Wednesday, April 21, 2010

President Obama expected a bounce in the polls from health care reform legislation.

Instead, he’s getting pounced on, just like former House Ways and Means Chairman Dan Rostenkowski as he and his party’s fortunes continue to plummet in the wake of the March 21 vote. Since then, Republicans have exceeded, or equaled, Democrats in the generic Gallup 2010 congressional preference poll, a rarity in Gallup’s 60-year history, having occurred only in 1950, 1994 and 2002, when Republicans won big on Election Day.

Of course, the “Rostenkowski Pounce” was a physical poll of sorts, when the elderly, manifesting their intense displeasure over the July 1, 1988, passage of the Medicare Catastrophic Coverage Act, providing outpatient coverage, literally pounced on Rostie’s car, given his role in shepherding through this wildly unpopular legislation.

Then, like clockwork, the law was repealed in November 1989 - just as voters, polls indicate, intend to do with Obamacare at the ballot box this November.

While Democrats might comfort themselves with the hope that Alf Landon’s ill-fated 1936 presidential campaign predicated on repealing Social Security is the model, the Rostie Pounce is the truer template.

The two bills - Medicare Catastrophic and catastrophic Obamacare - are social-engineering twins. The very same do-goodism contained in the Congressional Budget Office Staff Working Paper describing Medicare Catastrophic’s benefits underlies Obamacare - government bureaucrats purporting to tell Americans what’s best for them.

This 1988 document waxes, albeit not so eloquently, about all the benefits seniors would realize. However, just like Obamacare, it came with a price. For instance, take this beaut: “The net result of the act if it were fully effective in 1988 would be to reduce out-of-pocket costs (direct costs plus premiums) for poor and near-poor enrollees, while increasing costs for other groups.” The ceiling on those increased costs in 1989 was $1,600 per couple, $800 per individual. The legislation also assumed the almost 75 percent of seniors who had Medigap coverage would drop it in favor of Medicare. A big assumption!

Thus were the seeds of revolt planted.

Fast-forward 22 years, add a dash of tea and redistribution-of-wealth outrage, reflected in a recent New York Times/CBS News poll, and Americans clearly aren’t buying Mr. Obama’s promises that they could keep their coverage and costs would decrease. The facts don’t support such rosy scenarios - especially because we now learn from the Congressional Research Service that even members of Congress and their congressional staffs might lose their current coverage. About 80 percent to 85 percent of Americans in 2009-2010 - including the Hill’s hapless health care “fixers” - already had coverage they were happy with and only wanted a little cost control. Talk about bait and switch.

So, the logical path is simply this. Just like on March 21, when the House voted not for the actual bill, but for the Senate bill, then later a package of “fixes”- soon-to-be-in-charge congressional Republicans should vow, come January, to repeal Obamacare and then vote for a slimmed-down package containing only the “fixes” to the health care system that everyone agrees need addressing: e.g., pre-existing conditions, lifetime caps, illness-based coverage rescission.

The ultimate fix, of course, is to sunset the employer tax exclusion, a relic of World War II’s wage-and-price controls that bears little relation to today’s workplace reality and represents the Treasury’s largest tax loss - $250 billion. This money would be much better spent by individuals rather than corporations for purchasing health insurance - increasing competition and thereby lowering costs.

For the blueprint, Republicans and reality-based Democrats need look no further than the Patients’ Choice Act, co-sponsored by Sens. Tom Coburn of Oklahoma and Richard M. Burr of North Carolina and Reps. Paul Ryan of Wisconsin and Devin Nunes of California, all Republicans. It’s a guaranteed bounce. Especially considering that its Medicaid transformation would save states $1 trillion, the federal government $300 million per year, and improve health care for everyone - rich and poor alike.

Mary Claire Kendall, a Washington-based writer, served in the Department of Health and Human Services under President George H.W. Bush.

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