It’s another indication that the GOP is really serious about playing a substantive role in the health care debate. A week after promising to bring “common-sense solutions that promote competition and innovation,” in health care, Rep. Roy Blunt (R-MO) — who leads the Republican study group on health reform — told Congressional Quarterly that the GOP should apply frat boy pep rally cheers from the ’08 campaign to the health care debate:

If we could get the same kind of engagement on health care from our conference that we got on energy last year, that in and of itself would be a great success.

So what does this mean exactly? The goals here is to dumb down the debate to a few catchy buzz words (we’re accepting suggestions in the comments sections) that can then be regurgitated by Republican Congressmen on cable news and put to music. It’s not about slogans, it’s about solutions.

Yesterday, during a Congressional hearing on health care reform, Rep. Bruce Braley (D-IA) challenged health care crisis denier Sally Pipes on her academic credentials. Pipes assured Braley that she was indeed a health care “scholar” who had been published in the peer-reviewed journal Health Affairs:

BRALEY: Have you published any peer reviewed treatises in a journal of economics on health care policy?
PIPES: Yes.

BRALEY: Can you give us some examples?

PIPES: I’ve done some things in Health Affairs over the past and –

BRALEY: But can you just identify the scholarly journal that’s a peer reviewed journal of economics?

PIPES: Well, Health Affairs is, I think. I don’t know whether you would say it is.

UNINDENTIFIED: It’s peer reviewed.

Listen:

Searching ‘Pipes’ in the author field of the Health Affairs website yields one result — a Letter to the Editor titled ‘Piping A Different Tune.’ In the letter, Pipes responds to what she describes as a “hostile” book review of Who Killed Health Care: America’s $2 Trillion Medical Problem–and the Consumer Driven Cure:

The author of the review responds to Pipes, highlighting her not-so-academic approach to policy: “Sally Pipes’ riposte to my review of Regina Herzlinger’s book, Who Killed Health Care, offers rhetoric and faith-based posturing but little evidence. Whilst it can be intellectual fun and politically advantageous to repeat the principles of bottom-up, makret oriented health care, the practice is usually inflationary, inefficient, and inequitable.”

President Obama’s budget allocates $634 billion towards health care reform, a good start, but it’s certainly not enough to reach universal coverage. Today, the AP interviewed health care policy experts who estimate that “the Obama proposal to expand health insurance to all U.S. residents could cost about $1.5 trillion over the next 10 years“:

John Sheils, a senior vice president of the Lewin Group, said about $1.5 trillion to $1.7 trillion would be a credible estimate for a plan that commits the nation to covering all its citizens. That would amount to around 4 percent of projected health care costs over the next 10 years, he added.

Recently, Sens. Judd Gregg (R-NH) and Kent Conrad (D-ND) argued that the administration should not invest new money into an already bloated health care care system, suggesting instead, that Obama could somehow surgically remove the $700 billion in waste and reinvest that amount into reforms.

$1.5 trillion isn’t chump change, but it’s nothing if compared to the full cost of inaction. A $1.5 trillion plan (much of it paid for, just like the President’s $634 billion allocation) is meant to bend the curve on health care spending. Otherwise, total health spending will double “by 2020– rising from a projected $2.6 trillion in 2009 to $5.2 trillion by 2020 to consume 21 percent” of the GDP.

As premiums increase over time, millions of Americans will lose their jobs, many more will forgo coverage, file for bankruptcy due to unaffordable health care costs, and die due to complications from being uninsured.

Reform cost estimates are large numbers only if we strip them of their human context and future cost projections.

A bipartisan group of lawmakers and prominent veterans groups are outraged over an Obama administration proposal — currently under consideration — to allow third-party insurance companies to pay for combat-related injuries. The proposal would “save the Department of Veterans Affairs $530 million a year,” but critics argue that asking private insurers to pick up the tab for combat injuries is not just immoral but also economically disastrous. The private insurers could jack up premiums, families could lose coverage if a veteran meets the maximum benefit amount for their insurance, and insurers could deny claims if a veteran is insured through the individual market, deny coverage etc…

The episode highlights the inadequacy of the nation’s patchwork health system and the dangers of skyrocketing health care costs in the private insurance market. Outraged Republicans are also suggesting that access to affordable health care is more important than balancing budgets! (Bodes well for the health care debate, right?)

But the party of ‘country first’ now finds itself in a peculiar political position. While loudly and proudly caricaturing the administration’s health care proposal as government-run socialism, Republicans are tripping over themselves to keep veterans in the system.

Sen. Richard Burr (R-NC), who sits on the Health, Education, Labor, and Pensions Committee, demonstrates this hypocrisy:

On Veterans Leaving Government-Run Health Care: “If this bill reaches the Senate, I will strongly oppose it. The VA was created for the purpose of caring for those who have fought and sacrificed for our country, and the care for injuries sustained while serving is our responsibility.”

On The Consequences of Government-Run Health Care: “In short, government-sponsored health care will do for the health care economy what government-sponsored mortgages did to the housing market. The unintended consequences of government-sponsored health care would be catastrophic.”

On The Consequences of Obama’s Proposal: “If one side wins, one can expect the federal government to take over more of the responsibility of health care. To actually place the government in between a patient and their doctor. I’m not sure that’s what the majority of Americans want. I think they want a private sector that works for them as individuals, them as employers.

As Uwe Reinhardt asked during yesterday’s health hearing before the House Committee On Commerce and Energy, “Why do you give veterans socialized medicine when it’s so bad?” It’s a question Republicans are now struggling to answer.

On Monday, health officials in Washington D.C. released a report showing that “at least 3 percent of District residents have HIV or AIDS, a total that far surpasses the 1 percent threshold that constitutes a ‘generalized and severe’ epidemic.”

ThinkProgress interviewed Scott Evertz — director of the Office of National AIDS Policy from 2001 to 2002 — about his reaction to the report:

Shocking, but we shouldn’t be particularly shocked. We’ve known for some time that in the District and other place where we see severe economic disparities that the prevalence is as high in some of the countries that we’re assisting in Africa. I think what needs to be continued to be worked on is to recognize the differences in risk groups and the messaging and how you get messages into specific risk group populations.

Watch it:

Funding for government-sponsored domestic AIDS/HIV initiatives like the Ryan White Program flat lined during Bush’s tenure, as the administration focused its efforts around faith and community-based organizations preaching abstinence-only. In the District, the administration “called for renewing restrictions on the D.C. government’s ability to use its own funds for such purposes as a needle-exchange program for drug addicts,” despite city’s insistence that such programs were “crucial to curbing the spread of HIV and AIDS.”

Evertz, who himself “was forced out of his job at the White House in July of 2002” after bulking the conservative orthodoxy on needle exchange programs and safe-sex education for teenagers, rebuked the Bush administration’s one-size-fits-all approach to fighting the domestic AIDS epidemic.

“I think what needs to be continued to be worked on is to recognize the differences in risk groups and the messaging and how you get messages into specific risk group populations,” he said. “Abstinence until marriage has meaning to very few young gay people in the United States because they can’t get married. So I don’t think I’m being disingenuous to suggest that that message means nothing to a young gay person who’s struggling coming out.”

Transcript: Read more

When Rep. Bruce Braley (D-IA) asked health care crisis denier Sally Pipes about her credentials to testify as “an expert” on health care issues before the House Energy and Commerce Subcommittee on Health, Pipes’ lack of any serious background in health care policy exposed her real function. You see, Pipes doesn’t hold a masters degree in health policy or public policy. Nor she does have much experience in academia:

Listen:

With her ‘BA with honors’ in economics, Pipes leads a tiny ‘think tank,’ Pacific Research Institute, and advances special interest (PRI’s list of donors include Altria (formerly known as Philip Morris), Microsoft, Pfizer and ExxonMobil) agendas. PRI promotes itself a s “free-market think tank,” but Pipes offers little in the way of solutions. During her testimony, Pipes simply regurgitated Sen. John McCain’s (R-AZ) health care plan:

If we could change the tax code to level the playing field by removing the tax advantage from those who get their insurance through their employer, reduce state mandates that add between 20-50% to the cost of a premium, allow the purchase of insurance across state lines, and have medical malpractice reform, we could reduce costs and significantly reduce the number of uninsured in this country.

Pipes’ real contribution is her ability to conflate the administrations’ health care proposals with the evils of socialized Canadian medicine and reference discredited health care crisis deniers along the way. For instance, when Braley asked Pipes why “dont’ people who come from your point of view come to this committee and talk about constructive ways we’re going to reduce preventable medical errors” and lower overall health care costs, Pipes quoted fellow health care denier Betsy McCaughey!

The most outrageous moment of the hearing, however, belonged to Chairman Frank Pallone (D-NJ). In trying to keep the committee on time, Pallone accidentally pronounced Pipes as Peeps. Happy Easter, Sally!

The House Subcommittee on Energy and Commerce is holding a hearing on “Making Health Care Work for American Families: Ensuring Affordable Coverage” today and health care crisis denier Sally Pipes — who recently wrote The Ten Top Myths of American Health Care — is testifying at the invitation of the Republicans.

She’s busy propagating the myth that “the long-term goal of the new Administration and the Democrats in Congress is “Medicaid for All.” In her prepared remarks, Pipes compares Obama’s plan to the Canadian model:

My view is that the government plan will be priced lower than the private plans. The result will be “crowding out” of the private plans and a fateful turn down the road to a Canadian style “Medicaid for All” program. We may have universal coverage but not universal access. Taxes will increase significantly and weaken the entrepreneurial spirit in this country.

This is the same Sally Pipes who, in 1998, wrote an article to dismiss global climate change as an imaginary “hobgoblin” created by “propaganda” from the Environmental Protection Agency. The article also criticized the Clinton Administration for advancing the notion that efforts to reduce greenhouse gases could be harnessed to spur economic growth.

So this is who the Republicans invite to discuss reforming the health care system? An old global warming denier who caricatures the health care debate without engaging in the substance of the proposal? Things sure have changed since 93….

Yesterday, during an appearance on Fox News Sunday, Austan Goolsbee, a member of the White House Council of Economic Advisers refused to comment on whether the administration is seriously considering taxing health benefits to finance health care reform:

That is not in the President’s budget…it does not include this provision. This appears to be coming from the administration and representatives of the administration who went to Congress and said we are open to all ideas to pass health care reform…there are some people in Congress who are pushing for this, but that is not the President’s idea….he is open to all ideas. He said, let’s put all ideas on the table. That is not the president’s idea. It is not in his health care plan, it is not in his budget.

Watch it:

The press has argued that the “proposal is politically problematic for President Obama,” since it is similar to one he denounced in the presidential campaign as ‘the largest middle-class tax increase in history.” But in reality, the the consequences of Obama’s proposal are quite different.

The problem was never the tax exclusion itself. Rather, progressives were concerned about what would happen to individuals who lost their employer-sponsored health coverage once the tax code changed. McCain proposed replacing the employee deduction with a one-size-fits-all tax credit without reforming the health insurance market or expanding access to group coverage. Under his plan, Americans who lost their employer coverage would have had to fend for themselves in an unregulated individual health insurance market; Americans with pre-existing conditions would have joined the ranks of the uninsured.

Obama is using the measure as a means to finance comprehensive reform. Should someone lose their employer-based coverage, they will be able to purchase affordable insurance through a regulated exchange that cannot deny coverage to Americans with pre-existing conditions.

The theory behind capping the health exclusion rests on the assumption that the tax-preferred status of employment-based health coverage leads workers to over-insure and use more health care services than they otherwise would. Overuse of insurance drives up insurance premiums and makes coverage less affordable for lower-income workers. Read more

President Obama prioritized health care reform during the campaign, held a listening tour during the transition, allocated an admirable $634 billion towards reforming the health care system in his budget, hosted a White House Health Summit, and is now holding a series of regional summits all across the country.

At yesterday’s forum in Dearborn, Michigan, for instance, representatives from insurance companies, labor unions, “workers and retirees; and nursing professors, among other stakeholders in the health care overhaul debate” agreed “on the need for health care reform” and urged the president to “emphasize preventive, wellness and primary care, and to better utilize health information technology.”

Here is one account from the Detroit Free Press:

Being insured doesn’t always mean you’ll get the help you want. At 22, Adrian Campbell-Montgomery said, she learned she had cervical cancer. Seemingly covered under her family’s General Motors employee insurance, she was rushed into surgery. Blue Cross Blue Shield of Michigan denied payment, saying the surgery was only recommended for women 26 and older. She was in graduate school, had a small child and was now $8,000 in debt. “When does it end?” she asked during the forum. “You have to stop denying people.”

Obama’s approach serves a political purpose. Public opinion polls already indicate that the public supports comprehensive health care reform. But this kind of outreach weeds out the personal stories of insurance company malfeasance and hardships of families facing rising health care costs, and ultimately provide the administration with the same kind of emotional narrative about the need for reform that the Right often finds in the waiting lines of Canada or Great Britain.

It’s political, but it’s smart. These regional summits keep the issue in the local news — long after the national media has moved on to exploring the root cause of Anna Nicole Smith’s death — familiarize the public with progressive proposals, and allow the President and Congressional Democrats to shroud themselves in the flag of public opinion once the health care debate really heats up this summer.

For more on the White House’s regional health summits, click here.

Yesterday, Sens. Judd Gregg (R-NH) and Kent Conrad (D-ND) questioned Treasury Secretary Timothy Geithner about why the administration wanted invest new money into an already bloated health care care system. This morning, when Joe Scarborough asked Washington Post columnist Eugene “not an expert in health care” Robinson how President Obama’s proposed $634 billion investment would reduce health care costs, Robinson admitted that he didn’t know:

SCARBOROUGH: Where does it go? That’s my question. Retool how? I’m not being pushy. I just keep hearing “We gotta spend that money.” What do we spend it on?

ROBINSON: Well, you know. Hopefully more than computerized electronic medical records, which I don’t think should cost as much as the administration says it should cost. You know, I don’t know. I’m not an expert in health care. I’m not.

Watch it:

Robinson may not be a health care expert, but it doesn’t take a masters in health policy to push back against pundits and policymakers who argue that investing in the system won’t lower costs or improve health outcomes.

For one, half of the money in Obama’s $634 billion health care fund actually comes from re-investing money already in the health care system, just as Gregg, Conrad and Scarborough suggest. But most reform advocates also believe that to really lower health care costs and improve health quality, $634 billion is a good start, but it’s certainly not enough. One must first invest in the system to see long-term cost savings:

- Expanding Access To Contain Costs: Expanding coverage to the 45.7 million uninsured and treading their chronic conditions won’t come cheap, but it’s necessary if we want to manage chronic diseases and offer preventive services that will treat conditions before they develop into costly medical emergencies. By extending coverage to all, you can achieve efficiencies and end cost shifting.

- Investing In Preventive Measures To Contain Costs: While the United States spent $132 billion in 2002 treating Americans with diabetes, just $70 billion went to the prevention of all diseases. It can be difficult to quantify the possible savings from expanded prevention efforts, but experts estimate that just ensuring that every child receives every routine vaccination could reduce direct and indirect health care costs by up to $40 billion over time.

- Investing In Information On Effective Treatments To Contain Costs: Today, Americans are likely to receive the appropriate care just half of the time, and approximately one-third of individuals seeking care are likely to experience a medical error such as a medication mistake or the wrong lab results. Improving quality could help save lives and contain costs. Estimates of savings go as high as 150,000 lives and $100 billion every year.

- Using Health IT To Contain Costs: Fewer than 25 percent of hospitals, and fewer than 20 percent of doctor’s offices, employ health information technology systems. Estimates vary, and real-life experience is limited, but one group of researchers finds that implementing health IT would result in mean annual savings of $40 billion over a 15-year period.

Recently, PhRMA, SEIU, the U.S. Chamber of Commerce, AARP, Aetna, AFL-CIO, and AHIP signed a letter urging Congress to suspend pay-go rules when considering health care reform: “While the cost savings from improving the efficiency and quality of health care will be significant, many of the anticipated savings will be realized in the long term, and may thus not be evident in a ten year budget window…Requiring spending or revenue offsets for the entire cost of health reform within a ten year budget window, as required under a traditional pay-as-you-go rule, will significantly reduce the likelihood of enacting legislation to achieve essential reforms for long-term savings.”

Transcript: Read more

During today’s Senate Budget Committee hearing with Treasury Secretary Timothy Geithner, Sen. Judd Gregg (R-NH) argued that the administration’s investment in health care reform was a “massive expansion of the government”:

You’re adding another $664 billion in your budget, which you say is a down payment on the entitlement accounts relative to health care, which is probably a downpayment that’s only about half of what you’re really calculating — it’s probably closer to a trillion, a trillion-two. So you’re exploding the size of health care spending on top of health care spending which already exceeds any other industrialized country in the world by about 5 percent. So there’s no discipline there. In fact, there’s a massive expansion of the government.

Watch it:

Gregg is right about the Obama administration’s view of entitlements. As Peter Orszag argued during the administration’s fiscal responsibility summit,”health care reform is entitlement reform. The path of fiscal responsibility must run directly through health care.”

Since the rising cost per beneficiary is responsible for most of the fiscal problem, you can’t stabilize the economy without lowering the costs of health care, and you can’t lower health care costs without investing in the system.

Transcript: Read more

Yesterday, in an interview with former Surgeon General front runner Sanjay Gupta, President Bill Clinton reminisced on the failures of his health care reform effort and predicted that for President Obama, “the challenge is going to be not the coverage challenge…It’s going to be the cost challenge:

I — I don’t want us to wind up getting universal coverage, which is morally imperative and necessary, and not do enough preventative and primary and cost control changes about the way the system is organized to bring our costs in line with our competitors. Because if we are 5 points of our GDP more on health care than any of our competitors and we’re getting no better results, now we get worse results. But if we get no better results, then it will weaken our economy over the long run and we won’t be able to afford the system. So his problem — the challenge is going to be not the coverage challenge, which is what all of us from Theodore Roosevelt through Bill Clinton faced. It’s going to be the cost challenge.

Watch it:

Most of the major stakeholders — the insurance lobby, the business groups, the unions — understand that we can’t expand coverage without controlling costs. In fact, just today, the Business Roundtable — which opposed Clinton’s health reform plan — released a new report that says “Americans in 2006 spent $1,928 per capita on health care, at least two-and-a-half times more per person than any other advanced country.”

The report compares “statistics on life expectancy, death rates and even cholesterol readings and blood pressures,” factors the measures together with costs “into a 100-point ‘value’ scale’ and concludes that “the United States is 23 points behind five leading economic competitors: Canada, Japan, Germany, the United Kingdom and France.”

In 2009, businesses are at the table, making the argument that health care reform will lower the costs of the system, spread the costs across the different stakeholders and make the United States more competitive. The Roundtable doesn’t want to abandon the employer-based system — large companies use health benefits to entice better workers — they just want to lower the costs of providing coverage.

Obama stressed the importance of controlling costs during the White House Health Summit, and all of the leading health care policy makers agree. Everyone believes that we must invest in prevention, care coordination, and health information technology (to control heath care costs), the trick will be to force the insurance companies to take a haircut and agree to a new public plan, or get the business groups to okay a mandate (individual, employer, combined).

Today, Fox News spoke to Sen. Chuck Grassley’s (R-IA) about his recent spat with OMB Director Peter Orszag over the administration’s proposal to eliminate the government’s subsidy to insurance plans participating in the Medicare Advantage program:

This administration is proposing to cut that [Medicare Advantage]. I’m all for competitive bidding if it doesn’t cut services for rural America.

Watch it:

As Orszag articulated during yesterday’s hearing, “We’re all paying a $1.30 in order to deliver a dollar to a subset 20% of Medicare beneficiaries. I don’t think that’s competition, I think that’s an unwarranted subsidy.”

In its health care budget, the administration would replaces the 14 percent overpayment to Medicare Advantage and with a competitive bidding process. Insurers in each geographical area would bid to provide coverage, the government would average all of the bids, weigh that by the enrollment in the previous year, and pay out that amount.

Grassley is concerned that the elimination of the Medicare Advantage subsidy would encourage private plans to pull-out of rural areas and lead his Iowan constituents to lose their benefits. But Grassley’s objection, raises an important question: why should the federal government continue over-paying private insurers, if that same level of care could be provided at a cheaper rate?

The competitive bidding process is meant to weed out bloated or ineffective providers and hold down health care spending. Some of Grassley’s constituents might have to switch plans but only if their plan chooses not to bid or cannot provide services at the the market-driven rate. Even then, Iowan beneficiaries wouldn’t lose their Medicare benefits (they will continue to receive Medicare, albeit with some disruption as they move back to fee-for-service or find another MA plan), just the extra benefits that some Medicare Advantage plans provide.

Ultimately, Obama’s proposal does not eliminate Medicare Advantage. Rather, it opens up the process to the very same kind of market forces that conservatives claim reduces costs while providing the very best in care quality.

America’s Health Insurance Plans (AHIP) — the insurance industry’s lobbying arm — is hosting a health care policy forum in Washington D.C. This is the second of a series of posts from inside the conference.

When ThinkProgress asked AHIP spokesperson Robert Zirkelbach about the lobby’s opposition to a public plan, Zirkelbach explained that the insurance lobby was concerned the the “government-run program” (as he called it) would undermine health care providers, employers, and the “sustainability” of the entire health care system”:

- Impact on providers: “Public programs pay less than their costs and those costs are being passed through the health care system and it’s ultimately employers and consumers who are footing the bill.”

- Impact on the employer community: “This could cause many people to leave the employer market and enroll in a government-run plan. This is something employers have expressed concern.”

- Sustainability of our current health care system: “Medicare actuaries say that the Medicare system is going to start running deficits as soon as 2017. We have to make sure we’re using our public resources as responsibly as we can — as we can. We believe in a public program”

Watch it:

A public plan would actually alleviate AHIP’s “concerns” about runaway health care costs and running deficits. As Harold Pollack argues rather succinctly over at The Treatment, “experience suggests that effective public programs provide high-quality, cost-effective care” and it would “have greater leverage in encouraging standardized quality improvement strategies and electronic medical records.”

A public option could reduce projected health care costs by about “$2 trillion over 11 years, and lower premiums by about 20% on average.” Within a decade, 105 million people would be enrolled in the public plan, and about 107 million would have private insurance.

But brush AHIP’s objections aside, and their real concern is sacrificing profits to competition. Medical loss ratios, an indicator of how much revenue insurance companies spend on care vs. how much they keep as profits, have dropped precipitously in the last decade. Forcing private insurers to “shave-off” some administrative costs and compete with a public option may very well reverse that trend.

For policy makers, this is really an argument about the proper role of government. As Dean Baker argues, “some people, who tend to be left of center, think that the government’s role is to try to promote the general good, by providing basic services, protecting the poor and the sick, and ensuring a well-working economy. On the other hand, there are others, who usually place themselves right of center, who believe that the proper role of government is to redistribute as much income as possible to the wealthy. These competing views of government are coming to a head in the debate over national health care reform.”

Today, America’s Health Insurance Plans (AHIP) — the insurance industry’s lobbying arm — is hosting a health care policy forum in Washington D.C. This is the first of a series of posts from inside the conference.

AHIP bills its National Policy Forum as “the nation’s premier conference for health industry executives, health policy analysts and experts for in-depth discussions and a diversity of perspectives on the most challenging health care policy issues facing our nation.”

But when ThinkProgress asked National Federation of Independent Businesses (NFIB) President Dan Danner — whose organization opposes Obama’s employer mandate — where he’s willing to compromise with the President to pass comprehensive health care reform, Danner couldn’t answer this “challenging health care policy” question. After several seconds of silence, Danner simply reiterated his support for reform:

I mean, we’re anxious to get a solution. Compromise on what? I think that’s the — one of the challenges, if you’re talking about comprehensive health care, it’s a very complex puzzle, and how you fit all of the pieces together. You know? I don’t think that you can take any part of comprehensive health care in isolation. You have to talk about how’s all this fit together?

Watch it:

While all of the different stakeholders argue have claimed that they’re willing to compromise, few have specified specific points of concession. As Time Magazine reporter Karen Tumulty pointed out, “I think we’re all going to learn over the next few months, how and whether the environment really has changed all that much since 1994.”

Transcript: Read more

Today, the Senate Finance Committee held a hearing about President Obama’s Fiscal Year 2010 Health Care Proposals with OMB director Peter Orszag. Below are some highlights.

Orszag on why capitalism and Medicare Advantage overpayments are incomparable:

In a rather heated exchange with Sen. Chuck Grassley (R-IA), Orszag defended the Obama administration’s proposal to eliminate the subsidies provided to insurers participating in the Medicare Advantage. “Capitalism is not founded on excessively high subsidies,” he said.

ORSZAG: I know many people believe that capitalism is founded on private markets, and it is. But I very firmly believe that capitalism is not founded on excessively high subsidies to private firms. That is what this system delivers right now. For every Medicare beneficiary in Medicare advantage, the federal government pays a thousand dollar more than covering the same beneficiary under fee-for-service.

Listen:

Orszag’s approach may have come off as smug or arrogant, but he’s probably right on the substance. It’s unclear why Medicare would pay about 13 to 17 percent more for beneficiaries enrolled in MA Plans, if they’re not providing better quality care (and just pocketing the subsidy.)

And as Orszag points out, for every dollar the federal government provides to Medicare Advantage in additional benefits, it spends $1.30 in costs. “We’re all paying a $1.30 in order to deliver a dollar to a subset 20% of Medicare beneficiaries. I don’t think that’s competition, I think that’s an unwarranted subsidy,” he said.

Orszag on the unintended consequences of the health care crisis:

Many progressives have made the argument that the economic crisis demands health care reform. Chairman Max Baucus (D-MT) asked Orszag about the cost of doing nothing. Orszag checked off the usual talking points but then explained why college students should advocate for health care reform:

ORSZAG: Lots of families are experiencing higher tuition at public universities. Research clearly connects rising tuitions to rising costs of health care in state government budgets, which then means they don’t have room to support public education to the degree they did in the past.

Listen:

Most progressives — including President Obama — argue that allowing a new public plan to compete with private insurers would increase choice, promote effective competition, bring down health care costs and create incentives for effective performance. (Jacob Hacker has much more here).

Well, a new poll released today by Lake Research found that most Americans agree with this argument. “A whopping 73% of voters want everyone to have a choice of private health insurance or a public health insurance plan while only 15% want everyone to have private insurance.”

Republicans and the insurance companies are part of that stubborn 15%. They argue that competition would force private insurers out of business and lead to a complete government take-over of health care. But as Howard Dean explained in a recent interview with ThinkProgress, giving Americans a choice between a public and a private plan is the only way to achieve real health care reform.

Watch it:

According to the Commonwealth Fund, a public coverage program similar to Medicare would reduce projected health care costs by about $2 trillion over 11 years, and lower premiums by about 20% on average. Within a decade, 105 million people would be enrolled in the public plan, and about 107 million would have private insurance.

In August 2001, President Bush limited federal funding to what turned out to be just 21 embryonic stem cell lines and later twice vetoed bipartisan legislation to expand government funded stem cell research. Today, in a rebuke of Bush policy, President Obama lifted the Bush administration’s strict limits.

In response to Obama’s executive order, some conservatives — determined to carry on Bush’s legacy — falsely argued that lifting restrictions on federal funding for embryonic stem cell research would undermine more promising stem cell research:

- Karl Rove: “I hope it does not diminish the amount of money going into the non-embryonic stem cell research… What we have learned over the last seven or eight years is that there are many avenues, promising avenues to drive these stem cells that do not involve a troubling questions involved with the creation of human life for the purpose of destroying human life and harvesting the cells that were made by it.” [Fox News, 3/9/2008]

- Sen. Mitch McConnell (R-KY): “I support biomedical research and I believe the administration would be far better served by directing taxpayer funds to research on non-embryonic stem cells, which is both effective and ethical.” [FirstRead, 3/9/2008]

- Rep. John Boehner (R-OH): “Non-embryonic stem cell research is not only showing great promise in the laboratory, but its applications are already being used to treat scores of diseases and medical conditions.” [FirstRead, 3/9/2008]

But as CAPAF senior fellow Jonathan Moreno explained during an interview with ThinkProgress, “embryonic stem cell research actually has made possible the advances in alternative forms of stem cells, including the so-called pluri-potent stem cells”:

Without these embryonic stem cell lines, the work that’s been done so far on pluri-potent stem cells wouldn’t have been possible….One of the problems is that people are putting this dividing line between embryonic stem cells and other cells. Biology doesn’t recognize those kinds of divisions. We really need to ask the question ‘what is going to work for this medical problem or what is going to work in developing this drug or what is going to work in answering this basic biological question?’ it needs to be driven by the questions they are asking and not about the sources of the cells.

Watch it:

Obama’s order gives incoming HHS Secretary Kathleen Sebelius and yet-to-be-announced NIH director 120 days “to create a set of guidelines to govern the funding of research on embryonic and non-embryonic stem cells.” Federal officials are expected within weeks to “release a draft document that will be made available for public comment before being finalized.”

In the lead up to last week’s White House Health Care Summit, Republicans publicly repudiated President Obama’s proposal to give Americans the choice of enrolling a new a public health plan.

Despite a show of bipartisanship and openness for debate, the GOP sent a letter to Obama, effectively taking this option off the table. At the summit, Sen. Chuck Grassley (R-IA), the ranking member of the powerful Senate Finance Committee, warned Obama that “there’s a lot of us that feel that the public option that the government is an unfair competitor.”

Over the weekend, Rep. Roy Blunt (R-MO) — the chairman of the Republican party’s health care task force– doubled down on this opposition and dedicated the Republican radio address to opposing so-called “government run programs”:

Some people are spending a lot of time talking about how to spend more of your money on bigger government run programs…That’s why real competition is the key – it encourages innovation so that the health care treatments and services available to you are the ones that you need and you want. Republicans are committed to common-sense solutions that promote competition and innovation…Republicans will lead the effort to make health care work for Americans.

Watch it:

If Republicans plan to “lead the effort” on health care reform, their current approach leaves much to the imagination. In fact, Blunt’s so-called health care task force is concerned about messaging, not policy; rhetorical flourishes, instead of real workable solutions and compromise.

But on a larger scale, government workers complaining about government-sponsored health care is a bit like governors complaining about the stimulus, but then accepting the funds. If Republicans are really concerned about subpar care or rationing of treatments, then they should publicly abandon their government sponsored insurance (which they receive through The Federal Employees Health Benefits (FEHB) Program) and try their luck in the individual health insurance market. Until that exodus occurs, the Republican message sounds like hypocritical ideological stubbornness.

The FEHB, it should be noted, does not include a public option and is not a model for lowering health care costs. As Jacob Hacker points out, “the growth rate for FEHBP is virtually identical to that for private health insurance…This suggests that simply replicating FEHBP on a broader scale—without public plan choice—would be unlikely to provide the long-term cost restraint essential for successful reform.”

Government involvement in health care is certainly an uphill climb for the GOP. Most Americans support government involvement in health care and a large majority support a public option. After all, injecting competition into the health insurance market (in the form of a public plan) is a uniquely “American solution” — the very thing conservatives seem to be asking for.

In today’s Wall Street Journal, health care crisis denier Sally Pipes writes, “the assertion that the costs of providing health insurance cripples American corporations in the global economy is simply wrong.” At first glance, Pipes’ argument sounds manufactured.

We’re all familiar with the numbers. General Motors spends $71 per worker per hour on health care, while Toyota spends only $47. Health care costs add $1,525 to the price of every GM vehicle, and the company spent $5.2 billion on health care benefits in 2004. It spends more on health care than on steel, and Starbucks pays more for benefits than coffee beans.

But while Pipes’ argument is counterintuitive, it’s not entirely wrong. At least not according to the Congressional Budget Office (CBO), the agency responsible for scoring Congressional proposals. Last week, while testifying before the Senate Finance Committee, CBO director Douglas Elmendorf explained that “for employers, health care is merely a part of total compensation“:

Although U.S. employers may appear to pay most of the costs of their workers’ health insurance, economists generally agree that workers ultimately bear those costs. That is, when firms provide health insurance, wages and other forms of compensation are lower (by a corresponding amount) than they otherwise would be. As a result, the costs of providing health insurance to their workers are not a competitive disadvantage for U.S.-based firms.

But this doesn’t tell the whole story. Health care costs are soaring faster than inflation, and instead of cutting worker’s wages, businesses are struggling to keep up with costs and are scaling back coverage. The National Federation of Independent Businesses reports that “58 percent of all small-business owners” are having a “hard time keeping up with the cost of health care.”

Consequently, “in 2010, 49% of employers will reduce their health benefit plan offerings. Forty percent of employers will increase adoption on consumer-driven health plans and two-thirds of employers will move more costs to employees.

Meanwhile, the business groups are clamoring for health reform, arguing that they can’t sustain growing health care costs:

- NFIB: NFIB agrees that the current growth in healthcare costs is unsustainable for the government and for small businesses alike.

- Business Roundtable: Rising health care costs affect all American workers, employers and the government. Rising costs impact job creation, diminish the nation’s competitiveness and reduce Americans’ ability to save for retirement

- Chamber of Commerce: A healthy workforce is the backbone of a strong economy, but spiraling health care costs curb the competitiveness of U.S. businesses and constrain tight family budgets.

The CBO’s analysis, while economically and theoretically sound, is completely divorced from reality. While wages may pay for health care costs in the long run, workers won’t accept smaller paychecks every time premiums increase. As Sen. Max Baucus (D-MT) pointed out at the hearing with Elmendorf, when considering the costs and consequences of health care reform proposals, Congress should not be “in the old situation where whatever CBO says is God.” “In my judgment you’re not God,” he said.