For several days it’s been bugging me. Didn’t the president once argue with Republicans about the point now at issue, namely that his bill would force individuals out of the plans they wanted to keep? Maybe I had imagined it. Then it hit me — the 2010 health-care summit! Yup, there it is in the archives of the White House Web site.
I’ll reprint a whole chuck of the conversation between President Obama and House Majority Leader Eric Cantor (Va.), beginning with Cantor’s recitation of the Republicans’ objection to Obamacare:
CANTOR: We don’t care for this bill. I think you know that. The American people don’t care for the bill. I think that we’ve demonstrated in polling that they don’t. But there is a reason why we all voted no. And it does have to do with the philosophical difference that you point out. It does have to do with our fear that if you say that Washington can be the one to define essential health benefits, there may be a problem with that. And that’s the language that’s in the Section 1302 of this bill, that it says that the Secretary shall define for people what essential health benefits are.
But let’s — in the spirit of trying to come together, let’s try and say, maybe if — if we assume that Washington could do that, could really take the place of every American and decide what is most essential, what would be the consequences? And that’s also where we have a big difference in this bill and what would happen.
First of all, the cost, and Jon Kyl laid out the tremendous cost in the nearly trillion dollars of this bill. And I don’t quite know, because CBO said it couldn’t assess how much your additions would cost to it, but we do know that there are plenty of taxes on income. Now, you suggest investment income should be taxed. We have additional taxes on medical devices and the rest. What is a consequence of that? We know there are consequences that small businesses will feel because of the impact on job creation.
But also, Mr. President, when we were here about a year ago across the street, you started the health care summit by saying one of the promises you want to make is that people ought to be able to keep the health insurance that they have. Because as we also know, most people in this country do have insurance and an overwhelming majority of people do like that coverage; it’s just too expensive.
Well, the CBO sent a letter — I think it was to Leader Reid — about the Senate bill. And in that letter, it suggested that between 8 million and 9 million people may very well lose the coverage that they have because of this, because of the construct of this bill. That’s our concern. And so, as we are in — as we are in the market — in the section of this discussion about health insurance reform, I note, Mr. President, that you have suggested strengthening oversight of insurance premium increases. Because we want to make sure that there aren’t excessive insurance premium increases that take place.
The problem is when you start to mandate all of the essential benefits, there are going to be some insurance premium increases. None of us really want to see them. But if you stop them, who is going to pay for it? Well, then we get back to the fact that businesses won’t be able to pay for it and people are going to lose their coverage.
So I guess my question to you is, in the construct of this bill, if we want to find agreement, we really do need to set this aside. And we really do need to say, okay, the fundamental structure is something we can’t agree on, but there are certainly plenty of areas of agreement. And because I don’t think that you can answer the question in the positive to say that people will be able to maintain their coverage, people will be able to see the doctors they want in the kind of bill that you’re proposing.
Cantor was right then and he is right now. Interestingly, Obama gave a more honest answer then than in the months and years that followed:
THE PRESIDENT: Well, let me — since you asked me a question, let me respond. The 8 to 9 million people that you refer to that might have to change their coverage — keep in mind out of the 300 million Americans that we’re talking about — would be folks who the CBO, the Congressional Budget Office, estimates would find the deal in the exchange better. It would be a better deal. So, yes, they would change coverage, because they’ve got more choice and competition. So let’s just be clear about that, point number one.
Point number two, when we do props like this — stack it up and you repeat 2,400 pages, et cetera — you know, the truth of the matter is that health care is very complicated. And we can try to pretend that it’s not, but it is. Every single item that we’ve talked about on the Republican side, if we wanted to exhaustively deal with fraud and abuse, would generate a bunch of pages. So I point that out, just because these are the kind of political things we do that prevent us from actually having a conversation.
Now, let me respond to your question. We could set up a system where food was probably cheaper than it is right now if we just eliminated meat inspectors and we eliminated any regulations in terms of how food is distributed and how it’s stored. I’ll bet in terms of drug prices, we would definitely reduce prescription drug prices if we didn’t have a drug administration that makes sure that we test the drugs so that they don’t kill us.
But we don’t do that. We make some decisions to protect consumers in every aspect of our lives. And we have bipartisan support for doing it, because what we don’t want is a situation in which suddenly people think they’re getting one thing and they’re getting something else — they’re harmed by a product. What Secretary Sebelius just referred to — which is not a Washington thing; in fact, state insurance standards in many states are higher than anything that’s done in Washington — is as a consequence of seeing consistent abuses by the insurance companies and people finding themselves helpless to deal with.
Now, we can have a philosophical disagreement about how much insurance regulation is appropriate. What you’ve indicated to me, just based on the bills that I’ve seen, is you guys believe in some regulations. You’ve already said you did. You believe in making sure that you can’t just drop somebody with coverage. Now, if you don’t have a law there, let me tell you that happens all the time. I’ve got a bunch of stories in here of folks who thought they had insurance, got sick — the insurance company goes back and figures out a way to drop them. I’m not making this up. I’m not trying to just add to the pages of that bill. It’s in response to an actual problem, and you guys have agreed to it. So philosophically at least, on a whole range of issues, you agree that we should have some insurance regulation. My suggestion had been that we try to focus on what are the specific regulations — since we agree that there have to be some, what are the specific ones that you object to.
From the get-go the president never intended to let everyone actually keep their insurance. First he said it wouldn’t be that many people as a percentage of the whole population. Then he equated catastrophic coverage with fraud. And then he came right out to say it: He and his administration knew best, knew what insurance was good for you. If you lost what you wanted, so be it. It was for the greater good.
The only problem was that this was a stumbling block and noxious sentiment, revealing the full-flowering of liberal know-it-all-ism. And it was the essence of how the bill was to work. If young healthy people could stay outside the exchanges either because they refused to get insurance or because they insisted on cost-effective catastrophic coverage, then Obamacare would fix that by, respectively, fines and insurance invalidation.
It is plain dishonesty for the president to claim otherwise, and it is embarrassing for liberal pundits to try to cover for him. So, no, it’s not that Republicans were soothsayers; unlike the media they were critically evaluating what they read and heard. (Some honest columnists now concede the GOP was paying attention and so now seem “wise.“) They were simply listening to the president and reading the bill. And, moreover, it’s not simply catastrophic coverage that is lost; plenty of people simply get worse coverage at higher prices in the exchange. It’s not a “good product” as the president claimed.