Bush’s health care pitch isn’t ‘right out of the Democratic platform’

I mistakenly thought it was obvious that the president’s new health care ideas, unveiled in last night’s State of the Union, were awful. The media, however, seems to think Bush has suddenly become liberal on the issue.

Chris Matthews praised Bush for embracing a “bipartisan” approach to health care. Charlie Gibson said the proposals sounded like they came from the Democratic playbook. The Washington Post’s Ruth Marcus argued inexplicably that objections to the president’s health care agenda are driven by partisanship, not policy.

If George W. Bush proposes something, it must be bad. Such is the knee-jerk state of partisan suspiciousness that when the president actually endorses a tax increase — a tax increase that would primarily hit the well-off, no less — Democrats still howl. […]
Listening to Democratic reaction to Bush’s new health insurance proposal, you get the sense that if Bush picked a plank right out of the Democratic platform — if he introduced Hillarycare itself — and stuck it in his State of the Union address, Democrats would churn out press releases denouncing it. […]

It’s too bad, because the president’s proposal to cap the deductibility of employer-sponsored health insurance deserves more of a chance than Democrats, from their initial reactions, seem inclined to give.

Let’s go out of our way to give these establishment media figures the benefit of the doubt, and suggest that perhaps their praise for the Bush policy is a result of confusion. The White House just started talking about the details of the approach this week, and perhaps the media hasn’t had a chance to look at the policy in any real detail.

Frankly, it’s the only realistic explanation for these comments, because Bush’s policy isn’t bipartisan, isn’t progressive, and isn’t any good.

Kevin Drum explained why the reporters and media personalities might be fooled.

It’s true that if you look at Bush’s proposal solely though the prism of tax policy, it seems fairly progressive: increased taxes on rich people who have gold-plated health insurance combined with tax breaks for middle-income folks with private insurance. And Republicans have trained us so thoroughly to think of everything as part of their long-running war on taxes that this is apparently the only way pundits are now able to see things.

That’s a mistake. This is a healthcare plan, after all, and it should be looked at through the prism of health policy. And from that perspective it’s a lousy plan.

And Jonathan Cohn explained why it’s a lousy plan: it’s “an effort to remake medical care along the lines of conservative ideology.”

Yes, the Bush administration put itself on record as supporting a tax increase–and that was part of what made the proposal seem like such a breath of fresh air. For once, the administration seemed to be confronting fiscal realities — embracing, at least in principle, the idea that sometimes it’s worth raising taxes to achieve a broad public good. But then the rest of the details started to come into focus — chief among them the fact that, in encouraging the demise of employer-sponsored insurance, the administration had no plans to create a suitable alternative in its place. After all, a lot of people are going to have a hard time finding insurance in the individual market. Not only do costs run higher there, because the administrative overhead is higher, but insurers offer coverage and adjust premiums based on health condition–to the point where people with preexisting medical problems simply can’t get decent coverage at all. Even bigger tax breaks, the kind Bush is proposing to help these people, won’t help these folks.

Serious proposals to improve access to health care generally take this problem head-on: They propose to mandate that insurance companies cover everybody regardless of medical condition, like Governor Arnold Schwarzenegger has suggested; they propose to let people buy into the giant federal employees’ plan, like most of the 2004 Democratic presidential candidates have proposed; or they propose to expand coverage through public programs like Medicare or Medicaid, like Senator Ted Kennedy and Representative Pete Stark are urging.

The administration plan — as fully fleshed out tonight — offered nothing along these lines. Instead, its only determined effort to make health insurance more available in the individual market is a complementary initiative that would give the states grants — grants that cannot be used to bolster public insurance programs. Worse yet, to fund this initiative, it’s proposing to take money away from public hospitals and other charity care providers who take care of the uninsured now. This is classic conservative ideology, which insists that private insurance is always preferable to public — even though public insurance is actually more efficient and, particularly when it comes to the financially and medically needy, the only reliable option.

In addition, while the tax hike will hit only that small portion of individuals with the most generous health benefits, that doesn’t mean it will hit only society’s most well-off. Among those with extremely generous health benefits are not only CEOs and well-paid professionals, but also many union members who accepted better health benefits in lieu of higher wages. If they now lose some of those benefits — or, at least, the value of those benefits — there’s no guarantee they’ll get higher wages back in return. And, while some of these union members are reasonably well-off, many aren’t — particularly the younger ones who didn’t work during labor’s heyday in the 1950s and 1960s.

For the media to characterize this as some kind of breakthrough for the White House and a progressive approach to health care is unhelpful. This is the same old Bush, proposing the same old “solutions,” and continuing to avoid any serious attempts to improve access to quality health care.

The Democratic health care playbook is wide open. If the White House wants to borrow a page, the Bush gang should feel free. This ain’t it.