Health Care: 2009 Is Not 1994
Is 2009 the year of health-care reform?
In Monday’s Washington Post, E. J. Dionne declares it “health care’s year.” Mr. Dionne’s reasoning seems heavy on partisanship – he closes: “The president has invested too much in health-care reform to lose this fight. So he won’t.” – but many on and off the Hill have also concluded that 2009 is going to be big.
With that in mind, various groups are working feverishly to fashion their own proposals. Recently, Politico.com wrote a nice overview of the different players (notice the subtle product placement of my book in the 3rd last paragraph).
Writing in Roll Call, AEI’s Norman Ornstein provides a well reasoned and written essay on the factors favoring a major health-care deal this year.
Many of the items on Mr. Ornstein’s list aren’t earth-shattering -- yes, there are more uninsured than in 1994; yes, the White House is hungry to capitalize on the economic crisis; yes, economic uncertainty has left millions of Americans with a taste of life without the certainty of health insurance.
Mr. Ornstein makes an additional point, though, one often missed by commentators on this issue: health care has become a major issue because it has become a middle class issue. Mr. Ornstein points out the angst of insured middle America.
Now add to these groups the largest one--people who have good jobs, good employers and no reason to fear the loss of their health insurance, but who have the same recurring story. Every year, the human resources person comes to them and says something like this: Our insurance has gotten too expensive. We are changing the plan. Maybe a new insurer, maybe not. But new conditions, higher co-pays, higher out-of-pocket expenses, new doctors, a new pharmacy benefits manager with a different slate of acceptable drugs, new forms.
With the yearly turmoil and high costs, many more people are willing to take a leap of faith because the status quo is not acceptable.
And it’s easy to push further. For middle America, it’s not simply the frustration of changing health plans (and probably primary-care providers since new plans often mean new networks) or the fear of losing health insurance altogether, it’s also the fact that health costs have hit them hard in the wallet.
Between 2000 and 2006, the earnings of the median American worker stagnated – the recession before the recession. Indeed, this decade has been one long recession for many workers. How? Between 2000 and 2006, health costs have soared with health-insurance premiums having roughly doubled.
NewMajority Editor David Frum observes in em>Comeback< the bottom line for families:
Employers during the Bush years paid handsomely for labor. In fact, employers’ costs for employing a typical, median worker jumped from $19.85 per hour in 2000 to $25.67 in 2006. That’s a raise of more than $5 per hour, or 25%.
Yet the average worker saw none of the money. Every dime — and then some —was gobbled up by the rising cost of employer-provided heath insurance…
Look at this from the point of view of some typical American family. Married, two kids. Between 2000 and 2006, their pay has barely gone up at all. They’ve had a nice little tax cut from the Bush administration, worth perhaps $500. But they’re paying $1,100 more per year in out-of-pocket health care costs.
It would be one thing if Americans felt they were paying more for a better product. But would even the slickest insurance lobbyist attempt to argue that health care today is twice as good as it was at the beginning of this decade?
There are still hurdles for Washington to clear before achieving sweeping health-care legislation. It’s possible, for instance, that infighting between the White House and its very liberal allies in the House of Representatives will undermine the effort, or that Congress becomes so consumed with economic issues that health reform simply falls to the backburner – a scenario in which the lasting legacy of GM’s Rick Wagoner is preventing an Obama health-care success in 2009.
But Republicans and conservatives must realize that even if Democrats come up short this year – and that’s a big if – President Obama and his party have identified a major issue for middle America and a politically attractive prescription: focused government programs. Strong opposition without a strong alternative proposal may serve us well in the short-term and it may even sink a weak health-care bill; it is not a thoughtful long-term strategy, however.