http://seminal.firedoglake.com/diary/6722Public Option Expert Jacob Hacker on Why the Blue Dogs are Blowing Smoke
By: Scarecrow Monday July 27, 2009 9:05 pm
Jacob Hacker, the UC Berkeley Professor who wrote the original proposal for a robust public health insurance option has an op-ed in Tuesday's Washington Post explaining why the Blue Dogs are undercutting their own principles by not insisting on a strong public plan.
In fact, the Dogs seem to have everything backwards, and they'll have some explaining to do to their constituents:
The irony is that the Blue Dogs' argument -- that a new public insurance plan designed to compete with private insurers should be smaller and less powerful, and that Medicare and this new plan should pay more generous rates to rural providers -- would make reform more expensive, not less. The further irony is that the federal premium assistance that the Blue Dogs worry is too costly is the reform that would make health-care affordable for a large share of their constituents.
Hacker explains why the Dogs should strenghten the public plan if they're sincere about cutting costs.
Many Blue Dogs fret that a new public health insurance plan will become too large, despite the CBO's projection that the overwhelming majority of working people will have employer coverage and that the public plan will enroll less than 5 percent of the population. Their concern should be that a public plan will be too weak. A public health plan will be particularly vital for Americans in the rural areas that many Blue Dogs represent. These areas feature both limited insurance competition and shockingly large numbers of residents without adequate coverage. By providing a backup plan that competes with private insurers, the public plan will broaden coverage and encourage private plans to reduce their premiums. Perhaps that's why support for a public plan is virtually as high in generally conservative rural areas as it is nationwide, with 71 percent of voters expressing enthusiasm.
And
the Dog's arguments are just as wrong about employer play or pay requirements or reducing eligibility for Medicaid or premium subsidies. The first worsens the federal budget while the latter squeezes indvididuals out of coverage. It's penny wise, but pound foolish and cruel.But I doubt Hacker's op-ed is aimed solely or even primarily at the Blue Dogs. It seems aimed more at wavering Democrats in the House and Senate who assume the Blue Dogs' are credible. Hacker makes clear that what the Dogs are asking will only raise the nation's health care costs. They're asking Congress to give up on the fundamental elements of reform.
Paul Krugman aptly summarized what reform means:
Reform, if it happens, will rest on four main pillars: regulation, mandates, subsidies and competition. . . .
Now, however, they {Blue Dogs} face their moment of truth. For they can’t extract major concessions on the shape of health care reform without dooming the whole project: knock away any of the four main pillars of reform, and the whole thing will collapse . . .
When they're weakening reforms by listening to the Dogs, Congress is sitting around waiting for Max Baucus' predictably unproductive "coalition of the unwilling" to tell them what they'll accept.
And
the leaked trial balloon is pathetic: a twisted, two-legged stool with only half a mandate, no weakened employer contributions, insufficient subsidies, a weak, undefined co-op, but no public plan, that adds up to millions more left uncovered and no meaningful competition to force bloated insurers to lower their costs or lose market share.
Hacker and Krugman are telling us the Blue Dogs are blowing smoke and that waiting for the Finance team to fix our broken health care system is a mistake. They're right. Again.
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