But once that number entered the process, it began guiding the process. Sources on the Hill aren't really clear how the sum transformed from an estimate of the president's plan to a hard limit for their plan. Few recall that the original language included the qualifier "around." Even so, the number stuck. It strengthened the hand of moderates in both chambers and allowed them to create a ceiling. It also seemed clear that if the White House was comfortable with $900 billion, then it wasn't going to fight to protect the spending in any bill that exceeded that cap, so there was no point in the liberals bothering to push the issue.
The problem is that the number, which was chosen at a point of political weakness for health-care reform and the Obama administration, is too low. Most experts think you need closer to $1.1 trillion for a truly affordable plan. Limiting yourself to $900 billion ensures that the subsidies won't be quite where you need them to be, and means that virtually every spare dollar has to be spent strengthening them. If you want to add $30 billion to the bill creating coordinated care teams across the country -- a project that could transform chronic care in this country and eventually save many times its start-up cost -- there's little budgetary flexibility even if you could find the revenue, because each dollar is in a zero-sum competition with each other dollar so the entire plan comes in under the limit.
One hates to be a concern troll, and far be it from me to tell progressives how to run their programs. But it seems to me quite obvious how the number got picked and why it became a hard limit: it would be very difficult to sell a bill that's any bigger. A health care bill much bigger could be plausibly rounded up to a trillion dollars by the opposition, and though the American public is still somewhat blinded by sticker shock from the last eight years of deficits, $1 trillion still sounds like a lot of money. It also sounds like the highly unpopular bailouts.
Maybe Democrats could have passed a bill that cost $1.1 trillion, or more--cobbling together coalitions by spending freely on goodies is a time honored tradition. The problem is, the Democrats already spent a trillion dollars on goodies. That adds constraints from both voters and the bond markets. So I think a $1.1 trillion dollar bill, while making it easier in some ways to build a coalition, would have risked a voter backlash that would have rendered passage impossible. Health care can't lose too many percentage points off its approval rating before it becomes too radioactive to pass no matter how many wonks, lobbies, or narrow demographic segments like it.
Eh, I doubt it matters. You can only put so many different colors of lipstick on a pig. (Maybe they can just start the costs in year eight.)
Meanwhile, support is plummeting.
They can't sell this bill at $900 billion ... exactly how could they sell a bigger one?
This bill hasn't passed. And it's not going to pass. Democrats don't even want it to pass.
And the reason is simple: Barack Obama's was a failed presidency, and he's making jobless any politicians who stands with him - much in the same way he's made many in the country jobless.
Here, the Associated Press laments the Obama Malaise" that has settled over the country ... reminiscent of the national mood that accompanied the failed presidency of Jimmy Carter.
http://www.breitbart.com/article.php?id=D9BTBTVO0&show_article=1&catnum=0
Here, the Gallup Poll demonstrates with stunning clarity what will happen to any politicians who stand with Obama. Independents are breaking for Republicans in the 2010 Congressional races by 22 percentage points.
http://www.gallup.com/poll/124226/Republicans-Edge-Ahead-Democrats-2010-Vote.aspx
There's still time for Democrats in the House and Senate to distance themselves from Obama by protecting the country from him, but that time is quickly running out.
Otherwise, I'll see you Blue Dogs down the unemployment office. I'll show you where you fill out paperwork for food stamps.
So what you're saying is, incumbents poll poorly between elections and don't do great in off year elections? Shocking!
(Admittedly, Obama looks to be worse than most. But still, "permanent" in politics is usually about a year and a half. Obama's got a lot of time left. )
I'm not saying anything. On the contrary.
Polled voters are saying that Barack Obama has the country on the wrong track. Independent voters who elected Barack Obama are telling Gallup they intend to fire Democrats who follow his lead in destroying manufacturing jobs in the United States.
Emerson’s Farr Says U.S. Is Destroying Manufacturing
http://www.bloomberg.com/apps/news?pid=20601103&sid=a_EbBQyskKl0
But you keep fucking that chicken.
Anyways the $900B is a lie. They only get to that by moving the costs back and pretending to cut Medicare.
The real 10-year cost is closer to $2T.
Megan: I think you're right that the White House was trying to avoid the trillion dollar price tag and accompanying sticker shock. But I think the vast bulk of the public is sufficiently innumerate not to get worked up over a bill that costs, say, $1.2 trillion, especially when critics are going to round up, and label a (say) $934 billion bill as "a trillion dollar bill" anyways. I mean, with so little at stake politically, why not go for the one that buys you the most votes over the long term?
I think in the end, Obama has the eminently plausible excuse that he's not a dictator, and that he has to deal with a co-equal branch of the government. Lacking a line item veto, his only choice, he'll explain to voters, is to either accept a bill larger than he wants (stifle your laughter) or deny the American people this wonderful expansion of social insurance. And he's obviously not going to do the latter.
Most voters are blind to the varying sub-groups within the Democratic party in the House and Senate. All they see are substantial Dem majorities in both.
For Obama to claim that he couldn't get his own party to do as he wishes will seem either far fetched or incredibly weak.
Well, it's certainly not far-fetched, it's the truth: Congress zealously guards its prerogatives. And good for them for doing so, because in fact they are a co-equal branch. This isn't just some gauzy constitutional hypothetical.
And in getting HCR passed, I think the charge of "weakness" is going to be the last of his worries, given the fact that he'll be getting something done that Teddy Roosevelt, Franklin Roosevelt, Harry Truman, Lyndon Johnson, Richard Nixon, Jimmy Carter and Bill Clinton all failed to do.
But all this is pretty irrelevant, politically. I mean, are folks like you going to sing Obama's praises if he manages to bring in Evil Socialist Healthcare at only $900b? Of course not. The people who oppose this expansion of government power will oppose it, and oppose Obama, no matter what side of the trillion dollar mark it falls.
Of course, if, as is likely, the ultimate bill is Senate-ized, this whole discussion is likely to be academic, as we mostly likely will be looking at a sub trillion dollar piece of legislation.
The geeks, like those of us who debate here, don't care much which side of a trillion it falls on. The average voter does. Why do you think all those prices in stores end in a 9?
"Obama has the eminently plausible excuse that he's not a dictator"
Oh that he were, though...
Zelaya had a neat way around that. Ortega, too.
Old hat for Chavez, of course.
I thought that at 900b the bills proponents could argue that the bill is revenue neutral. Now, everyone can (and do) argue about the math, but at least there is some semi plausible argument of "This is so much better and doesn't cost anything". Meanwhile, if even the bills proponents agree that this bill is going to cost a fair bit, than it plays badly with all the voters who are concerned about the levels of debt/deficits.
Obama wasted his "responsible spender" bonafides early in his administration --
if voters believed he was a judicious steward of their tax dollars, he might have been able to make a case for an effort with a bigger price tag.
Obama has only himself to blame for making voters price tag sensitive.
I wonder if he could reverse it by redirecting the unspent stimulus money to health care reform. Easy speech "As I said before, that bill was important to stabilize the financial system. Now that the crisis has passed, we need the money to clean up other messes left by the previous administration."
it would be a brilliant political move with respect to average voters nationally.
the problem is that the stimulus was a huge pile of congressional pet projects, handouts and payoffs. To take them back would be to really hack off 99% of the Dem caucus.
The answer is that it was of course a terrible idea to put a cap on the price of the health care bill. Health care is a good thing and thus spending more on it is always better. Saying that you won't spend more, on the other hand, is evil.
Clearly, this was the result of nefarious machinations by the venal Republicans, that's the only explanation. Possibly they drugged the President's tea and used mind-rays to have him mouth the $900B figure.
Frankly, to get a truly cost-effective bill, one that will lower the cost curve, rationalize care, pick up the uninusred and dramatically lower costs for the rest of eternity while delivering exponentially better standards of care to everyone, we should really be spending upwards of $2T on this thing. Possibly more.
The savings that would materialize would more than offset the price tag. Heck, we'd already be living the dream if we didn't persist in pretending to care what the half the country that disagrees with progress has to say about it.
I was particularly struck by this from Ezra: "Most experts think you need closer to $1.1 trillion for a truly affordable plan."
Damn. I was hoping they'd spend at least $3 trillion, to make it really affordable. Does "affordable" become "profitable" before or after you reach $5 trillion?
Shelby beats me to the punch! The logic is bizarre.
Shelby beats me to the punch! The logic is bizarre.
No it's not. Shelby is being disingenuous. You're apparently just being dense. Klein was obviously referring to affordability from the standpoint of people mandated into buying health insurance.
Let's just say that "affordable" has multiple meanings and Ezra is not being very careful about distinguising them.
Focusing on "affordability" questions for those being subsidized while ignoring the "affordability" questions for the government itself would seems to be more disingenuous.
Extending Ezra's nomenclature, a completely affordable system would require only about 16% of GDP.
H. Protagonist -- I think you don't understand how government provision of vital services works.
See when an individual pays for something out of his own dwindling pile of cash, it must be cheap to be affordable or else it is cruelly denied him by the heartless vicissitudes of the market.
When the government provides it for him or grants him a subsidy to help him afford it, that money is magical government money that is limitless & free and thus the entire concept of "affordable" is a red herring.
That's why it's always just plain mean to say that we can't or shouldn't have the government give more things to more people, it's like saying Santa Claus should operate on a budget. It makes no logical sense.
jasper --
once you get to a price tag that high, implying that subsidies would be available for people in the middle class--
yet funding such a program would require broad based taxes, and that means middle class people.
aren't you just taking taxes out of their left pocket to stick a health care subsidy in their right pocket?
it would sure seem more efficient to let middle class people keep the money in the first place
I don’t think you even have to do any “round[ing] up” to show that the bill is going to cost way more than a Trillion dollars since (a) most of the proposed “savings” from provider reimbursement cuts that were criticial to making the bill "deficit neutral" are being undone in a separate bill that was introduced by Speaker Nancy Pelosi and (b) the health care bill is being phased in over three to four years so that the CBO’s 10-year score only shows about 6 or 7 years when the program is implemented right before the costs explode.
One thing that bears repeating: Democrats did not lose Congress in 1994 because they failed to pass HillaryCare. Democrats lost Congress because they dared to even consider passing HillaryCare.
Since the healthcare bill debate began this summer, Gallup has the GOP steadily gaining, and this week moving into 1994 levels of support. If the increasingly unpopular bill is actually passed, one has to wonder just how huge the backlash would be. It might actually be repealed before it took effect.
Yeah, right. Who are you kidding? It's like your favorite thing in the world.
In my view, the $900 billion number plays a positive role in the current debate. It will function as an anchor for the last stages of the negotiations, when the temptation to bloat the bill by bribing the last few votes in the House or Senate will be very strong. It's likely that the final number will exceed $900 billion, but it won't be by much.
Punditry is a wonderful thing.
Yeah, Megan, we can afford trillions for bank bailouts and wasteful foreign wars, but we have really got to watch our pennies when it concerns UHC, eh? it is unfortunate that Obama had to spend a trillion bailing out the banks and then another trillion trying to fix the economy after the bankers and the Republicans fooed it up , but there it is.No money left over to extend coverage to the uninsured.
Ezra is right on this. Instead of getting a good bill, we are just getting a bill based on what some DINO thinks is a "good number"-a number that looks "economical" even if it is not based on any rational plan whatsover. The same thing was done with the stimulus package. It was cut by $100 billion bevause the otherwise the costs of the bill would seem "unreasonable" . No reason was given why the final estimate of the bill was any more "reasonable" then the previous amount, but that didn't matter.
The result? A lousy stimulus and 10.2% unemployment. Thank you,republicans and Blue Dogs. I see the same logic being applied to UHC.
Damn, why the hell couldn't we call getting UHC a war or something like the the Health Care Defense Program? Then the sky would have been the limit, not some arbitrary $900 billion limit.
Nobody said we could afford those things, and the American economy IS paying the price for those wasteful wars and bailouts. You seem to think that because we've already cut off our nose, why not cut off our ears and gouge out the eyes too? Insanity...
You are confusing normative with positive argument.
I agree. Let's spend and waste forever in big ways, but just on liberal,populist issues going forward. Who needs change anyway??
My favorite statement on this issue comes from Yglesias.
"By far the fastest way to end the war in Afghanistan would be to ask General McChrystal’s staff to produce a plan to make it deficit neutral and find sixty votes in the senate for his financing plan."
I have yet to see Megan or any other conservative argue that we should place any limit on defense or war spending for any reason, (least of all budget deficits)and I don't suppose I ever will.
I never expect to see titles like
"Defense spending increases-can we afford them?"
"The war in Afghanistan-are we robbing our children to pay for it?"?
"Do excessive bank bailouts lead to bubbles?"
The Dems were just helpless to stop the headlong rush to disaster. If only they had control of Congress a couple of years before the collapse, I'm sure they would have stopped all the bad things.
Oh, wait...
If only they had control of Congress a couple of years before the collapse, I'm sure they would have stopped all the bad things.
If they had veto-proof control of Congress, you'd have a point.
What fixes did the Dems pass that Bush vetoed?
Yes, I remember when Barney Frank warned us Fannie and Freddie were in trouble... oh wait, no, he said Fannie and Freddie were fine and all this talk of risk was designed to hurt the poor.
Putting the Dems in charge was like saying "Hmmm, Dad's weaving a little, better let the dog drive."
This was not such a bad political calculation, or much of a limiting factor, when you consider all the ways Democrats are fudging the numbers to get under it. Pulling things out of the bill to pass separately, gaming the forecasts with a delayed start, and including phantom future cost savings, have allowed them claim it can be done for less than $1 trillion. What a bargain! And what a fiscally responsible party!
How old is Klein? The naivete he displays on a constant basis would lead one to think he was born yesterday, or last month at the earliest.
Eh, the lefty bloggers just don't see much data from the right of the MSM (and instinctively discredit any such heretical notions that do somehow leak into their worldview) so there are generally huge gaps in their understanding of the world.
People on the center-right by and large don't have this problem, because you really can't escape the center-leftism of the MSM and educational system.
It doesn't matter because:
THE REVOLUTION WILL BE APP'D
http://naturalfake.wordpress.com/2009/11/11/the-revolution-will-be-appd/
I think the problem with Ezra is that he really, really cares about health care. He has studied the issue, has the numbers, and hoped that the so called "world's greatest deliberative body" would pass a health care bill after informed debate, based on rational factors.
However, the reformers didn't say , " What would be the best health insurance plan for the USA" and try for that. Instead the backers of reform negotiated with themselves, set limits based on the idea that the Republicans would negotiate in good faith, and dragged their feet hoping for a "bipartisan bill".
Mean while , the opponents released a giant flood of misinformation ("death panels!", "government takeover!", "socialized medicine!" , "Hitler!", " good people like Stephen Hawkings will die if health care reform is enacted!").
This poisoned the debate so that there is no real chance that a rational universal health insurance plan can pass. If we were rational, for example, we woulds pass a bill with a robust public option, since that would save money and deficit reduction and cost control is now supposed to be paramount. But nope, it turns out it's more important for there to be no public option than for there to be cost control. Rationality goes out the window when conservative ideology comes in. Ezra sees this happening repeatedly, which is why you are seeing him getting so pissed at what's happening.
The $900B limit is more of the same. Why $900B? Obama should have just said, "We'll pass the best bill we can , and then figure out the limits".
Instead, he set a pre-existing limit, hoping that some Repubs would come on board and give him credit for being " reasonable". Result? NO Repubs came on board, and we are now committed to a bill that's less affordable for consumer. Hell of a job, "reformers".
The Dems have a majority. The Repubs haven't filibustered anything. The only reason to be "bipartisan" that I can see is for the Dems to cover their butts in 2010.
"set limits based on the idea that the Republicans would negotiate in good faith". You're joking. Or buying propaganda whole. These bills and anything like them are light-years away from what almost all Republicans and conservatives want. If you want to really "reach across the aisle", make suggestions that the other side of the aisle can be expected to tolerate.
"If we were rational, for example, we woulds pass a bill with a robust public option, since that would save money and deficit reduction and cost control is now supposed to be paramount." Uh, no. It will only save money if you stop paying for things, and no Democrat is willing to do that or admit it. Otherwise it ends up costing much more.
"Instead, he set a pre-existing limit, hoping that some Repubs would come on board and give him credit for being " reasonable"." Uh, no. He set a limit, knowing that the American people expect fiscal discipline right now. Not that this is it...
the Dems could have very, very easily created a bill that would have siphoned off 10-20 Rep house votes and 5-8 Senate votes by including meaningful medical tort reform.
Usually compromise means giving up something important to get something important.
Dem Congressional leaders, nor Obama ever made it a priority. Why? Because "bi-partisanship" was a marketing slogan they never intended to seriously pursue. They calculated that they had the votes without a single Republican vote, and thus, any serious bi-partisan compromise was unnecessary.
Had they included med malpractice in the bill? This would have been passed three months ago.
Let's be brutally honest.
Ezra and people like him are looking for a way to achieve redistribution, and health care happens to provide the most effective emotional propagandist hook to achieve that end.
What he wants the extra whatever billions spent for is -- precisely -- more redistribution.
This, mind you, is to reward people who won't pay money to insure their own children.
When he says that people earning $66K -- $88K -- whatever number he wants -- can't "afford" to insure their own children, you wonder how people who aren't earning that much can -- and do -- deny themselves whatever the hell the $66K or $88K crave more than insuring their own children.
Let's be brutally honest: You seem to think that "paying to insure your children" is the equivalent of "not providing health care" for your children.
You do realize that you've been successfully brainwashed into believing that "buying insurance" = "providing health care." Insurance agents the world over rejoice at your ignorance.
My kids are not covered by insurance. I, and many billions of other people on the planet believe that insurance is morally wrong. Muslims, for example, believe that insurance is gambling and their Koran forbids its purchase. Mennonites believe insurance is immoral and forbidden by the Bible. As do the Amish.
Insurance is not health care and never will be. Not buying insurance is perfectly normal.
Forcing people to buy insurance is immoral and against many people's religious beliefs. So, if you support it, then you support forcing your religious beliefs onto other people ... which is an attitude that will come in really handy once the Muslims try to force Sharia on you and put your wife into a burqa.
Let's be brutally honest: You seem to think that "paying to insure your children" is the equivalent of "not providing health care" for your children. You do realize that you've been successfully brainwashed into believing that "buying insurance" = "providing health care." Insurance agents the world over rejoice at your ignorance.
It's not ignorance. Robust insurance coverage and healthcare are effectively the synonymous, unless one is wealthy, or one wins the DNA and accident lottery and never has a serious ailment or injury. You might like playing craps with your health and your finances. Most people don't.
My kids are not covered by insurance.
Fortunately for them, they soon will be.
Forcing people to buy insurance is immoral and against many people's religious beliefs.
Not it's not. I'll tell you what is immoral: allowing children in the world's richest nation to go without health insurance.
most people are not expensive health risks by default. breaking your arm can be paid off in installments.
health insurance is not in fact the only possible way to pay for health care. nor is it actually stupid or dum to pay out of pocket.
what is immoral is telling families to shell out thousands in premiums on basic care that costs 100s out of pocket. a complete annual exam is perhaps 500 dollars. you don't need 'insurance' to cover that. if something is found, even with tests, it is usually (again, speaking of those aggregates) also not v. expensive.
having saved a fortune in premiums by paying for well-woman care out of pocket (went from 2k/yr in premiums to 300-400 cash/yr, including bloodwork), i think it is absolutely monstrous that people keep insisting that health insurance is the One Way to pay and that the gummit has to also be The One Provider.
''Most experts think you need closer to $1.1 trillion for a truly affordable plan. ''
When did borrowing money make something more affordable? This is the flaw of Keynesian economics. Money borrowed is not money earned. If we borrow $1.1 Trillion dollars to fund a program it can't be more affordable than a $900 Billion dollar one.
Yeah, throwing money out the door didn't work too well for Zimbabwe.
Obamanomics: we elected an African-American President, and he's bringing the African economic model to America.
"When did borrowing money make something more affordable?"
They're not borrowing. The Federal Reserve is unable to find borrowers in the numbers required to support Barack Obama's spending.
So, it is buying Treasury notes itself, with money it prints. That's not borrowing.
And for those that think that Ezra meant more affordable to the taxpayer. Funding a program with interest only debt (that is what T-bills are) and tax increases does not make anything more affordable it makes it more expensive.
And while I'm venting here when did $900 Billion become 'revenue neutral'
The dems are using the language of conservatives like 'competition', 'revenue neutral', 'bend the cost curve', etc. But that's all they are is just words. The legislation does nothing of the sort.
On the other hand, I would rather a $900 billion dollar program exceed cost estimates than a $1 trillion dollar one.
Either number is pure fiction once the implementation starts.
Stonetools: I think the problem with Ezra is that he really, really cares about health care. He has studied the issue, has the numbers, and hoped that the so called "world's greatest deliberative body" would pass a health care bill after informed debate, based on rational factors.
Exactly! I do not get the sense he fully realizes that real, imperfect, emotional, selfish, greedy and irrational people will be implementing any solution. This is not an academic exercise.