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What is Cost Control?

January 26, 2010
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John McCain and Mitch McConnell are both advocating a national market for health care, tort reform, and equating the tax policy for buying insurance on your own.  Drum sighs:

That’s two Republican leaders saying exactly the same thing, so I think it’s safe to say that this is pretty much the GOP party line right now. Nothing about preexisting conditions, nothing about Medicaid, nothing about cost control, nothing about subsidies. Just a tired attack on medical malpractice suits, a gift to the insurance industry, and a tax cut. That’s the Republican plan.

Lots of Washington pundits are willing to concede that Republicans were “uncooperative” on healthcare, but most of them also seem to think that maybe if Democrats had tried a little harder they could have talked them into some kind of compromise. This really ought to stop that kind of talk. These suggestions are little more than jokes, not the kind of thing that comes from a party that takes healthcare reform seriously.

Well, I can see how you’d feel that way.  A small ambiguity, though: “cost control” is a pretty vague term.  In this instance, I think it’s pretty clear that Drum is talking about the insolvency of Medicare and Medicaid.  This obviously needs to be fixed (and the Republicans have clearly not addressed it because they want to clean up this fall and they are scared of the elderly just like every other namby-pamby politician), and I think means testing might be the only way to do it.  I’d bet the farm that nothing gets done on this front because of the current political climate (as a stand-alone policy, that is—the House could still pass the Senate bill), so complaining about this is basically a moot point right now.

There is, however, a difference between “fixing” health care and covering the uninsured.  While Drum sees “cost control” as shoring up the Medicare and Medicaid budgets, some of us see cost control as figuring out a way to solve the problem of costs rising faster than inflation.  And the three things that McCain and McConnell propose will all help.  Republicans really need to figure out something to propose with regard to preexisting conditions, such as high-risk pools or reinsurance, but that’s not really something that is threatening our country’s financial status at this point.  Democrats would probably never go along with any of this, especially since it would look like a Republican victory before a midterm election.

It’s looking more and more like nothing is going to happen for the next nine months, so after that gestation period we’ll see what happens.  Until then, I suspect that Democrats will continue to dismiss Republican ideas as frivolous, and Republicans will be too frightened of the elderly to get on board with any Medicare cuts.  Let’s hope for some kind of compromise that prevents our bankruptcy as a nation.  FYI: I’m not holding my breath.

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