Proponents say this is a terrific way to hold down health care costs. If policyholders have to pay more out of their own pockets, they will be more careful -- that is to say, more reluctant -- to access health services. On the other hand, people with very serious illnesses will be saddled with much higher out-of-pocket costs. And a reluctance to seek treatment for something that might seem relatively minor at first could well have terrible (and terribly expensive) consequences in the long run.

Herbert also explains why the central assumptions of the plan are patently unrealistic.  There are substantive replies one can make to these claims, but Herbert's column demonstrates a truth that has been deliberately distorted by the President's defenders:  the progressive case against the health care bill is not grounded in "ideological purity" or childish anger or any of the other deceitful strawmen that have been created.  It is based on these substantive policy objections.  Along with the extreme burden that will be imposed on those forced by penalty of law to purchase private insurance policies they cannot afford and do not want, the argument has always been that the Senate bill will cause massive amounts of harm both from the perspective of health care policy and generally by filling the coffers of large insurance and pharmaceutical industry interests at the expense of the middle class.

The title of Herbert's column is "A Less Than Honest Policy."  The same can be said of the principal tactics used by the bill's proponents, who have relied far more on the old reliable, trite derision and demonization of The Angry, Purist Left than they have on honest discussions.

Glenn Greenwald

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