Long-time readers may recall a discussion we had last year about what I call “conversation enders.” These are comments that lead you to know, the moment you hear them, that the writer/speaker is either clueless or intellectually dishonest. Either way, the moment you hear a “conversation ender,” you know the discussion has ended. “If they’re willing to say that,” the voice in your head tells you, “then the rest is probably nonsense.”
I have a few of these. When I hear, “Tax cuts are fiscally responsible because they pay for themselves,” it’s a conversation ender. When I hear, “Evolution is just a theory,” it’s a conversation ender. When someone says, “Global warming can’t be real because it’s cold outside,” it’s a conversation ender.
And when someone bashes Hillary Clinton’s healthcare proposal from 1993 as a “government take over the health care system in America,” you know the person doesn’t have a clue. Take John McCain, for example.
John McCain devoted a substantial chunk of his town hall meeting Thursday to drawing contrasts with Barack Obama on health care policy, stressing his opposition to the presumptive Democratic nominee’s health care plan and noting the “great difference” between them on abortion.
McCain’s strongest denunciation of Obama came when discussing the Democrat’s health care plan, which would cost $50-65 billion per year but would not mandate insurance coverage for all adults, only children.
“My friends, we’ve seen this movie before,” McCain said. “It was called ‘HillaryCare’ back in 1993, and we’re not going to do it again. We’re not going to have the government take over the health care system in America. And that’s what Sen. Obama wants to do.”
Now, McCain has been in Congress for more than a quarter of a century, so he’s been around long enough to look into healthcare policy at least a little. Presumably, he went to a hearing or two on the Clinton plan in the ’90s, and even read a book or two before unveiling his own healthcare “plan” during this campaign.
Which leads to one of two possibilities: either McCain doesn’t know anything about healthcare policy (in which case he’s spectacularly uninformed), or he does know something about healthcare policy (in which case he’s being spectacularly dishonest). It’s really either one or the other.
First, Hillary Clinton’s plan had its flaws 15 years ago, but it was not a policy premised on a “government takeover” of the health care system. That’s what the right-wing talking points said, but that’s not what the reality was.
Second, has McCain even considered reading Obama’s plan before bashing it? (Or maybe having someone read it to him?) Not only is there no “government takeover,” it’s actually a modest, reasonable, pragmatic approach to the issue. It’s not similar to the Clinton plan from 1993, and under no circumstances is it “socialized” medicine. Either McCain doesn’t know what his words mean, or he doesn’t know anything about the plan he’s attacking. Even the Wall Street Journal noted that Obama’s policy “is much different from the 1993 Clinton plan and most outside observers agree it is far from a government takeover of the health care system.”
And third, McCain is making this wild-eyed, demonstrably-false charges in the hopes that few will notice that his own healthcare plan is rather pathetic.
McCain unveiled his idea a few months ago, and it left much to be desired.
Senator John McCain detailed his plan to solve the nation’s health care crisis in a speech here Tuesday, calling for the federal government to give some money to states to help them cover people with illnesses who have been denied health insurance.
Mr. McCain’s health care plan would shift the emphasis from insurance provided by employers to insurance bought by individuals, to foster competition and drive down prices. To do so he is calling for eliminating the tax breaks that currently encourage employers to provide health insurance for their workers, and replacing them with $5,000 tax credits for families to buy their own insurance.
His proposal to move away from employer-based coverage was similar to one that President Bush pushed for last year, to little effect. And his call for expanding coverage through market-based competition is in stark contrast to the Democrats’ proposals to move toward universal health care coverage, with government subsidies to help lower-income people afford their premiums.
The good news is, the contrast between McCain’s approach and the Democrats’ approach couldn’t be greater. For voters concerned about healthcare, there’s a clear and distinct choice.
The bad news is, McCain’s plan is pretty awful, and probably won’t receive much in the way of scrutiny.
In April, McCain, sensitive to criticism he’s received from Elizabeth Edwards (among others), told George Stephanopoulos, “We’re not leaving anybody behind.”
The problem, not surprisingly, is that he’s leaving all kinds of people behind. TNR’s Jonathan Cohn took a close look at McCain’s proposal and concluded, “His great new plan isn’t new or great. And it still wouldn’t help Elizabeth Edwards get decent insurance.” After reviewing McCain’s patchwork solution for people who can’t get insurance due to pre-existing conditions, Cohn added that McCain’s approach is “absolutely preposterous.”
Come to think of it, why should we even believe McCain takes this issue seriously? His Democratic counterparts, Hillary Clinton and Barack Obama, issued detailed policy proposals more than six months ago — with pages of analysis and explanation, right down to the budget dollars. Those details were a sign of commitment and, on a more practical level, their constant hyping of them represent an investment of political capital.
By contrast, even today’s announcement from the McCain campaign–which was supposed to help fill in the many blanks left before — came with only minimal detail and supporting evidence. The actual proposals are still vague, consisting mostly of bland vows to “work with governors” and make sure premiums for people with pre-existing conditions are “reasonable.” And while health care is the campaign’s focus this week, it’s never occupied the place in his agenda that it does in the Democrats’.
Quite right. The NYT report on McCain’s presentation explained, “Mr. McCain’s speech here implicitly acknowledged some of the shortcomings of his free-market approach. But rather than force insurers to stop cherry-picking the healthiest — and least expensive — patients, Mr. McCain proposed that the federal government work with states to cover those who cannot find insurance on the open market.”
What does “work with” mean? No one has any idea.
Just to add one thing to Cohn’s analysis, there’s also the not-inconsequential matter of affordability. McCain wants to discourage employers from offering employees healthcare, and replace subsidies with $5,000 tax credits. In turn, Americans could go and get their own insurance, detached from their job. (That is, unless you’ve ever been sick, and private insurers don’t want you.)
What McCain didn’t mention is that “average cost of an employer-funded insurance plan is $12,106 for a family, according to the Kaiser Family Foundation, a health policy group. Paul B. Ginsburg, the president of the Center for Studying Health System Change, a nonpartisan research organization financed by foundations and government agencies, said, ‘For a lot of people, the tax credits he’s talking about would not be enough to afford coverage.'”
Hilzoy summarized the situation nicely:
So, in a nutshell: McCain plans to eliminate tax breaks for employers who offer health insurance. In exchange, he will offer employees less than half the cost of the plans they now have. If their employers eliminate care, they will have to swallow the difference. But those employees are the lucky ones. They will only have to cough up $7,000 or so. People with preexisting conditions or serious health risks will have to pay $100,000 as a down payment, and $14,000 a year thereafter.
But hey: at least he’s going to cut the gas tax! […]
It’s easy to make health policy when you don’t allow little things like facts to constrain you: when you can wish away chronic diseases, pretend that corporations are completely unresponsive to changes in the tax structure, and describe programs that leave people with hundreds of thousands of dollars in health care costs as “making sure that they get the high-quality coverage they need.” It’s just not particularly helpful. Plus, it would be even better with ponies.