Healthcare: Lawmakers Caught Between Public Trust and the Devil

If Daniel Webster were alive, the Blue Dogs in the House of Representatives would do well to seek his counsel. On health care, these conservative-leaning lawmakers are caught between the public trust and the devil.

Most Americans believe the U.S. health care system needs reform but don’t like the reforms the President Obama and the House leadership want to serve up.

The plan on the table would require everyone to obtain health insurance, subsidize those that can’t afford the full price, impose an 8 percent payroll tax on businesses that do not provide health insurance, and offer a government run plan to those without employer-paid insurance.

According to the most recent NBC poll, 47 percent of voters oppose a government run health insurance option, whereas 43 percent support one. Importantly, only 24 percent believe the plan emerging would improve the quality of health care.

Most voters understand it would be cheaper for many private employers to drop their health plans, pay the 8 percent tax, and push their employees into the government run program. As tiresome and inflexible as private insurance claims departments may be, most voters simply don’t want their health insurance run by the Post Office and disputes adjudicated by the IRS.

The Democratic leadership notwithstanding, the distribution of votes in the House of Representatives reflects these sentiments. Democrats hold 256 of 435 seats but the 52 conservative-leaning Blue Dog Democrats generally don’t support a public plan.

Left free to vote their conscience and the sentiments of their constituents, it is fair to say about 200 members of Congress would vote for a public plan, whereas the remaining 235—mostly Republicans and Blue Dogs—would vote against it.

Democratic leaders in both chambers view those that oppose their health care plan not merely wrong but “evil mongers,” to repeat the words of Senate Majority Leader Harry Reid.

Convinced the voters are not competent to know what is good for them, Congressional leaders will pressure Blue Dogs to vote for a bill that pushes many Americans into a government run health care program.

Blue Dogs should just say no, but Pelosi and her lieutenants have levers.

Liberal Democrats in the House won’t vote for a bill without a public option, and if the Blue Dogs don’t go along, no health care bill may pass this Congress. Then congressional Democrats will appear inept and to have failed to address the public desire for genuine reform. Democrats would take losses in the mid-term elections, many Blue Dogs could lose their seats, and they would be blamed for pulling down the party.

The Democratic leadership can lavish generous campaign support on helpful Blue Dogs, and campaign money is such a temptation.

Although Blue Dogs tend to represent conservative-leaning constituencies, a public plan would not harm most voters until after November 2010. Blue Dogs can make their deal with the devil and burnish their conservative credentials, later, on other issues.

Ultimately, the Blue Dogs are caught between voting their conscience and supporting a Democratic leadership that holds the judgment of most voters in contempt.

Comments

[Steven Hansen:]

i think health care legislation itself is the least of the problems congressman have in 2010. health care is polarizing our country.

if there are demonstrations on the street - most incumbents will not be re-elected. if there was ever a time for bipartisan legislation, it is now for the good of the country.

Aug 23 04:22 AM

[TinyTim:]

"Most Americans believe the U.S. health care system needs reform but don’t like the reforms the President Obama and the House leadership want to serve up."
"Convinced the voters are not competent to know what is good for them, ...."

It would be nice to know what the options being discussed are instead of the "scare-bites" dished up by the media.

This is not like TARP. Most people already have healthcare and can't be panicked into doing something poorly thought out.

Unfortunately, most people don't realize how tenuous that healthcare is- subject to cancellation or layoff. Given the odds between what they have and what they hear the govt is proposing, they would rather have the devil they know.

Aug 23 07:20 PM

[Bob55:]

I couldn't agree with you more when you mention the tenuousness of healthcare in this country. With layoffs expected to continue into 2011, the need is more desperate than ever to have a health plan that can finally provide a safety net for Americans who have lost their jobs or who will be losing it. A safety net that can protect American families from losing their life savings and even having to file for bankruptcy because a family member develops a debilitating or deadly illness.

While so many see the value of depending on government to secure our financial system against future abuses by increasing regulation and aiding American industry against collapse like the lifeline that was provided to GM, the notion that government can't be trusted with perhaps the most important asset that each and every American holds dear - their very health and well-being - is a bit puzzling. I am in agreement with those who believe that before anything is ratified that a health plan be done right, but the belief that we can NEVER trust government to "do it right" because it is simply impossible for them to do is taking it a bit too far. If countless billions upon trillions can be spent helping banks and industry until that time they can finally stand on their own again, until that time that Americans and American businesses can finally get loans again, and the American auto industry can finally be profitable again making cars Americans really need, why can't we see them doing the same for America's health care?

We have to ask ourselves where we are placing our priorities. Yes, our financial system is important, so is our industry, but is there anything more important that the health and well-being of you and your family. This is very much a life-and-death issue for so many American families today and hopefully something can finally be done. This should not be a Democrat vs. Republican issue, an issue between rich and poor, young and old as so much of the rhetoric the media is making it to be. Let's just come up with a plan that can cover all Americans and let's do it right.

Aug 23 11:09 PM

[Moon Kil Woong:]

Sad to say we are caught between a broken health care system and a socialized one. Although socialized healthcare has a habit of leading to financial ruin even for governments as rich as Japan, the US seems quite adept at running up deficits towards fiscal ruin with or without a public health care option. Thus I'd rather pay $700 billion where some people get surgury they need versus $700 billion going to multimillionaire bankrupt execurtives getting to ride on coroprate jets and pay themselves million dollar bonuses come rain or shine. There is a lot worse way to misuse public money than healthcare, and as far as I can see the US is already abusing the government this way.

Thus, for me socialized medicine before socialized banks. Especially since we already socialized heathcare with medicare and medicade a long time ago. We just made it very inefficient and tied it up with lots of paperwork and red tape.

If you don't believe we have ruined our healthcare we rank worst out of the top 20 nations in almost every health care metric including preventable deaths from illnesses (a little important don't you think), sudden infant mortality, and life expectancy. And this is going up against socialized medicine. We are behind Cananda and France (how embarassing). The only thing we rank 1st in is cost. We are choking off our economic viability with close to 20% of all GDP going to healthcare. This is inefficient and absurd. Taxes are bad enough. No wonder no one has disposable income.

When blue dogs say we need to wait until after the recession really what they are saying is we must wait until tens of thousands of people are dead because they couldn't get the medical treatment when the most needed it during the time they were unemployed or were in the worst position to afford it. Even though I am fiscally conservative, I still have a heat.

We need medical reform and we need it now, public option or not. The US medical establishment is a utter discrace, not because of bad doctors but because of the insurance and HMO leeches the Nixon administration put in place to run out medical system in the 60's.

Aug 24 03:44 AM

[YoYoMama:]

"Then congressional Democrats will appear inept and to have failed to address the public desire for genuine reform. Democrats would take losses in the mid-term elections, many Blue Dogs could lose their seats, and they would be blamed for pulling down the party."

Actually, Peter, if most Americans oppose the current proposals, and the Blue Dogs are in conservative districts as you say, then logic would say they would sail into re-election if reform as the President proposes does not pass, and it is the liberals who have the most to fear.

Keep an eye on Kent Conrad (D). He has made it abundantly clear that his "gang of six" in the Senate WILL NOT RUSH this through, and are ignoring the President's mandate to have something passed in September. The gang of six, who are working out proposals for cooperative care, can be out-voted, but it would be politically difficult for the Democrats to do so.

If the proposal to form co-ops works as well as Group Health does in Washington, this could go a long way for those of us who are under-insured under personal policies. My family will certainly sign up. However, I'm not sure how well co-ops will work for the working poor, who don't qualify for Medicaid and are too poor for insurance.

I'm still waiting to hear what cost-containment measures will come out of this process. This is the fly in the ointment. Public option, cooperatives, insurance reform...it's all irrelevant unless we address the issues that lead to spiraling costs, which is at the heart of our health care problems.

Aug 24 07:48 AM

[Bob55:]

I hope there's no misinterpreting of what I wrote. I do agree with the need to help the banks and the car industry, and there will indeed be a payoff to taxpayers for years to come for that help, but it irks me when the same urgency and help can't be provided to the many Americans who currently have no health insurance, many who are in this bind because of the "bad choices" made in these very industries the government is helping.

I am in agreement with President Obama in the need for a public option. Just as rules and regulations have been put into place to minimize abuses from financial institutions (which include everything from banks to credit card companies), the same can be done to minimize abuses within the health care industry. Only through a public option can "real change" be made in a quick enough timeframe. Real cost concessions by healthcare providers (doctors and hospitals) and the pharmaceutical companies won't continue to be made without a government-run healthcare option. Private health insurers alone won't have that pull, but I don't see why they can't they also be the beneficiaries of any cost cuts. Without the "clout" of government, it's just a matter of time before things go back to the way it always is- cost going up year after year without restraint.

Aug 24 12:48 PM

[jack789:]

A National Health Care system is probably going to happen ... When and what are the big questions. Right now there is just too much confusion and misunderstanding about what Congress is proposing... well, Congress has not, as a full body, proposed, and neither has the President.

Plus -- I don't think most Americans trust either the President or Congress to craft a sensible plan, and they are also, from the get-go, scared of govt. provided medical care, as they should be if past scandals, such as treatment provided in certain DC area military hospitals for our war wounded are what we might expect on a national scale, or what people in Canada and Great Britain are reported to get, is what we can expect.

There are some countries: notably France and Switzerland, and maybe some others I do not know about, that seem to have arrived at a decent compromise between, and melding of, private/government health care that is affordable and provides for all.

Congress should stop what it is doing, appoint a non-partisan commission to study other countries' plans/experience, as well as get input from consumer groups and health providers, and then based on that study, craft a plan tailored to America's uniqueness that can be verified and will be verified by the CBO as able to meet the desired objectives, at reasonable cost, borne primarily by beneficiary contributions over a lifetime, and at minimal taxpayer input.

Also, at some point, this umbrage at Health Insurance companies not covering pre-existing conditions needs to take a breath and get some clarification. We are talking about insurance here? You do not get insurance for the automobile accident you just had, after the fact. You might pay for years and it never happens, but if it does, you are covered. Same for health care. I do realize there are some people caught in a trap when switching jobs or losing a job and trying to get new insurance right when an illness hits, or a condition discovered.

Not talking about that, but of those who never bothered to insure against something, when given the chance, and now complain the insurers won't cover their pre-existing condition.

Aug 25 06:08 PM

[Bob55:]

Hopefully when health care reform finally goes through, the whole concept of pre-existing conditions is a thing of the past as well as coverage linked to employment. When we can have health insurance cover everybody for all illnesses regardless of employment status will be the day Americans can finally have peace of mind.

Aug 26 12:19 PM