Sunday, September 6, 2009

$30 billion

There's been a lot of attention in the news media devoted to the far-Right extremists and nutcases, upset with health care reform (and the President giving pep talks to young students). Birther, Deathers, and Tenthers.

My concern, though, is that the Center is failing. The antics of Glenn Beck and Lou Dobbs are symptoms of a failing elite Center -- for one thing, the elite Center, which includes the corporate executives, who head major Media corporations, are unwilling to fire Lou Dobbs or Glenn Beck. The University of California will not fire torture lawyer John Yoo, let alone uber-econ-hack Lee Ohanian.

The trick in all politics, as I learned from Stirling Newberry, is to create a coalition of the sane, decent and rational against the crazies. And, key to such an elite coalition is a moderate Center of pragmatists, concerned with what is possible, what works. Barack Obama presents himself as the embodiment of such a Center.

The danger is that such a Center does not hold, that the Center lacks all moral conviction, abandons all intellectual effort for complacency and corruption.

That's what I see looming in the fate of health care reform. Not reform killed outright, by the extremism and nuttiness of the Right, but health care reform killed by the corruption of the Center.

Ezra Klein - What If They Had a Health-Care Reform Bill and Nobody Could Support it?:
"I'm firmly on the record as being willing to support all manner of compromises on health-care reform. Policy dogmatism has not, over the long history of this issue, proven a successful strategy. But there's an increasingly evident path by which health-care reform begins to hurt the very people it's meant to aid. . . . , making health-care reform affordable for the centrists in the Congress could make it unaffordable for the people.

The basic structure of the bill has three main planks working in conjunction with each other: The individual mandate creates a mechanism for a universal, or near-universal, system. A universal, or near-universal, system creates the conditions for insurance market reform. The subsidies make the individual mandate affordable for people to follow.

There are a few ways to destabilize this system. The most likely way is to reduce the subsidies so that the individual mandate isn't really affordable.

The happy news is that the difference between a plan with decent benefits that's affordable for people and a plan that's not affordable for people and doesn't offer decent benefits is not that large. Optimally, you'd want to spend about $1.3 trillion over 10 years. You could probably do it for $900 billion to $1 trillion. But you can't do it for, say, $700 billion, which is a number I'm hearing fairly frequently.

The difference between doing this right and doing this wrong is, in other words, about $30 billion a year, or $300 billion over 10 years. To put that in perspective, many of the legislators who are balking at the cost of health-care reform voted for the Kyl-Lincoln bill to reform the estate tax at a cost of $75 billion a year, or $750 billion over 10 years."

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