Debating Health Care Could Be Politically Healthy

With Republicans on the defensive in Congress and in the increased number of state legislatures dominated by Democrats, the coming debates on health care could, in fact, be healthy both for Republicans and other Americans.

As in so many other areas of public debate, the Democrats have had a virtually free pass over the past years to criticize Republican policies and administration. That changes somewhat when they have to actually legislate, be more practical, and take responsibility for their actions.

Libertarian and small-government Republicans who criticized their big-government-type brethren or who isolated themselves in ideological corners effectively outside the public debate are probably the majority of conservative activists and commentators. They will also have to either be more involved in the coming debate or yield to even more and more pernicious Democrat big-government schemes.

In short, both activist Democrats and Republicans will have to be either more practical or be more at risk of recrimination or recusal from impact.

Many conservative commentators have, rightfully, noted that only post-election are media analyses emerging with coverage favorable to Republican stewardship of the economy, or the comparative corruption of Democrats, or the wild-eyed ‘60’s gleam in the eye of the next Democrat Congressional committee chairmen, or, or, or… Conveniently, or otherwise, ultimately facts can’t be denied, completely and continuously.

Even the most biased of reporters are directly subject to the same threats to the quality, availability and cost of health care as everyone else. Here, too, facts are creeping in to reporting.

Today’s Los Angeles Times reports that, “On drug prices, are Democrats in a fix?”

"From a rhetorical perspective, Democrats may feel like they gain a lot with this issue, but there are many substantive hurdles that the government faces in trying to negotiate prices," said Dan Mendelson, president of Avalere Health, a consulting firm that tracks the Medicare prescription program.

"If you look historically at the government's experience in trying to regulate prices, it's poor."…

In other words, the VA offers lower drug prices, but fewer choices.

American consumers have repeatedly resisted efforts to save money on medical care by restricting choice. Health maintenance organizations, for example, were once seen as the answer to rising healthcare costs, but millions of people rejected the approach, saying they wanted the freedom to choose their doctors.

One prominent advocate of government-negotiated prices has had a change of heart. Tommy G. Thompson, President Bush's first Health and Human Services secretary, once expressed regret that he hadn't been given the power to bargain.

But in a recent interview he said: "This plan is working much better than ever anticipated. When you've got a law that is working well in the federal government, why change it?"

Why, indeed.

The Washington Post has a similar report, “Success of Drug Plan Challenges Democrats:Medicare Benefit's Cost Beat Estimates.”

It sounded simple enough on the campaign trail: Free the government to negotiate lower drug prices and use the savings to plug a big gap in Medicare's new prescription-drug benefit. But as Democrats prepare to take control of Congress, they are struggling to keep that promise without wrecking a program that has proven cheaper and more popular than anyone imagined….

The cost of the program has been lower than expected, about $26 billion in 2006, according to the nonpartisan Congressional Budget Office. The cost was projected to rise to $45 billion next year, but Medicare has received new bids indicating that its average per-person subsidy could drop by 15 percent in 2007, to $79.90 a month.

Urban Institute President Robert D. Reischauer, a former director of the Congressional Budget Office, called that a remarkable record for a new federal program.

Initially, he said, people were worried no private plans would participate. "Then too many plans came forward," Reischauer said. "Then people said it's going to cost a fortune. And the price came in lower than anybody thought. Then people like me said they're low-balling the prices the first year and they'll jack up the rates down the line. And, lo and behold, the prices fell again. And the reaction was, 'We've got to have the government negotiate lower prices.' At some point you have to ask: What are we looking for here?"

Government-run nationalized health care is a cure worse than the disease as the way to increase availability, control cost escalation, and create more regulated quality. Some welcome this leaching of the free-market life blood that has, actually, created greater quality, available to more, and at costs – if one includes quality and access – that most Americans support compared to rationing prevalent in the crumbling systems in Canada and western Europe, whose costs are also rapidly rising past affordability by their stagnant welfarist economies. Some despair of preventing the factually hollow populist arguments of providing something for nothing.

Instead, practical resolutions like increasing the competition in the market, a la the Medicare Rx program, and increasing self-responsibility, a la the Massachusetts experiment, are actually the coming wave in health care.

Sterile arguments for statism will not have traction, and offer an opportunity for Republican free-market commentators to drive home the difference. If they will.

No subject I write about gets fewer responses, or links, than health care. Conservative bloggers and commentators need to get up to speed on this issue, or miss an opportunity to impact the public’s understanding of the practical implications of Democrats stuck in the ‘60’s by being Republicans stuck in the ‘50’s.