Politics & Policy

Mission Remission

Now that we have lost the battle, how can we win the war?

Pelosicare may have passed the House, but the debate on health care is far from over. What should conservatives be doing to influence the next phase? We contacted a few of National Review Online’s health-care experts and asked them for their recommendations.

JEFFREY H. ANDERSON

As the health-care debate moves to the Senate, Obamacare opponents should emphasize that the Senate bill is not remotely moderate. It would cost $1.7 trillion in its real first decade (2014–23), according to the Congressional Budget Office — 95 percent as much as the House bill.

Two points should be hit particularly hard: One, the Senate bill would provide tremendous incentives for people not to buy insurance until they are already sick or injured — which would raise most Americans’ insurance premiums substantially. Two, it would brazenly pay for Obamacare by siphoning hundreds of billions from Medicare. The bill even says it would cut Medicare Advantage benefits, and would cut doctors’ Medicare payments by 25 percent and never raise them back up. If it didn’t follow through, it would become a massive-deficit bill.

Crucially, we should also advance — and persuade Republican senators to champion — a clear alternative. To avoid the criticism that the House GOP bill got for not doing enough to address the number of uninsured, GOP senators should basically take the House Republican bill and add a targeted tax break — finally ending the unfair tax on the uninsured (without touching employer-provided insurance or its tax status). Unlike the $1.7 trillion Democratic bill, the CBO says, the $61 billion House GOP bill would lower Americans’ premiums. The GOP Senate bill would also significantly lower the number of uninsured — and could do so in a deficit-neutral manner.

Americans’ choice would be clear: massive cuts to Medicare benefits and doctors’ payments, or none; $1.7 trillion, or one-tenth of that; government control or private control; mandates or choice; higher premiums or lower premiums. The GOP bill would accomplish more, cost less, and destroy less. It would highlight the core weaknesses of the Democratic bill while bringing Americans into the GOP camp.

– Jeffrey H. Anderson is a senior fellow in health-care studies at the Pacific Research Institute and was the senior speechwriter for Secretary Mike Leavitt at the U.S. Department of Health and Human Services during Pres. George W. Bush’s second term.

GARY ANDRES

The House bill is a target-rich environment from both a policy and a political perspective. It’s a bloated, partisan government takeover of the health-care system that doesn’t address Americans’ central concern, affordability. Moving forward, conservatives must continue to highlight its many shortcomings, including higher taxes and increased health-care premiums, a $1.3 trillion price tag, $505 billion in Medicare cuts, and a long list of new mandates. But conservatives can also confidently appeal to the most salient concern Americans express in poll after poll: how much health care costs.

On this point, the House-passed bill and the Republican substitute offer a stunning contrast. The GOP alternative makes health care more affordable; the Democratic bill makes it more expensive. This radical difference alone should be a game-changer.

According to CBO, the Republican substitute reduces premiums by 10 percent for small groups (50 or fewer employees), 8 percent for individuals without employer-based coverage, and 3 percent for those employed by large companies. CBO says the government-run plan in the Democratic bill would result in higher premiums and costs for individuals and businesses.

Reducing frivolous lawsuits and offering more choices are two other ways the Republicans apply conservative principles to contain costs. The Democratic bill fails on these fronts as well.

Conservative policies produce more affordable health care, for individuals, businesses (small and large), and the government. This should be conservatives’ mantra moving forward.

Gary Andres is vice chairman of research and policy at the Dutko Group Companies and a frequent NRO contributor.

SALLY PIPES

Conservatives must focus on the Pelosi/Obama bill, reminding Americans that this is what happens when Democrats have total power. They talk center and legislate left — raising taxes, building bureaucracy, and limiting freedom. A battle has certainly been lost, but the war may yet be won. Conservatives should highlight the absurd details of the House legislation and communicate the issue in terms that resonate with moderate Americans. The issue is too important to lose.

Conservatives must compare the massive costs of the bill to the modest benefits. Deficit neutral does not mean household-budget neutral. Democratic health reform will cost trillions, much more than the CBO estimate of $1.3 trillion.

We must remind Americans that the bills contain nothing but wishful thinking — discredited and disliked ideas — to control costs. As Thomas Sowell points out, shifting costs to taxpayers is not the same as controlling them. Price controls always lead to rationing. As for government being more efficient than the private sector, a recent 60 Minutes exposé on Medicare shows it efficiently pays $60 billion a year to fraudsters.

Most important, these people cannot be trusted to tell the truth or keep their promises. Candidate Obama campaigned on no middle-class tax increase. He lambasted Hillary Clinton for endorsing an individual mandate and McCain for wanting to tax health insurance. Today, he’s endorsed bills that will punish the middle class, tax health insurance, and mandate that people purchase a government-approved form of it or pay fines.

This all seems so obvious to those of us tracking the issue. Yet we obviously haven’t clearly communicated it to the public.

– Sally C. Pipes is president and CEO of the Pacific Research Institute. Her latest book is The Top Ten Myths of American Health Care: A Citizen’s Guide.

TEVI TROY

Ten months ago, Republicans were in despair, convinced that the golden-tongued campaigner Barack Obama was going to consign them to permanent minority status.

Now, even the New York Times wonders if the president has lost his speaking touch. As Peter Baker wrote in “A President Whose Words Once Soared,” “Mr. Obama’s addresses these days may not resonate quite the way they did. Speeches that once set pulses racing now feel more familiar.”

His campaign skills did not prevent Democrats from losing the two most high-profile races of election night 2009, for governor of New Jersey and of Virginia. Democrats are making much of the New York 23 race, but it seems clear that the conservative candidate would have won that as well if not for some last-minute sabotaging by the liberal Republican who had withdrawn a few days earlier.

In addition, the president’s vaunted organizational skills, which helped him secure the nomination over the favored Hillary Clinton and a relatively easy general-election win over John McCain, have often failed him in even basic White House tasks like ensuring that cabinet nominees had paid their taxes.

From a policy perspective, House passage by no means guarantees or even foreshadows Senate success. Witness the cap-and-trade bill, which lies dormant, with limited prospects in the Senate. As for the narrowly passed health-care bill, Lindsey Graham has declared it “dead on arrival” in the Senate.

The Congressional Budget Office can be invaluable for analyzing the various Democratic plans, highlighting their high costs, increased taxes, and unrealistic assumptions. Meanwhile, the Republicans came up with a plan that would have reduced insurance premiums, which the CBO dutifully noted. If the GOP plan had done a better job of reducing the number of the uninsured, it might have even put a scare into the House Democrats. The Republicans did win on an abortion amendment, and the ability to offer amendments is far more limited in the House than the Senate.

Republicans need to keep pushing. At best, they will stop a disastrous bill. At worst, they will have shown voters that Democrats had every opportunity to address their plan’s flaws, but chose not to.

– Tevi Troy, who was deputy secretary of health and human services from 2007 to 2009, is a visiting senior fellow at the Hudson Institute.

GRACE-MARIE TURNER

Confusion has reigned in the health-reform debate. The American people were assured by President Obama that their health costs would be lower and that they would be able to keep the insurance they had. Now they hear of independent analyses that show just the opposite — that their health costs will rise and that more than 100 million people could lose the coverage they have now.

Many don’t know who to believe, especially since coverage of the debate is obscured by bewildering terms like “public option,” “guaranteed issue,” and “sustainable growth rates.” All the while, people are being told it’s too soon to form an opinion because no one knows yet what’s going to be in the bills.

Well, we do know. The House bill is a federal takeover of our health sector, as evidenced by the 118 new programs and bureaucracies it will create, and the Senate bill will be cut from the same cloth.

Our job now is to slice through the jargon and the false promises to explain and show the American people what this legislation would mean for them: higher health-insurance costs; higher taxes on the middle class as well as the rich; less freedom of choice in health coverage; job-killing mandates on employers; federal mandates that everyone must have expensive health insurance or face penalties and even jail time; cuts in Medicare; a dramatic expansion of entitlement programs; and burgeoning deficits.

– Grace-Marie Turner is president of the Galen Institute.

CHARMAINE YOEST

What’s next? The answer for us moving forward is all about mobilization. Pro-lifers may not currently hold any of the official centers of power, but we do have the power of compound interest. That’s what Twitter and Facebook and the forward button on e-mail letters give us.

The abortion lobby may be strikingly out of touch with the American people, but it does have the votes to pass its vision of “health care.” The only way to counter this overwhelming firepower in terms of votes is to give voice to that gap between the lobby’s vision and what people really want. By making use of today’s technology, we can leverage our resources to spread information quickly. Nancy Pelosi allowed a vote on the pro-life Stupak-Pitts amendment partly because pro-life America made its outrage over federal abortion funding impossible to ignore, melting down the phone lines into Capitol Hill and flooding district offices too. Americans United for Life was inundated with people asking, “What should I do next?” after they had called, e-mailed, and called again. We have to continue to mobilize and focus that passion as this battle shifts to the Senate.

– Charmaine Yoest is president & CEO of Americans United for Life.

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