Obamacare’s Weakest Links

May 26th, 2010 at 7:40 am | 10 Comments |

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A clear majority of Americans now favor a full repeal of the President’s health-reform proposal.

The latest Rasmussen poll has support for repeal of the Affordable Care Act at 63 percent, including 46 percent who “strongly favor” repeal.

Pollsters aren’t perfect, and Rasmussen polls seem harder on Democratic efforts than others (and – not surprisingly – Democrats have been more critical of Rasmussen as of late). But another survey finds a similar result: according to the most recent Kaiser Family Foundation poll, the President’s health-reform proposals have grown less popular over the last month. A majority of Americans have a “somewhat unfavorable” or “very unfavorable” view of the reforms.

Here’s the bottom line: For Republicans heading into November, this is only good news. The White House spent the last year pushing through sweeping changes and people are hardly sold. Now, with the ugliness of the political process behind us (remember the Louisiana purchase), Obamacare is sinking, not rising, in the polls. Repeal is a popular rallying cry on the stump, and has won strong support in conservative circles.

But if the pledge is repeal, Republicans will have a hard time delivering. Even if Democrats lose both the House and the Senate in November, the President still holds the veto pen. That means between now and 2013, talk of repeal is just that: talk.

But, post-November and in a strengthened position, the GOP can temper Obamacare. Amendments to non-healthcare bills and budgets all present opportunities for change. And if Republicans are able to reach out to moderate Democrats with focused criticism and concern, the potential is even greater.

What then should Republicans target?

Three areas of Obamacare are particularly problematic: health-insurance exchanges meant to spur competition that will instead strangle it with heavy regulations; a new technocratic committee to “guide” healthcare spending; and a tax on medical devices that will drive up cost inflation and impede innovation.

In a long essay for The New Atlantis, I explain why these key features of ObamaCare would be bad medicine for American health care and why Republicans should focus on them.

The essay can be found here.

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10 Comments so far ↓

  • Obamacare supporters continue to bristle at calling Obamacare ‘Obamacare’ | The Daily Caller - Breaking News, Opinion, Research, and Entertainment

    [...] with the public. The health care law he spent so much time and so much political capital on is unpopular with the public. Chastising people for calling it “Obamacare,” or capitulating to those who do, will [...]

  • mlloyd

    http://www.balloon-juice.com/2010/05/26/this-is-why-we-cant-have-nice-things/

    Beck’s noisemaking wouldn’t make any difference except for the help of 74 Democrats, who recently sent a letter to the FCC saying that it needs to wait for Congress to act on new broadband legislation. That group isn’t just Blue Dogs—it also includes 7 members of the Congressional Black Caucus who have taken close to $200K from the telecoms this cycle.

    Here’s a clear-cut case of Obama going using existing powers to push a moderate, popular, good-government goal. But even this modest effort is killed by mobbed-up members of his own party in Congress, acting against the interests of their own constituency, and in the interests of an oligopoly.

    You bark and lie loudly enough, and spread enough money around, and you can make something unpopular. It’s a shame that the GOP, and its intellectual leaders like Beck, Palin, and Limbaugh, have chosen to act as though tthis proposal based on what the GOP proposed in 1994, and what Heritage Foundation and Bob Dole’s group put together, is some sort of Islamofascist plot. But hey, it’s working in the polls, so who cares that we spend twice as much as any other country on the planet for health care and get worse results? What good is policy when there are four more seats in the House they might pick up?

  • mlloyd

    Formatting fail– first two paragraphs are from the link; last para, about health care, is mine.

  • Smarg

    “A clear majority of Americans now favor a full repeal of the President’s health-reform proposal.

    The latest Rasmussen poll has support for repeal of the Affordable Care Act at 63 percent, including 46 percent who “strongly favor” repeal.”

    Count me in on this one.

  • easton

    Rasmussen??? Ah yes, the Republican pollster, always handy to prove a Republican talking point.

    From Chaits blog:

    Rasmussen polling occupies an odd place in the political culture. In the conservative world, it is the gold standard. If you go to a conservative set on basically any random day, you’ll see somebody touting a Rasmussen poll. Here is John McCormack at the Weekly Standard touting a poll showing huge support to repeal the Affordable Care Act. Here is Peter Wehner at Commentary doing the same. Rasmussen frequently asks unusual polling questions that produce results almost certainly calculated to demonstrate public support for the conservative position. Rasmussen has become a right-wing celebrity. He’s the author of a conservative book. This fall he is a featured guest on National Review’s cruise, along with other conservative luminaries.

    Part of Rasmussen’s celebrity status derives from the fact that even his polls on commonly-asked questions skew strongly toward the conservative position.

    Rasmussen’s role in the public debate is problematic for several reasons. It’s not altogether clear what causes him to consistently project results so much at odds with those of the rest of the polling community. But if there is something problematic about his methods, he has little incentive to correct it, because Rasmussen’s business model increasingly relies upon maintaining the loyalty of staunch Republicans.

    Now, to be perfectly clear about this, it’s possible that Rasmussen is right and everybody else is wrong. The safest approach to using polling data is to include all results. The trouble is that Rasmussen can have such large outliers, and it polls so often, that the very inclusion of Rasmussen changes the results. The graph near the top of this item, showing level public approval for Obama, would show a steep dip if it included Rasmussen’s findings, the latest of which has Obama sporting a disastrous 42/56 approval rating.

    But the more problematic dynamic is Rasmussen’s symbiotic relationship with the conservative base. The habitual practice by conservative pundits of quoting only Rasmussen polling reinforces conservatives’ overweening certainty that they embody public opinion. It’s an important component of right-wing epistemic closure, the Republican base having its own pollster who always tells them what they want to hear. In theory, there ought to be a corrective dynamic. If Rasmussen is wrong about the 2010 elections — and, again, you can’t be certain he will be — in theory, this would cause Republicans to question their reliance upon his unusual findings. But it’s entirely possible that Republicans would simply question the validity of the results themselves. It’s massive voter fraud! Obama dirty tricks! Having heard on a daily basis that the American public had rejected the Democrats wholeheartedly, disbelieving the validity of the election results would create less cognitive dissonance.

    Of course, one solution would be for the conservative pundits who relentlessly cite Rasmussen’s findings to inform their readers that those findings, while not necessarily wrong, represent an outlier among pollsters. But I wouldn’t hold my breath waiting for that to happen.

  • easton

    By the way, as to your calls to improve Obamacare, I absolutely support any sensible option that can be shown to be an improvement, and if Republicans had chosen to be part of the process beforehand many of these things can now be law.

    As to repeal, yes, lets now throw the cancer patient out of her insurance plan, lets go back to the days where people are forced to stay in jobs that they are not as productive as they could be because of pre-existing conditions. I am sure Republican candidates can proudly point to early deaths and the money saved that would otherwise have gone into treating these flawed excuses for human beings, (don’t you know, getting sick is a moral failing)

    By the way, out of all the OECD nations, the US has the highest costs but only middling outcomes. The US pays 16%, Japan 9% and has better outcomes, even Taiwan (that hotbed of socialism, oh wait) at 6% has outcomes near the US. And what do Japan and Taiwan have in common, are they Health care libertarian paradises? No? You mean it is possible to pay less and have better outcomes? What would John Locke say? I am sure he would disapprove.

  • Ruminant

    From your article:
    “In a truly national insurance marketplace, consumers could choose to buy catastrophic-care insurance or shop for insurance plans tailored to their needs. Prices would be lowered both through increased competition and through the reduced effects of state mandates.”
    How would eliminating mandated benefits lower the cost of health care for the people who need those benefits? When the only people paying for diabetes-related insurance benefits are people with diabetes, how can their insurance premiums do anything other than skyrocket?

    For example, the average yearly health care cost for a person without diabetes is $2,560. The average yearly cost for a person with diabetes is $11,744. The source for these numbers is http://www.health.state.ny.us/diseases/conditions/diabetes/.

    Since it costs a lot of money to treat diabetes, a health insurance plan that doesn’t cover diabetes-related expenses could have lower premiums and still be profitable. Customers without diabetes would switch to this less expensive plan, because they don’t need diabetes-related benefits. The only people who would seek out diabetes-related benefits would therefore be people with diabetes (and maybe a few people at serious risk for it). When almost all of the people with diabetes benefits are people who will be using those benefits, the insurance company must charge those people the full cost of those benefits, which based on the figures above cost approximately $9,000 per year.

    So while “custom-tailored” plans will increase the premiums for people with diabetes by about $9,000 per year, the people who no longer have to subsidies those diabetes benefits will not be saving anywhere close to that amount. This is because most people do not have diabetes, and so the high costs required to treat the few people who do have diabetes was spread out among the people who do not have it.

    Now it’s true that the people with diabetes may also save money because they are no longer required to “subsidize” other medical benefits that they do not need. However, since those individual savings will be small (because the cost of those benefits were also spread out over a large group of consumers who never used them), they will still likely end up paying much higher insurance premiums than they did previously.

    Many of those people with diabetes may not be able to afford an increase of $9,000 in their insurance premiums, so they will have to switch to a plan that doesn’t offer diabetes benefits or just drop their coverage all together. Either way, the average price of insurance premiums will fall, allowing the people who supported the elimination of mandates to claim that they have solved the problem of affordable health insurance. This is essentially how Rep. John Boehner was able to claim that his proposal for health insurance reform would “help” Americans. However, I’m not convinced that society benefits by denying a minority access to the treatments they need to work and live, just so the majority can save a few dollars on their insurance premiums.

  • LFC

    Ruminant, you have just described the Republican health rationing plan quite well. Of course, they use the term “free markets” while claiming that Obama is going to kill grandma by rationing her care, but the fact is that the status quo and the few ideas Republicans put forth will ration care for the sickest people.

    Alan Grayson, while a bit of a loon, was right about the Republican health plan. If you get really sick, spend all your money and then die.

  • mickster99

    Wasn’t the Health Care Bill passed with most every amendment requested by the congressional rightwing??? Where was the congressional rightwing when this passed. They served on all the committees. The had loud voices in all the media. The idea that the congressional right wing did anything other than complain and vote “no” is ridiculous and that they will fix everything when they regain power is a willfully ignorant rant. Take a look at their Medicare plan D and other medicare legislation passed in 2003-2006 to see some true autocratic rule, incompetence and malfeasance. What boozos. Those who don’t learn from the past are doomed to repeat. We are doomed.

    http://en.wikipedia.org/wiki/Medicare_Part_D

  • mlindroo

    I find it difficult to believe Rasmussen since all the other polls indicate there is less ACA opposition now than five months ago — see this chart http://www.pollster.com/polls/us/healthplan.php

    As others have pointed out, Rasmussen’s voter sample is *VERY* biased in the GOP’s favor. While this might make sense as far the 2010 generic House ballot is concerned, pollsters shouldn’t casually ignore the ACA support of voters that are less likely to vote this year.

    MARCU$