Some commentators have been ringing the alarm bells about the health care provisions in the recently enacted American Recovery and Reinvestment Act (The Stimulus). As I discussed in a previous post, this started with an opinion piece in Bloomberg, which has since been discredited by CNN and others. Among other things, the author misquoted the language in the bill to make it look more "sinister" and she indicated that it was creating a new administrative body to make health decisions for patients when, in fact, that administrative body already existed and doesn't do that. Now NBC News claims that there is a leaked letter sent from the author of the hit piece to the large drug companies, saying that she would help them shape public opinion for a fee, through the Big Pharma-funded Hudson Foundation.
This debunking has not stopped the manufactured controversy, however, as seen in a recent TLB post. To go along with the alarmist language like "Socialism!", there are some substantive points made in the post that I would like to respond to:
Assertion:
President Obama has future plans to dictate what treatments patients can get.
Response:
First of all, there seems to be a backing-off of the original claim that the provisions in the Stimulus Bill dealing with health care gave the government power to mandate that patients receive certain treatments. I assume that means that there is an acknowledgment that the Bloomberg article was either outright trying to mislead people or perhaps merely grossly negligent in their journalism. Instead, now the argument is moving to future dangers that are, of course, what the "sinister" lefties are certainly going to do.
The problem with this is that we don't know what is going to be proposed. The previous post links to a vaguely-worded plan on the Obama campaign website, which says that health providers that participate in the plan will need to use "proven disease management programs." That is about as vague as it can be, but it certainly is a big jump from that to"the government will make tell a patient what treatment to get."
In fact, I'm not sure that the government deciding to disallow certain kinds of treatments would even be a big departure from how things are already done, since the government makes decisions about lots of health care issues. For instance, the government makes decisions and enforces things like sanitary conditions in hospitals and what medications are safe and legal (see, the FDA). I suppose that could also be considered governmental intervention into private choices, just like ANY regulation.
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Assertion:
It is coercion for the government to require health care facilities to provide records if they want to receive Federal funds.
Response:
Yes it is. In fact, there are two main ways the Federal Government gets states, private actors, or any other entity to do or to not do things. One is to directly mandating it, i.e. making it illegal to do something. The second, and less coercive way, is to tie federal money to compliance.
Every single law or regulation enacted by the Federal Government uses one or both of those forms of coercion. As the government is using the less coercive of the two forms of regulation, I fail to see why this is an issue at all, unless one has the opinion that all regulations are bad or improper (a view that few people would agree with).
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Assertion:
The health care provisions were "hidden" in the Stimulus Bill, and when right-wing talk show hosts started talking about it, they were "hushed."
Response:
The provisions were in the many different iterations of the Stimulus Bill, and those different versions of the bill, such as the House and Senate bill were available on-line for weeks. That alone means that there has been MORE transparency about the bill than just about any other large spending bill to come out of Congress that I can think of, at least ones that are more than single-project bills. Yes, the bill is long, and yes, it contains many different subjects. However, there is no reason to think that the health care provisions were any more "hidden" than any other omnibus-type spending bill. It strikes me as a bit of selective outrage to single this one out despite the increased transparency compared to the normal process.
As for the right-wing talking heads being hushed, I would like to see some evidence for that, as I can find none. There has been fact-checking, but I don't agree that fact-checking counts as being "hushed." At the very least, Rush Limbaugh alone has 20 million listeners a day, and the falsehoods were also spread throughout other parts of the media such as Fox News and even CNN (before they actually went to the trouble of fact-checking it). So the falsehoods spread to plenty of people, hushed or not.
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Assertion:
Not a single Republican voted for the bill in the House, and only three voted for it in the Senate, therefore it was a bad bill.
Response:
There is a simple alternative explanation to the Republicans not voting for it - they did so for political reasons.
As Nate Silver reasoned over at fiverthirtyeight, the Republicans had few tactical reasons for voting for it.
Then there is the fact that the Republican leadership issued a statement telling Republicans to vote against it right BEFORE meeting with Obama about it.
"House Majority Leader Steny Hoyer (D-Md.) had told CNSNews.com on
Tuesday: “Mr. Boehner and Mr. Cantor have already told their members to
vote against it. They issued that before even discussing it with the
president of the United States. They have taken a political stance:
‘Our party is going to oppose it.’ I think that’s unfortunate because
it takes two groups to be bipartisan.”
Then there are the statements by Republican Senator Arlen Spector, one of the three Republican Senators to vote for it, saying that at least some of the other Republicans voted against it due to pressure from the Right-wing:
"When I came back to the cloak room after coming to the agreement a
week ago today," said Specter, "one of my colleagues said, 'Arlen, I'm
proud of you.' My Republican colleague said, 'Arlen, I'm proud of you.'
I said, 'Are you going to vote with me?' And he said, 'No, I might have
a primary.' And I said, 'Well, you know very well I'm going to have a
primary.'"
"I think there are a lot of people in the Republican caucus who are
glad to see this action taken without their fingerprints, without their
participation," he said.
Specter was asked, How many of your colleagues?
"I think a sizable number," he said. "I think a good part of the
caucus agrees with the person I quoted, but I wouldn't want to begin to
speculate on numbers."
Listen to the audio
Then there is the fact that Republicans wanted tax cuts, so Obama included tax cuts. Then they wanted more tax cuts, so he included more tax cuts. Then they had an issue with money to fix up the National Mall, so that was taken out. Then they had problems with family planning money, so that was taken out. Then the Dem's made still more concessions during the senate negotiations, such as reducing the size of the spending, taking out money for schools and states like the Republicans wanted, and so on. None of those things changed a single Republican vote.
Add that all up, mix in mostly the exact same republicans voting for even larger and less-necessary things like the giant medicare-Big Pharma giveaway during Bush's term.
Or how about all 211 House Republicans voting for Bush's tax cut during less perilous times than the current situation that cost 70% more than this Stimulus ($1.35 Trillion)?
It's pretty clear that some, if not many, Republicans voted against the Stimulus because they saw a political advantage to voting against it, NOT because they are opposed to deficits.