The Morning Jolt

Health Care

Kamala Harris Is Already Backtracking on Health Care

Sen. Cory Booker and Sen. Kamala Harris confer during the confirmation hearing for Supreme Court nominee Judge Brett Kavanaugh, September 4, 2018. (Chris Wattie/Reuters)

Making the click-through worthwhile: Kamala Harris suddenly changes her mind on eliminating private insurance; many in the Senate GOP say that they have no interest in another government shutdown and won’t support the president if there is one; and Georgia Democrat Stacey Abrams is cursed to give the response to the State of the Union address.

Kamala Harris Retreats on Banning Private Insurance

Kamala Harris pulls an Emily Litella: “Never mind.”

By stating she would eliminate private insurers as a necessary part of implementing “Medicare-for-all,” California Sen. Kamala Harris during a CNN town hall Monday night sent a shockwave through the national health care debate.

. . . As the furor grew, a Harris adviser on Tuesday signaled that the candidate would also be open to the more moderate health reform plans, which would preserve the industry, being floated by other congressional Democrats. It represents a compromise position that risks angering “Medicare-for-all” proponents, who view eliminating private health insurance as key to enacting their comprehensive reform.

The effort to enact Medicare-for-all would not look like a rerun of the passage of Obamacare. One of the reasons Obamacare passed was because health-insurance companies bought into the idea, seeing it as a bonanza of new customers — literally, the government would require you to purchase their product, or pay a fine in the form of a new tax. (Even after the Supreme Court ruled that the penalty was constitutional because it was a tax increase and not a criminal penalty, the Obama administration and its surrogates continued to insist that it was not a tax increase. In short, it was a tax increase when they wanted it to be one before the court, but not a tax increase when they didn’t want it to be one on the campaign trail.) After several years of insurers leaving the exchanges, 2018 was a pretty good year for insurers.

In any given year, the insurance industry spends anywhere from $140 million to 168 million on lobbying alone. In the 2018 cycle, Blue Cross/Blue Shield spent $18 million, Cigna Corp. spent $7 million, the industry group America’s Health Insurance Plans spent $6.7 million. That’s separate from the hard-money donations of the industry to political campaigns; nearly $3 million from Blue Cross/Blue Shield, $1.7 million from AFLAC in the past cycle.

Much like “the Green New Deal,” “Medicare for All” is a brilliantly selected phrase that picks two things that people like and mushes them together, whether or not it accurately describes what the program would do. Medicare is generally popular, and people like the idea of something that they like being extended to everyone.

The Kaiser Family Foundation found that if you tell respondents, “Some argue this would give the government too much control over health care,” support drops by 21 percent! Saying it would eliminate the Affordable Care Act drops it 13 percent, and that it would require higher taxes drops support by 19 percent. In other words, people love Medicare-for-all until they learn what it actually would require.

Kamala Harris is selling the idea through the same slogans and bromides as Obama did back in 2008. A bit more than ten years ago, Tom Brokaw asked the presidential candidates if health care was a right, a privilege, or a responsibility.  Obama answered:

I think it should be a right for every American. In a country as wealthy as ours, for us to have people who are going bankrupt because they can’t pay their medical bills — for my mother to die of cancer at the age of 53 and have to spend the last months of her life in the hospital room arguing with insurance companies because they’re saying that this may be a pre-existing condition and they don’t have to pay her treatment, there’s something fundamentally wrong about that.

(By the way, Obama’s mother did not fight with her insurance company about a preexisting condition. A biography of Ann Durham published in 2011 revealed that the insurance company covered her medical treatment; Durham fought with the insurance company about disability insurance, intended as a replacement for lost wages.)

At the CNN Town Hall, Harris declared, “We have to appreciate and understand that access to health care should not be thought of to be a privilege. It should be understood to be a right.”

Treating health care as a right is a wonderful concept that is exceptionally difficult in practice because everyone needs it; asking the government to pay for all of the health care needs for every citizen inevitably leads to long waits as demand overwhelms the supply in efforts to control costs that involve the government restricting care in some way. Pick your flaws: Do you want the current system, where patients complain about co-pays or deductibles? Or do you want a system where the government pays, but because of high demand and limited supply, you have to wait for care, and the government gets to veto treatments it deems too expensive or not cost-effective? Harris describes her plan as if the government will cover any treatment you want at no cost to the patient, as quickly as you like.

That’s not the way it’s worked in Canada. Up north they’re celebrating the fact that the wait time for consultation with a specialist is only about nine weeks, and the wait for treatment from that specialist is eleven weeks. It’s “only” a four-week wait for a CT scan, about the same for an ultrasound, ten-and-a-half weeks for an MRI scan. More than a million Canadians are waiting for treatment at any given time.

Finally, don’t let anyone tell you that Harris isn’t backtracking. Do you see any openness to keeping private insurance in this answer at the CNN town hall?

TAPPER: So for people out there who like their insurance, they don’t get to keep it?

HARRIS: Well, listen, the idea is that everyone gets access to medical care, and you don’t have to go through the process of going through an insurance company, having them give you approval, going through the paperwork, all of the delay that may require. Who of us has not had that situation, where you’ve got to wait for approval, and the doctor says, well, I don’t know if your insurance company is going to cover this? Let’s eliminate all of that. Let’s move on.

Senate Republicans: We’re Not Going to Get Dragged into Another Government Shutdown

A little while back, Dan McLaughlin observed that if you’re going to have a government-shutdown fight, you need to go in knowing exactly what your negotiation priorities are and how long your congressional allies are willing to stand with you.

In the case of President Trump, Senate Republicans aren’t willing to stand with him at all.

Republicans are in no mood to be dragged back into another partial closure in mid-February, the deadline to get a deal on spending for roughly a quarter of the government.

Senate Majority Leader Mitch McConnell (R-Ky.), modifying a well-known quote, told reporters Tuesday that “there certainly would be no education in the third kick of the mule.”

“I don’t like shutdowns. I don’t think they work for anybody, and I hope that they would be avoided,” McConnell said. “I’m for whatever works, which means avoiding a shutdown and avoiding the president feeling that he should declare a national emergency.”

Sen. John Thune (S.D.), the No. 2 Republican in the Senate, characterized a shutdown as a “pox on all of our houses.”

“I think the leader wants to see a result come from this,” said Thune. “There’s no appetite for government shutdowns and there is not much appetite for an emergency declaration for a lot of reasons.”

In other words, if there’s no deal on border-security funding, many Senate Republicans will vote for a spending bill that doesn’t include it.

Back on December 20, I wrote that Trump had already functionally surrendered on the wall. I was told by Trump fans that I was wildly premature in that assessment, that he would get it by forcing the Democrats to make concessions to end the government shutdown.

Well, here we are.

Stacey Abrams Gets Selected as This Year’s Sacrificial Lamb

Sure, Stacey Abrams is a “loser” in the sense that she didn’t win the 2018 Georgia governor’s race. But Republicans shouldn’t chuckle too loudly; that was the best performance by a Democrat in a statewide race in the Peach State in many years.

No, the more interesting question is why Democrats would doom a woman that they think is a rising star by sending her to the cursed task of responding to the State of the Union. Really, almost everyone who does it ends up having some terrible setback or defeat in their careers. It’s the political equivalent of the Sports Illustrated cover jinx or “the Madden curse.”

As for the notion that speaking for about 15 minutes before a national-television audience makes stars . . . last year the response was given by Congressman Joe Kennedy III. Heard much about him since?

ADDENDUM: Let’s say you think Kamala Harris’s policy of jailing parents of kids who are truant is not such a bad idea.

Do you think a child arriving 30 minutes late to school more than three times warrants a “truant” label? Do you think it warrants a $2,000 fine?

Do you think the problem of a chronically truant child is helped by locking up a mother for 20 days? Or in another example, 180 days?

Does that strike you as problem-solving, or a prosecutor chasing headlines?

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