A blog about politics.

False Choice

In this op-ed in today's Washington Post, Jackson Diehl argues that there are strong similarities between Barack Obama and George W. Bush, and asserts that Obama's decision to pursue health care reform can be compared to Bush's to go to war in Iraq. Each, he suggests, is a "war of choice":

So Obama hasn't strayed far from Karl Rove's playbook for routing the opposition. But surely, you say, he's planning nothing as divisive or as risky as the Iraq war? Well, that's where the health-care plan comes in: a $634 billion (to begin) "historic commitment," as Obama calls it, that (like the removal of Saddam Hussein) has lurked in the background of the national agenda for years. We know from the Clinton administration that any attempt to create a national health-care system will touch off an enormous domestic battle, inside and outside Congress. If anything, Obama has raised the stakes by proposing no funding source other than higher taxes on wealthy Americans, allowing Republicans to raise the cries of "socialism" and "class warfare."

Just as Bush promoted tax cuts as a remedy for surplus and then later as essential in a time of deficits, so Obama has come up with strained arguments as to why health-care reform, which he supported before the economic collapse, turns out to be essential to recovery. Yet as he convened his "health care summit" at the White House on Thursday, the stock market was hitting another 12-year-low; General Motors was again teetering on the brink of insolvency and the country was still waiting to hear the details of the Treasury's proposal to bail out banks. George W. Bush might well be asking: Is the president taking his eye off the ball?

I agree that we should think about General Motors as we decide whether it is the right time to finally do something about health care reform. But that brings me to the opposite conclusion: If we don't fix our health care system, everything else we do for the automakers may well be a waste. That's because health care costs are one of biggest things that are killing this country's auto industry. Detroit is spending more on health care these days than it is on steel. Diehl might read this story that his colleague Ceci Connolly wrote in 2005:

American manufacturers are losing their ability to compete in the global marketplace in large measure because of the crushing burden of health care costs, General Motors Corp. chairman and chief executive G. Richard Wagoner Jr. said yesterday as he called on corporate and government leaders to find "some serious medicine" for the nation's ailing health system.

In a speech at the Economic Club of Chicago, the auto executive, who is responsible for providing health insurance for more people than any other private employer in the nation, graphically detailed how rising medical bills are eating into his company's bottom line and ultimately threatening the viability of most U.S. firms.

"Failing to address the health care crisis would be the worst kind of procrastination," Wagoner said, "the kind that places our children and our grandchildren at risk and threatens the health and global competitiveness of our nation's economy."

After spending several years on the health policy sidelines, Wagoner is launching a mini media blitz, hoping the competitiveness argument will be the one that finally prompts lawmakers to take on an increasingly expensive system rife with inefficiencies and inequities. Wagoner said he intends to press his case personally in Washington and with the nation's governors.

Though self-interest may be at the heart of Wagoner's crusade, he and a range of corporate leaders and policy analysts warned that GM's woes are a harbinger of what lies ahead.

"GM is the canary in the coal mine for Medicare and everyone else," said Sean P. McAlinden, chief economist at the nonprofit Center for Automotive Research. "There are many, many more companies out there in trouble because of health care costs than just the auto, steel and airline industries."

McAlinden, a labor expert sympathetic to union views, said many in Washington have mistakenly concluded that GM and other carmakers are simply whining about costly union contracts.

"GM and the United Auto Workers didn't cause this double-digit inflation in health care," he said. And if GM pushed for sharp reductions in health benefits, the powerful union would likely strike and send the company into Chapter 11 bankruptcy protection, he predicted.

Last year the automaker, known for its innovative approach to health care, spent $5.2 billion to cover 1.1 million retirees, employees and their families. Prescription drugs cost GM $1.9 billion, and the company projects overall medical spending will increase by $400 million this year. That could be offset by a provision in the Medicare drug benefit to pick up a portion of firms' retiree drug costs.

But the figure that prompted Wagoner to raise his voice is $1,500. That is the amount of money added to the price of every single vehicle to cover health care, a cost that his foreign competitors do not bear.

"The cost of health care in the U.S. is making American businesses extremely uncompetitive versus our global counterparts," he said. "In the U.S., health care costs have been rising at double-digit rates for many years. In 2003, they were about 15 percent of GDP, at least 30 percent higher than the next-most-expensive country."

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  • 1

    It's nonsense. Individuals cannot avoid health care, and the time is past when American society can ignore it.

  • 2

    Let me add as well that Paul Krugman has often made the point that big auto fought health care reform in the past (in the US) while they were simultaneously support it in Canada.
    .
    Fixing health care is both the smart thing to do and the right thing to do.

  • 3

    I was struck by this "Obama has come up with strained arguments as to why health-care reform, which he supported before the economic collapse, turns out to be essential to recovery." I certainly don't see his arguments (before for after the economic collapse) as "strained". I wish someone would ask Diehl for an explanation for this characterization, which suggests that the arguments are weak.
    .
    Of course, I notice his portfolio at the WaPo is foreign affairs, which might explain his cluelessness (but not why his opinion was deemed worthy of ink by the WaPo overlords). His well-documented conservative bias explains the rest. He's probably good to have around when people complain about the liberal press, though.

  • 4

    K-Tum, that is perilously close to media criticism.
    .
    About time. Others have taken Diehl apart more brutally, including the most excellent JedL in:Obama is (not) like Bush because... and Steve Benen in: OVERLOOKING THE CHANGE.....
    .
    This is really weak. For one thing, the comparison is silly -- a deadly and costly war that should have never been fought bears no resemblance to health care reform. For another, the policy dispute over health care probably will "touch off an enormous domestic battle," but that doesn't make the idea Bush-like -- Obama is delivering on the platform on which he campaigned. By Diehl's logic, any president that proposes any kind of ambitious policy proposal is reminiscent of our failed 43rd president.
    .
    KT, Diehl should - no MUST - be mocked for drivel like this. And that mocking should be coming from their peers in the MSM.

  • 5

    I suggest that people like Diehl, congresspeople, etc. all be dropped from their current coverage and be required to find their own health care on the open market right now. After that, they may get the sense that there is a problem for many, many people.

  • 6

    Lookie who became a media critic. LOL just teasing K Tizzle but you and I both know its just an example of lazy journalism. Its much easier to come up with some grand mound of bullsh*t, color the lines in and say "Aha they are exactly the same!" than to get into the weeds of just how different the approaches really are. Hell President Obama isn't controlling any financial data and shaping it to convince people the economy is tanking. Hell he was calling for action on the economy last year when the idiot brigade including John McCain kept saying the economy was just fine. Isn't it convenient how certain members of the media have memory loss about that time? You would think the Republicans had been screaming about deficits and job losses and the state of the economy all last year but anybody paying attention knows thats a load of crap. Diehl just figured he would throw some sh*t together and nobody would notice that he didn't even use common sense let alone any form of research to write that oped. At some point when people write drivel like that they have to pay consequences like not being taken seriously ever again otherwise you can expect more of that coming down the pike.

  • 7

    sgw, interesting that we both used the word "drivel", no? John Cole had a relevant observation a short while ago:
    .
    ... the last few years have been really eye opening for me. I was never one of the Republicans who thought the media was liberally biased. I always felt they were just lazy and superficial (and MoDo is a fine example) and on issues outside their safety zone (faith and religion, for example), and they just were not equipped to discuss them. However, it becomes more and more clear every day that the media is not biased towards liberal or conservatives, but rather, it is simply in the business of defending the status quo for the wealthier members of society. The reason social conservatives and progressives both hate the media is because they really don't care about either group or their issues. This is about protecting the amassed wealth of the few.
    .
    The past couple of weeks we have faced nothing but story after story about how the market (translation, the folks who created this mess) are nervous about the Obama plans, when no one will admit that the “markets” will only react positively to bail out after bail out with no pain for the people at fault. The same people who created this mess are now bitching about the attempts to fix it, and upset because it might not continue to reward them. The MSM is providing no critical analysis but serves merely as a platform for people kvetching about reverting to the tax rates that were in place just a few years ago. The fact that the same people whose buddies are receiving trillions in taxpayer dollars to fix their mistakes are allowed to go on television and chant socialism is mind-numbing.
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    It really is breathtaking (especially since most families in the country just got a tax cut from the Obama administration).

  • 8

    the fact that Jackson Diehl is deputy editor of the Post's editorial page tells you just how much of a vacuous idiot he is.
    _
    unlike 9-11, which directly impacted only a few thousand families, this economic crisis is hitting tens of millions of Americans. There is simply no comparison when it comes to Bush's failure to call for sacrifice and Obama's -- Bush presided over a war of choice and chose not to ask Americans to make the necessary sacrifice to pay for it; Obama is faced with an economic crisis in which "paying for it" right now could be counterproductive (although I oppose the tax credits Obama imposed, raising taxes on middle America would have been a bad idea as well.)
    *******
    I certainly don't see his arguments (before for after the economic collapse) as "strained".
    _
    I don't see those arguments at all. While Obama does tie in health care reform to our long-term economic prospects, except for the "health care records" portion of the stimulus bill, there is really no relationship between "economic recovery" and "health care reform". And the primary reason that "health care records" were included in the stimulus bill is because its necessary in terms of accomplishing long term savings on health care and is the kind of labor-intensive "infrastructure" project that provides the most efficient stimulus to the economy.

  • 9

    Hey KT, I have a post in moderation. It makes me sad.

  • 10

    SGW - "Hell President Obama isn't controlling any financial data and shaping it to convince people the economy is tanking."
    .
    Maybe Diehl is assuming that because Bush did it (with the media's help, of course), Obama's doing it, too? I certainly hear some paranoia of that sort. A couple of weeks ago, some Republicans were accusing the Obama administration of using "fear tactics". I suppose Paul Revere did the same thing, though...

  • 11

    I don't see those arguments at all. Given that this recovery will likely take many years, and given that our current health care "system" imposes an enormous and growing drain on the economy and on people's attitudes toward the future, I have difficulty imaging a coherent plant for recovery that failed to include health care reform.
    .
    But thanks for noting that Obama did something right by including "health care records" in the stimulus bill "because its necessary in terms of accomplishing long term savings on health care and is the kind of labor-intensive "infrastructure" project that provides the most efficient stimulus to the economy." It is so unlike you to give Obama credit for anything that I was somewhat taken aback..

  • 12

    Three words: Keep. It. Up.

  • 13

    BTW, my #11 post was directed to pluk.

  • 14

    OK, then… if this is the best he can do, Jackson Diehl is someone whose views need not be considered. Better to consign him to the category of delusional opinion, to keep company with Cal Thomas.

  • 15

    Sure 50 million uninsured Americans, plus tens of millions of under insured Americans is just like the great WMD snipe hunt in Iraq. Fred Hiatt and his minions really suck.

  • 16

    OT, but I'll bet Brook's inbox is already full of hate mail:
    .

  • 17

    KT:
    .
    You mention that you agree with Barack Obama's decision to propose the immediate reform health care, citing the universally acknowledged imperative to reduce health care costs as a rationale.
    .
    Last week on the program Washington Week in Review, David Wessell of the Wall Street Journal asked you the question (my transcription, official transcript unavailable until later this week):
    .
    Your brother was an example of somebody who had insurance. It turned out, as your story says, that the company claimed it didn't have to cover him, because it was a pre-existing condition, and you actually get some satisfaction out of the state regulators.
    .
    But, is the Obama plan --as best we know-- going to do anything for people who already have insurance?

    .
    This incredibly simple, yet powerfully important question you answered by saying:
    .
    Well, what the...ah...their...the two...ah...two big thrusts of the Obama plan...One is to cover everyone, and the other one is to bring down costs for everyone, and it's really because the costs are so out of control, that...that people are really so insecure about their...umm...you know, about their status in the health care system.
    .
    So...umm...you know, it's bringing both of those things onto the table, and convincing everybody as a result that they really have something to gain from this.

    .
    That strikes me as a non-answer, KT.
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    People in your brother's situation, i.e. purchasers of insurance from companies committed to paying out as little as possible on a case by case basis until they are literally under threat of legal sanction from state agencies, are both covered and can afford the cost of their premiums, the two conditions you state the Obama plan means to address.
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    One of the major points of your piece was that, in and of itself, being insured under the current rules of our system is no guarantee of adequate health care provision or against bankruptcy.
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    If the Obama Administration is comfortable with the idea of Federal subsidies for individual families, isn't there every risk that those families will simply throw their money away on (relative to large employers' plans) inexpensive premiums that produce very little in the way of either preventative or remedial health care?
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    If the Obama Administration is comfortable leaving alone the heterogeneous system of state regulations and enforcement, and the insurers who structure their policies around those realities, won't that simply mean that amount of situations like your brother's will increase, KT?
    .
    ...Or is there something else left unsaid in your answer to Wessell's quesiton of which we should be aware?
    .
    I'll ask you again:
    .
    "is the Obama plan –as best we know– going to do anything for people who already have insurance?"
    .
    , and add:

    Is there anything under discussion likely to make it into a final plan that will prevent, or at the very least de-incentivize companies like Assurant from effectively defrauding their customers out of billions of dollars of --now the taxpayers'-- money?

  • 18

    Jackson Diehl must think he's the journalisitic equilalent of Jackson Pollock. Just throw something up on the canvas and call it art. Diehl's just throwing words up there and trying to convince us that it means something. The assertion that Obama's pursuit of healthcare reform can be compared to Bush's decision to go to war in Iraq lacks any credibility at all. Each, he suggests, is a "war of choice". That's like saying a motivational speaker is the same as a hooker that specializes in oral sex because "they both use their mouths to make money". He's delusional.

  • 19

    sz –
    .
    Seems to me this is exactly why we need an optional federal program as an alternative to private sector coverage. If public and private coverage are comparably affordable, people will gravitate toward the option more likely to approve than deny coverage. The mere existence of this alternative should provide a significant incentive for existing carriers to moderate their presumptive denial approach.
    .
    It's an open question whether a government agency can run such a program efficiently, but better a less efficient operation motivated toward delivery of effective care than one more efficient but motivated toward denial of coverage.

  • 20

    SZ
    .
    But you have to remember some things about Karen's brother, at least from my reading of her piece. First of all he thought he was covered from policy to policy on a cumulative basis when in fact each policy was a new policy which was how they were able to try to deny the claim because of a preexisting condition in the first place. Second when KT is saying the Obama plan is going to cover everyone that also means, from what I understand, those with preexisting conditions or who are high risk. Basically that helps the people who already have insurance but are underinsured just like Karen's brother because they have a pre existing condition and or are high risk for certain diseases. Its truly crazy that the people with the greatest need for health insurance in this country have the hardest time getting it. I am sure KT can speak for herself but that would seem like an answer to your question.

  • 21

    I went to the WP site to view the article and it crashed my browser. That must be some kind of sign, what, I don't know. The only positive contribution of Diehl's piece is to display a preview of some of the inane illogic to come during the health care debates.

  • 22

    But surely, you say, he's planning nothing as divisive or as risky as the Iraq war? Well, that's where the health-care plan comes in: a $634 billion (to begin) "historic commitment," as Obama calls it, that (like the removal of Saddam Hussein) has lurked in the background of the national agenda for years.
    .
    Because everyone knows that causing tens of thousands of unnecessary deaths and devestating a population of millions is JUST LIKE spending a lot of money to improve health insurance coverage.
    .
    Needless to say, anyone who can type those words without retching over himself doesn't really deserve a reasoned argument to counter him.
    .
    But thank you for doing so anyway.

  • 23

    Jackson Diehl...Fred Haitt...Deborah Howell...credulously printed and uncorrected lies in the news and opinion pages...reasons why I canceled my twenty-plus-year subscription to The Post.

  • 24

    After reading through the responses on this thread, I wonder how much of the general public agrees with Diehl and how many have views similar to ours? Another thing I've been wondering is if the conservatives are trying to paint Obama as being similar to Bush because Rush has been portrayed as being the face and voice of the entire republican party? If this is tit for tat, they'd better work some more on their tats because so far they're doing a lousy job.

  • 25

    SG:
    .
    ...they were able to try to deny the claim because of a preexisting condition in the first place...
    .
    ...the Obama plan is going to cover everyone that also means, from what I understand, those with preexisting conditions...
    .
    You're confusing two issues:
    .
    1) claims denial based on pre-existing condition
    .
    2) denial of coverage based on pre-existing condition
    .
    Even if the plan to which Obama eventually agrees (there is no "Obama plan") prohibits denial of coverage on the basis of a pre-existing condition --coverage at a premium rate far, far more expensive than normal coverage, it should be noted-- what is to stop denial of claims?
    .
    How does subsidized --only for those below a certain income level, it should be noted-- super-ginormous expensive coverage for those who would normally be never be able to get a policy "Basically" help "people who already have insurance but are underinsured"?
    .
    If somebody buys a policy that's a bad payout deal because they aren't poor enough to qualify for subsidy, and therefore they can more easily afford the lower premiums, what's to prevent those people from being underinsured, i.e. left with thousands and thousands of dollars in co-pays?
    .
    What's to prevent the insurance company from simply adjusting their premiums to ginormous levels once a condition emerges, i.e. a claim, and then telling the customer "Go get help from the Federal government --if you qualify for help, that is...", and deny continued coverage for lack of premium payment, albeit not on the basis of "pre-existing condition"?
    .
    Its truly crazy that the people with the greatest need for health insurance in this country have the hardest time getting it.
    .
    Yes, but it's also truly crazy that people can buy health insurance that doesn't actually cover the cost of health care, SG, and only find that out in their time of greatest need.
    .
    In any case, yes, I'd like to hear KT's answer to a question regarding that distinct issue.

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