Going for health-care gold: Who's got the better game plan?

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By Matt Miller
Wednesday, February 24, 2010; 11:14 AM

"Welcome back. I'm Bob Costas. The Health Care Hoax and Hypocrisy competition is always a fierce battle, but as the world gets ready for the televised finale Thursday, Republicans clearly have the edge. For a preview of the action, here's NBC's Brian Williams at Blair House."

"Thanks, Bob. As both teams huddle to map strategy for the finals, GOP intransigence is at an all-time high. Start with the uninsured. Today they number nearly 50 million. President Obama and the Democrats have a plan to cover 30 million. Yet Republican leader John Boehner's plan would cover just 3 million by 2019. That's not a typo, Bob, that's 3 million versus 30 million. It's a stunning break with some previous Republican game plans. George H.W. Bush put out a plan in 1992 that would have covered 30 million of the then 35 million uninsured. Mitt Romney passed near-universal coverage in Massachusetts a few years ago. And Bob Dole, the team's 1996 champion, joined Howard Baker and Tom Daschle last year to offer a bipartisan plan to cover every American at a cost of more than $1 trillion over 10 years -- more than Obama's new proposal would spend. So clearly the GOP's 2010 team has simply decided not to compete on the uninsured."

"Do we know why, Brian? After all, $1 trillion over 10 years is less than 1 percent of GDP."

"Bob, as one top Republican told me, the uninsured aren't their voters. This just doesn't put points up on the board for them."

"Some seniors are asking about Obama's Medicare cuts, Brian -- what should they make of them?"

"This gambit alone could get the Republicans another gold, Bob. Consider these facts: Medicare this year will spend around $500 billion. Under the Democrats' plan, it will spend around $860 billion in 2019. Calling that a 'cut' takes some chutzpah. What it means is that instead of Medicare growing 6.6 percent every year, as now projected, it'll grow 6 percent. Given America's waste-ridden health-care system, the idea that this tiny slowdown will hurt anyone is crazy."

"But haven't Democrats used this Medi-scare play, too?"

"Great memory, Bob. In 1995, Democrats crushed Newt Gingrich and took the Hypocrisy gold with the same come-from-behind move. And make no mistake: Democrats may not be as primed this year as the GOP, but they still hope to make a solid showing tomorrow when it comes to pandering to special interests in ways that poison sound policy."

"Tell us what we should look for."

"Well, the absence of real malpractice reform is exhibit A. One senator tells me the trial bar's campaign cash bought that little omission pure and simple. That kind of corrupt transaction may look easy, but it only comes after years of practice and hard work. The really impressive cave, however, is on financing. Coaches on both teams agree that making employer-provided health benefits taxable is the only way to create incentives for cost control. To his credit, John McCain pushed this issue in 2008. But Democrats have outdone themselves. By bowing to union leaders who negotiated generous benefits and who thus couldn't stomach this change, they've ironically guaranteed that millions of workers may never see wage increases again, because employer cash is being gobbled up by soaring health costs. I've been around this game a long time, and believe me, getting workers' support while shafting them in ways they don't understand is not easy to pull off."

"So what's the bottom line for Thursday?"

"Bob, the grand bargain we need on health care requires Democrats to accept the existence of a private insurance industry and Republicans to accept the need to help everyone buy a decent policy. It's about liberals agreeing that innovation shouldn't be regulated out of U.S. health care, and conservatives agreeing that justice has to be regulated into it. And here's a fact we should get up on the screen: The uninsured may seem invisible, but today their ranks are equal to the combined populations of Oregon, Oklahoma, Connecticut, Kentucky, Iowa, Mississippi, Kansas, Arkansas, Utah, Nevada, New Mexico, West Virginia, Nebraska, Idaho, Maine, New Hampshire, Hawaii, Rhode Island, Montana, Delaware, North Dakota, South Dakota, Alaska, Vermont and Wyoming. Would America turn its back on the citizens of these 25 states if every one of them lacked basic health coverage?"

"Food for thought, Brian. Any chance we'll see that deal tomorrow?"

"Zero, Bob."

"Thanks as always. After this break: the downhill, where Americans are now favored."

Matt Miller, a senior fellow at the Center for American Progress and co-host of public radio's "Left, Right & Center," writes a weekly column for The Post. In recent years he has given paid speeches or paid advice to doctors' groups, hospitals, pharmaceutical firms and insurance companies as well as to low-income advocacy groups promoting universal coverage. He can be reached at mattino2@gmail.com.


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