The recently passed healthcare reform bill is far from perfect, but it must have some decent aspects particularly given that just about everyone hates it. The left believes it reflects plans first developed during the Eisenhower and Nixon adminstration of a market for health care based on private insurers and employers. The right attacks it as socialist plan that represents a complete government takeover of medicine, despite the fact that is lacks a public option and does not remotely resemble the single-payer systems the Canadiens or British have.  

The good things are obvious.

• insurance companies are prevented from denying coverage for pre-existing conditions,
• insurance companies will be banned from dropping people from coverage when they get sick
• insurance companieswill be banned from imposing lifetime caps on coverage
• kids will now be able to stay on their parents’ insurance plans until they’re 26
• begins closing the “doughnut hole” in prescription drug coverage in 2011.

(For more detail see Matt Yglesias, What’s In the Healthcare Act?”)

But there is much that needs change. David Frum lists some interesting thoughts on a positive Republican response to fixing some of the bad elements. At least engage in the debate - much better than the “leadership” response that they should double down on their strategy and work to repeal it.  

 Frum’s ideas:

• Start thinking about how to get rid of the new taxes on work, saving and investment — if necessary by finding other sources of revenue, including carbon taxes.
• Embrace exchanges. Employer-provided care is the problem of American health care. Employers choose different policies for employees than those employees would choose for themselves. The cost is concealed.
• Reduce regulation of the policies sold inside the health care exchanges. The Democrats’ plans require every policy sold within the exchanges to meet certain strict conditions. Expand options and press for more scope for insurers to cut prices if they think they can offer an attractive product that way.
• Remove small business fine. Uninsured employees have now through the exchanges been provided an easy and even subsidized way to buy their own coverage. There is no justification for the small-business fine: Republicans should press for repeal.

Update:  Frum has been fired by the American Enterprise Institute.

Not a fan of Paul Krugman’s column in the New York Times, but today he correctly levels a charge against the GOP that is on target and deserved. I have often said that the Republicans are good with the bullhorn but over the past 10 years, when push came to shove over budget issues they were not willing to do the hard work. Krugman:

The idea — propounded by many members of the conservative intelligentsia, from Alan Greenspan to Irving Kristol — was basically that sympathetic politicians should engage in a game of bait and switch. Rather than proposing unpopular spending cuts, Republicans would push through popular tax cuts, with the deliberate intention of worsening the government’s fiscal position. Spending cuts could then be sold as a necessity rather than a choice, the only way to eliminate an unsustainable budget deficit.

O.K., the beast is starving. Now what? That’s the question confronting Republicans. But they’re refusing to answer, or even to engage in any serious discussion about what to do.

Krugman of course will argue against proposed cuts, but he has a valid point. The cuts will have to come from the very popular programs - Medicare, Medicaid, Social Security. Defense, Social Security and Major Health Programs make up 61% of the budget*. This is where big government lives. For many years I have believed that - like Nixon going to China - it would take a Democrat to make headway in reforming Medicare and Social Security, but it will also require the willingness of a serious opposition. With the current GOP leadership of Mitch McConnell and John Boehner the opposition is not serious.  

Time to step up and do some heavy lifting, not just point fingers at the other guy.

* Defense and international security: 21 percent of the budget, or $625 billion; Social Security:  21 percent of the budget, or $617 billion; Medicare, Medicaid, and CHIP: 20 percent of the budget, or $599 billion. ($391 billion went to Medicare)  

Gawker (‘I’m Not Saying Your Mother’s a Whore’: How Fox News Censored Jon Stewart vs. Bill O’Reilly) does a great job of examining the full, unedited interview with John Stewart. However, you have to give O’Reilly credit, he is willing to discuss the issues Stewart wants to raise. And, on several subsequent shows he consistently pointed out that the “full” interview was available online. Shep Smith and O’Reilly may right the ship at Fox News before you know it.

Source: Center for Budget and Policy Priorities

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