Health Care by the Numbers: What’s In It for You?
By Al Giordano
When it comes to the blogosphere debates over the health care bill, what is really at the core of the often bitter shouting match between the bill supporters and the bill killers on the left side of the Internets?
As this recent polling memo by the Mellman Group to Democratic US Senators demonstrates, it is a battle for the hearts and minds of a relatively small pocket of public opinion: the twelve percent of Americans who want national health care but believe the current bill “doesn’t go far enough.”
It is also a battle over who can lay claim to representing this constituency, which the bill killers mistakenly call "the base" (and therein lies their first tactical blunder: this twelve percent is not a monolithic bloc, many don’t consider themselves represented by anyone, and many don’t easily rally behind any aspiring leader).
The bill killers are essentially the 2009 version of the 2008 PUMAs, that whacky species of supporters of Hillary Clinton’s presidential campaign who, once Barack Obama won the nomination, shouted “Party Unity, My Ass,” and engaged in a summer-fall effort to convince Democratic Clinton voters to stay home in November or vote for the McCain-Palin ticket. They of course failed miserably, as the exit polls and hard results demonstrated on election night. Then, as now, both groups deny there is a racial component to their attack. Others of us can spot it a mile away. But there ain’t much use arguing about that because you either see it or you don’t.
Since everybody agrees that Senators and House members worship at the altar of the public opinion poll, the bill killers' gambit has been to convince that specific and relatively small twelve percent of the population to tell pollsters, on a yes or no question, that they “oppose” the health care bill, even though they support progressive national health care policies. Specific progressive policy proposals in the current bill poll much better on the merits:
Why aren’t progressive Democratic Senators, looking at the parade of public opinion polls citing supposed public opposition to the health care reform bill bolting from their support of it? It’s because they and their political consultants understand how to read beyond the over-simplified media coverage of polls. They may worship at the altar of polling, but they do know their god very well.
The more important number to them is what the polling will show next November and in even-numbered Novembers beyond, after the health care bill has become law and begins, step by step, to take effect over the next four years. Starting sometime in January the bill killers – like the PUMAs before them – will drift back into irrelevancy. The bill – like the 2008 election – will have already won the day, they will have lost, and public opinion will follow its self-interest more closely. And a great mass of that twelve percent of the population that might be called progressives against the bill will begin to weigh their opinions based on the actual merits of what the new law provides them. In sum, the question will become for most Americans: What’s in it for me?
Nate Silver, earlier this month, produced this bar graph, showing that the cost of health insurance to the average family of four earning $54,000 a year will be significantly lower once the bill takes effect:
Jonathan Cohn at The New Republic went on to make a wider graph, demonstrating how much less expensive health insurance will become for five different income ranges. If you’re middle class earning, say, $80,000 a year, you pay less. And the poorer you are under that annual income number, you pay far less, indicating the truly progressive nature of what this bill accomplishes:
There has been considerable (and business-as-usual) “concern trolling” from bill killers and it goes like this: “We’re worried about the political impact on President Obama and Democratic legislators because the insurance subsidies don’t take full effect until 2014.” US Senator Paul Kirk, who fills Ted Kennedy’s seat in Washington, explained the other day, however, those aspects of this bill that will take effect immediately, most bringing significant immediate benefit to the people:
“…with all due respect to my friend Chairman Dean, he is just plain wrong. He states that few Americans will see any benefit under this bill until 2014. In fact, as early as 2010 the Senate bill will do the following:
"Establish a high-risk pool that will give uninsured Americans with a pre-existing condition access to coverage;
"Prohibit insurance companies from dropping coverage for Americans because they get sick;
"Prohibit the imposition of lifetime limits on coverage;
"Require insurance companies to report the percentage of premium revenues that they spend on medical benefits for their enrollees, and force them to rebate any excessive costs or profits;
"Require insurance companies to provide free preventive services;
"Require insurance companies to cover dependents up to age 26;
"Provide a discount on drug costs to seniors who fall into the Medicare Part D doughnut hole.
"Provide a tax credit to small businesses that provide health insurance for their employees.
"In these and other ways, the Senate bill is immediate and real reform."
And although the full subsidies will wait another four years to fully kick in, with the debate about whether to pass the bill or not soon-to-be-moot, more careful attention will be given in the media and by everyday citizens to the “what’s in it for me?” concerns. Charts like this one, based on Congressional Budget Office estimates, will become more prominently displayed in the media and more interesting to the average citizen than the heated media circus over crossfires between political personalities:
The generous benefits down the line then become so close that the average citizen will be able to taste it. He and she will find out just how much less health insurance is going to cost them (and for most people, that really is a much, much bigger deal than to whom - the public or private sector - they will be paying their hard earned money).
People will also discover that those who have used the bill’s “non mandatory mandate” provision to scream “the bill will FORCE you” to do anything were grossly distorting and manipulating the facts to provoke fear and make a false portrayal. The "mandate" is this year's version of George W. Bush's "weapons of mass destruction" in Iraq. History will turn against its modern-day Judith Millers, as before.
And the fifteen minutes of fame that some of the bill killers enjoy today will become as extinct as the dodo or the PUMA, with considerable resentment about how they’ve behaved as what one commenter here called "footstompy douchebags" during this chapter in political history.
Once this bill passes – and this will be the most upsetting part of all for the bill killers, revealing the ulterior motives of many them – the President’s popularity numbers, and those of his party, will rise precisely at the start of the 2010 political season leading up to November midterm Congressional elections.
Their candidates will have all kinds of new and extra health care goodies (no ban on preexisting conditions, free preventive services, expanded coverage for young dependents, discounts on drugs for seniors, tax credits to small businesses, etcetera) to hand out to rank-and-file voters and campaign on.
(Republicans, in their opposition to the bill, are apparently much more conscious of this factor: they know that the Democrats will use the goodie-bag against them to win votes. That's why they don't buy the "concern trolling" either. If they did, they wouldn't be trying so hard to obstruct the bill, to the unsightly extreme of wishing aloud that Senator Byrd would croak before the roll call.)
The sky will not have fallen, but, to the contrary, if the sky is defined by popularity, it will rise markedly for the proponents of the bill. (And in early 2010, you'll actually have a yardstick by which to measure which side of this seemingly - but not really - internecine fight was right, and which was wrong, wrong, wrong all along.)
That’s why the progressive Democratic Senators and House members haven’t imbibed from the bill killer Kool Aid vat. They know politics. That’s how they got there. And they know how this is going to play out two, three and four steps ahead.
And the bill killers, like the PUMAs before them (and some, indeed, are the very same footstompers, I don't even need to mention names), will grit their teeth, their resentment simmering once again, and will go hunting for the next “issue” opportunity to vent their intense personal hatred for the president and to make future public claims for representing “the base,” which they evidently do not represent, and never will.