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Republicans Never Fail to Fail

January 29, 2010
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By all accounts, the President’s, um, session with the Republicans in Baltimore today was a legitimate victory for the White House.  Drum says the format virtually guaranteed a win for the President:

It didn’t just put Obama on an equal footing with Republican attacks; in fact, the format forced Republicans to tone down their attacks and then gave Obama an inherent advantage in responding since he was guy at the mike. The guy at the mike always has the advantage.

Yglesias:

It was sort of like Prime Minister’s Questions and it revealed, simply put, that Barack Obama is a lot smarter and better-informed than his antagonists. A lot. He very calmly and coolly dismantled them.

Matthew Continetti:

The meeting was definitely positive for Obama: he was able to tout his willingness to work with the opposition; he was, as usual, thoughtful in his speech and tone; and he had plenty of time, as usual, to blame Republicans for closed-minded obstinacy. A few of his Republican interlocutors made him look like Socrates in comparison. The State of the Union address made Obama look small. This meeting made him look large-hearted and in command–at least for the moment.

It’s always good to hear that the Republicans are doing themselves no favors and doing their constituents even less.  By agreeing to the setup (the President was the only one with a microphone and the camera was always on him), they undermined their own positions from the get-go, and then apparently were outclassed from a policy standpoint anyway.  Ezra Klein:

There’s a value in proving that you understand the other side’s ideas deeply enough to disagree with them. And that was the message of Obama’s session. Not that the Republicans were right. But that he’d looked hard enough at their ideas to realize they were wrong. I’m willing to work on tort reform, Obama said, but it’s not a credible way to rein in health-care spending. The GOP budget might save a lot of money in theory, he admitted, but it does that by voucher-izing Medicare and holding its spending constant even as health cost increase — which means seniors will go without a lot of necessary care. And it’s hard to take that proposal seriously coming from the party that spent the past few months saying slight decreases in Medicare Advantage reimbursement represented an unforgivable threat to seniors.

Even if the Republicans were unable to respond to this, I’d at least like to give it a shot.  Here’s what the President said about tort reform:

You know, if I’m told, for example, that the solution to dealing with health care costs is tort reform, something that I’ve said I am willing to work with you on, but the CBO or other experts say to me, you know, “At best, this could reduce health care costs relative to where they’re growing by a couple of percentage points or save $5 billion a year, that’s what we can score it at, and it will not bend the cost curve long term or reduce premiums significantly,” then you can’t make the claim that that’s the only thing that we have to do.

Well, I certainly believe that tort reform is part of the equation, and I don’t think “that’s the only thing that we have to do”, but is it really convincing to just take the word of “CBO or other experts” and call it a stone cold fact?  One of the great things about tort reform is that we have no idea how much money it could actually save.  As I’ve said before, “The best way to reduce waste in our system would be tort reform, which would reduce defensive medicine practices as well as the price of malpractice insurance for doctors”.  Is there any way to realistically measure how much?  The idea that tort reform isn’t a “credible” way to bring down health care costs, or to argue, as the President does, that so-called “experts” don’t think it’s really that much, is not a good reason to do it a’tall.  On this front, anything really would be better than nothing.  And it would probably have its greatest effect in the coming decades rather than the immediate one as the practices of doctors become less and less defensive as litigation along with malpractice insurance costs go down.  The cost-saving potential of this measure is huge, and to dismiss it because we don’t know enough about it only serves to further the stereotype that the Democratic party is run by trial lawyers.

With regard to “voucher-izing” Medicare, however, I think the President is right:

OBAMA: Well, look, as I’ve said before, this is an entirely legitimate proposal. The problem is two-fold.

One is that, depending on how it’s structured, if recipients are suddenly getting a plan that has their reimbursement rates going like this, but health care costs are still going up like that, then over time the way we’re saving money is essentially by capping what they are getting relative to their costs.

OBAMA: Now, I just want to point out — and this brings me to the second problem — when we made a very modest proposal as part of our package — our health care reform package to eliminate the subsidies going to insurance companies for Medicare Advantage, we were attacked across the board by many on your aisle for slashing Medicare. You remember? “We’re going to start cutting benefits for seniors.” That was — that was the story that was perpetrated out there; scared the dickens out of a lot of seniors.

(CROSSTALK)

OBAMA: No — no, but here’s my point.

If the main question is going to be what do we do about Medicare costs, any proposal that Paul makes will be painted factually from the perspective of those who disagree with it as cutting benefits over the long term.

Paul, I don’t think you disagree with that — that — that there is a political vulnerability to doing anything that tinkers with Medicare. And that’s probably the biggest savings that are obtained through Paul’s plan.

Well, yeah.  All the proposals on the table (including the one in the Senate bill) end up cutting Medicare benefits.  There’s just no way around it.  And the President is right about “political vulnerability”, which is why I don’t see any health-care proposal that cuts Medicare materializing until after November.  Of course, some of us think means-testing (via a buy-in, perhaps?) is the best way to cure Medicare insolvency, but neither party is listening to that right now.

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