Think Progress

by Faiz Shakir, Amanda Terkel, Satyam Khanna, Matt Corley, Benjamin Armbruster, Ali Frick, Ryan Powers, and Igor Volsky

Republican Health Deform

Just weeks after GOP pollster Frank Luntz advised Republicans that they should not attack President Obama's health care principles without offering an alternative  -- "It's not enough to just say what you’re against. You have to tell them what you're for," Luntz warned -- two different groups of Republicans released separate health care bills this week. On Wednesday, Reps. Paul Ryan (R-WI) and Devin Nunes (R-CA) and Sens. Richard Burr (R-NC) and Tom Coburn (R-OK) unveiled the Patients' Choice Act, while so-called "moderates," Reps. Mark Kirk (R-IL) and Charlie Dent (R-PA), released the Medical Rights Act. CBS News observed that the effort "stands little chance of progressing in the Democrat-led Congress, but it makes a clear statement that the Republican party can 'emerge as the party of new ideas,' as Republican National Committee Chair Michael Steele said Tuesday." However, there is nothing "new" in these plans. Moreover, both groups are more interested in characterizing the Democrats' effort as a "government takeover" of health care than offering real policy solutions. "As a practicing physician, I have seen first-hand how giving government more control over health care has failed to make health care more affordable and accessible," Coburn said in a statement. "Nothing will rally ordinary Americans against the president's plan more than his allies arguing too forcefully for a system run by politicians and bureaucrats in Washington," the authors of the Patients' Choice Act wrote in an editorial introducing the legislation.

THE PATIENTS' CHOICE ACT: Using Sen. John McCain's (R-AZ) health care plan as a foundation, the Patients' Choice Act proposes taxing the full value of employer health benefits, issuing refundable tax credits ($2,290 per individual or $5,710 per family), and expanding the use of Health Savings Accounts. States are encouraged to "establish rational and reasonable consumer protections" by forming State Health Insurance Exchanges to give Americans a choice of "different" private "health insurance policies" and issue standard benefits, offering "coverage to any individual regardless of age or health." The act places the 158 million Americans who receive their health care through their jobs in danger of losing coverage and provides an inadequate safety net for the newly-uninsured. As Washington Post blogger Ezra Klein points out, "the minimum benefit package is too stingy. There aren't sufficient subsidies for low-income consumers. The plan controls costs by encouraging people to purchase less comprehensive insurance." Indeed, Americans can choose a private health insurance plan from the State Health Insurance Exchanges, but that doesn't mean they'll be able to afford it. The $5,710 tax subsidy for families proposed in the Republican plan is less than half of the $12,680 that the average American family paid for health care in 2008, and the proposal allows private plans to charge sicker Americans higher rates for coverage. Republicans include a European-style "non-profit independent board" that "would penalize insurance companies that cherry pick healthy patients while rewarding companies that seek patients with pre-existing conditions," but they do nothing to prevent higher prices based on sex, age, occupation, or medical condition. 

THE MEDICAL RIGHTS ACT: Kirk and Dent argue that the Medical Rights Act is essential to guarantee that the government does not interfere with medical decisions made by physicians and patients. The measure is designed to "ensure Americans keep the choice, quality and access currently denied citizens of the U.K. and Canada" and promises to protect Americans from the deficiencies of foreign health care systems. And while the bill "would expand the number of public health clinics, increase the use of electronic health records and strengthen state-run high-risk insurance pools," it does little to increase access to affordable coverage. Instead, the measure, which does not include a public option or an individual mandate, reverses existing regulatory practices already in place by agencies like the Federal Drug Administration and seeks to protect Americans from a non-existent threat. One section, for instance, "prevents the federal government from regulating the hiring practices of organizations that provide health care, such as hospitals, clinics, and the like." Other sections prohibit "the federal government from regulating privately supported medicine" and "protects the rights of patients to buy health insurance, or make any other arrangements to pay for their own health care." "One thing we know about government health care is governments always run out of money. And once they run out of money, if they are in charge of your health care, they'll start denying care to your family and to you. And I want to make sure that doesn't happen in this country," Kirk said in a radio interview. 

DEAD ON ARRIVAL: Both bills act as ideological arguments against greater government spending on health care and don't represent viable solutions to the health care crisis. The extended summary of the Patients' Choice Act argues, "Patients should be able to choose from a variety of private insurance plans. The Federal government would run a health care system -- or a public plan option -- with the compassion of the IRS, the efficiency of the post office, and the incompetence of Katrina." The bill also prevents greater government involvement in health care and minimizes its existing role. Republicans would transfer low-income families with dependent children out of Medicaid and into "higher quality private plans through direct assistance that will be coupled with a tax credit" and expand the Medicare Advantage program. Ultimately, however, these Republicans are wrong to argue that "Americans already know that government will not work." Earlier this week, the Commonwealth Fund released a new survey indicating that "elderly Medicare beneficiaries reported greater overall satisfaction with their health coverage, better access to care, and fewer problems paying medical bills than people covered by employer-sponsored plans." "The findings bolster the argument that offering a public insurance plan similar to Medicare to the under-65 population has the potential to improve access and reduce costs," the organization concluded. Indeed, Medicare beneficiaries reported easier access to physicians, were less likely to report not getting needed services, and reported fewer medical bill problems. As Democratic strategist Paul Begala observes in a recent retort to the Luntz memo, "Because they know they cannot win the argument honestly, Republicans are resorting to mendacity." In fact, it's still unclear whether Republicans are willing to support health care reform. Last week, during an appearance on NBC's Meet the Press, RNC Chairman Michael Steele responded, "Noooooo. No, no. no," when asked if health reform will pass this year.

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"[Torturing terror detainees] prevented the violent death of thousands, if not hundreds of thousands, of innocent people."
-- Vice President Cheney, 5/21/09

VERSUS

"A top-secret 2004 CIA inspector general's investigation found no conclusive proof that information gained from aggressive interrogations helped thwart any 'specific imminent attacks.'"
-- McClatchy, 5/21/09