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Monday, September 24, 2007

Rove Care

There are two major issues going into the '08 campaign -- war in Iraq and health care. Republicans have pretty much ceded the issue of Iraq to Democrats, taking the position on the issue farthest from the mainstream. The hope seems to be that the occupation of Iraq will either be over or winding down by November '08, with Bush and the GOP able to brag about glorious victory for the fatherland... er, homeland.

Given the extreme unlikelihood of this scenario, the right seems to be trying to compete on the health care issue and the White House, seeking to give Bush some kind of legacy, is jumping in with its own health care plan.

In an op-ed in the Wall Street Journal, former White House aide Karl Rove writes:

All around America, families are grappling with health-care concerns. They wonder if they'll have insurance at a price they can afford. They worry about how much out-of-pocket health costs take from the family budget. They question if they'll be able to pick their own doctor. Some feel trapped in jobs they don't like out of fear of losing their health insurance.

As the latest government-heavy plan announced by Hillary Clinton yesterday once again shows, the answers politicians offer on health care highlight the deep differences between liberals and conservatives. This is a debate Republicans cannot avoid. But it is one we can win -- if we offer a bold plan. Conservatives must put forward reforms aimed at putting the patient in charge. Increasing competition will ensure greater access, lower costs and more innovation.

Remember back when Bill Clinton signed the Telecom Bill into law? Remember how increased competition was supposed to bring down cable and internet costs? Remember how it didn't?

Rove's plan, which is clearly the White House's plan, is basically a collection of bad old GOP ideas. What Rove calls a "bold plan" is timid as all hell. In fact, despite his claim that "[g]overnment can help poorer and older Americans get quality health care without sacrificing what everyone wants," Rove's first two proposals would shut out people without a lot of money.

Not surprisingly, one remedy is more tax cuts -- see, tax cuts can do anything. In this case, "every worker should get a deduction for health-insurance premiums." It's not extremely clear how this would help the elderly, not being workers and all, but there ya go. The right points out at pretty much every opportunity that "the poor don't pay taxes" -- despite the fact that they do. But an income tax deduction isn't going to help them any, either. He mentions a tax credit, which would put money in these people's pockets, but that's no guarantee that it'll be used to offset healthcare costs.

Which brings us to point #2 of Karl's "reform" -- health savings accounts. This has been a bad idea since whoever the hell it was first brought it up. People have a hard enough time salting a little money away as it is and now we're supposed to save even more? Yeah, I pretty much guarantee that's not going to happen. The poor can't save now, let alone put away more. And the elderly could be excused for thinking they're pretty much done saving -- wasn't retirement the biggest reason for putting all that money aside in the first place? Again, the plan shuts out the two groups Rove claims it will help.

Rove brings up the issue of portability -- the ability to change jobs and keep the same insurance -- but, since you're basically buying it yourself, that should go without saying. But that's Karl Rove for you; liabilities are assets. He also brings up tort reform in the same way -- if you get screwed, you stay screwed. Without your constitutional right to redress, you're stuck with the bill for bad medical care. Like the issue of portability, this is a bad thing spun into a good thing -- suing quacks increases costs. As if dealing with the consequences of quackery is free.

This is pretty much what you expect from the Bush White House, which is basically a bad idea factory. The idea is to pretend we have a health care policy, then apply patches to it. But there's nothing to patch -- the US has no health care policy. You can't fix what doesn't exist. Our health care policy is the same as our bread policy or our toothbrush policy or our bicycle policy; you put it on a shelf and you sell it. Period. And those who can afford better, get better. This plan doesn't do anything to change that. It's just a way to keep the insurance industry intact.

If Bush wants to put this forward himself, he's got a tough sell. The right hates health care reform with the burning passion of a thousand suns. And, if Bush dead immigration reform taught us anything, it's that Bush is such a lame duck that he can't even lead his party. If they don't like this, it's not going anywhere. The President's bully-pulpit lacks a bully.

Of course, it's always possible that Bush wants to put this across as a plan for someone ealse to run on. The right side of the presidential race is embarrassingly light on health care proposals. Accoring to the New York Times, John McCain "has not said anything substantial about health care, nor has he even included it among issues listed on his campaign Web site." Fred Thompson hits a lot of right wing talking points, without actually saying anything. NYT tells us he "opposes new mandates, higher taxes or a Washington-controlled program, and calls for free-market solutions." In other words, a lot of nothing.

Rudy Giuliani has a plan, which is "sketchy." His plan most resembles the one Rove put across -- with tax breaks. Like Thompson, Rudy calls for "free-market approaches," as if what we have now isn't capitalistic. Mitt Romney, the only candidate who's actually done health care reform (Massachusetts has it's own plan), is pretty much abandoning the issue entirely. Although NYT says Mitt "has the most developed health plan among the Republicans," it's hard to see how this is any plan at all. He wants each state to deal with the problem.

But the indications seem to be that Bush will put forward the Rove plan himself, to take the sting out of vetoing a popular children's health care bill. "Bush, according to [Health and Human Services Secretary Mike] Leavitt, will urge Congress to join him in seeking health-care coverage for all Americans while also promising to veto a Democratic plan to provide $35 billion in taxpayer subsidies to the Children's Health Insurance Program over five years," says Rowland Nethaway for Cox News Service.

If this plan dies -- and there's no reason to believe it won't -- then it's unlikely that any of the '08 candidates will take up any part of it. Like Iraq, Republicans will cede the health care issue to Democrats, leaving them sitting out the top two issues of the campaign. If that's the case, any Democrat -- no matter who it is -- wins.

In a walk.


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