When we were still talking about “health care reform”, before it was renamed “health insurance reform”, one of the big selling points was government was going to change the way we did business. I.e. it was going to stress “preventive care” which, so the Dems claimed, would be less costly in the long-run.
The CBO, however, has said, “not so fast”. In a letter to Henry Waxman, among others, Dr. Douglas Elmendorf, Director of the Congressional Budget Office writes:
“Although different types of preventive care have different effects on spending, the evidence suggests that for most preventive services, expanded utilization leads to higher, not lower, medical spending overall,” Elmendorf wrote. “That result may seem counterintuitive.
“For example, many observers point to cases in which a simple medical test, if given early enough, can reveal a condition that is treatable at a fraction of the cost of treating that same illness after it has progressed. In such cases, an ounce of prevention improves health and reduces spending — for that individual,” Elmendorf wrote. “But when analyzing the effects of preventive care on total spending for health care, it is important to recognize that doctors do not know beforehand which patients are going to develop costly illnesses. To avert one case of acute illness, it is usually necessary to provide preventive care to many patients, most of whom would not have suffered that illness anyway. … Researchers who have examined the effects of preventive care generally find that the added costs of widespread use of preventive services tend to exceed the savings from averted illness.”
This is another in a long line of “facts” the Democrats have attempted to use to sell their “more coverage, better care, less cost” health
care insurance reform. And it is another “fact” that has been found to be false.
Going through Elmendorf’s reasoning provides a very good explanation of why it is false. But I’ll bet that none of that reasoning or information will find its way into Democratic talking points about the goals of this legislation. Instead the false “fact” about preventive care lowering overall costs will stubbornly remain.
If so, my suggestion is you send it in as a “fishy” statement to be refuted by the White House crew that deals with these sorts of fishy facts.
Oh wait, nevermind. Apparently the White House has already dealt with the fishy CBO’s report- well sort of:
Responding to the CBO letter, Linda Douglass, the communications director for the White House Office of Health Reform, said that, “to work, prevention has to be targeted. Proven services need to be directed to populations that need it, as the CBO letter suggests. We will continue to work with Congress on ensuring that dollars are spent on prevention that gets the biggest bang for the buck.”
Douglass argued, however, that there would be long-term financial savings, saying “we can’t forget that many of the benefits of prevention will accrue to the Federal government in thel long term as opposed to the near term. Prevention results in longer, healthier, more productive lives — yielding savings that don’t typically show up on a score sheet. We have to return to common sense: keeping people out of a doctor’s office or hospitals saves money. Seventy-five per cent of our health care spending goes to treat chronic diseases, many of which could be prevented from developing in the first place . Proven preventive services are worth it.”
Notice that the CBO says the problem is that preventive care can’t be targeted because doctors have no idea who would benefit until they run batteries of tests on everyone. And that is what the CBO highlights as running the costs up.
Additionally, no one is claiming “proven preventive services” don’t work or aren’t “worth it”. What CBO is claiming is they’re not “less costly”, something Douglass avoids addressing. All in all a most unsatisfactory and fishy response to the CBO argument.
The videos of what are described as “angry” townhalls around the country keep pouring in. Here’s one from Green Bay, WI.
Of course there are tons of others.
The Democrats and the left have answered the protests by claiming that they’re nothing more than “right-wing extremists” under the control of powerful interest groups. Thus the charge of “astro-turfing”.
These accusations by the DNC seem to ignore the Tea Party movement’s origins which was, on inspection, a true grass-roots movement (and one that has taken both Democrats and Republicans to task for their profligate spending). Notice too that they include the “birthers” in their vid to underline their “extremist” claim.
The White House, instead of trying to calm the waters, has chosen employ Saul Alinsky against the protesters:
A key part of the developing strategy: ridicule the opposition — and portray those who disrupt meetings with loud chants and signs as part of the same ilk of people who showed up at campaign rallies for John McCain and Sarah Palin right after the 2008 Republican National Convention.
So this turns into a propaganda war. The left will be attempting to turn public opinion against the protesters by portraying them a certain way.
Patronizing opponents is a tried and true tradition in Washington, and Democrats have used the tactic with success. They ridiculed the hundreds of thousands of conservatives who protested the stimulus package as “tea baggers.”
But Republicans are just as responsible for the perception. The folks who tend to show up at protest events tend to be to the right of the mean in the party. And, as the spread of the birther movement demonstrates, not a small chunk of these Republicans are reactionaries. The challenge for the White House and Democrats is that they find a way to separate genuinely anxious conservatives who ask good questions — even if those questions are provided by conservative groups — and the crazies who tend to pack town hall meetings.
Of course, most reasonable people would suggest, upon reflection, that if this was an “astro-turfed” movement, those who are paying for it would have much tighter control and avoid the obviously unhelpful signage and any connection with the birther movement. That’s obviously not the case.
So the right and Republicans have the momentum, at least for now, but it isn’t clear if they have an advantage for the reasons stated.
The challenge for Republicans is to prevent the media from labeling everyone who attends a meeting with a Democratic lawmaker and who calls him or herself a conservative as a crazy person. Some polling suggests that the percentage of Republicans who don’t know whether President Obama was born in the United States is fairly high, although it is hard to say how much of that confusion stems from ignorance or from a generally jaundiced, perhaps racist, view of the President.
A range of smaller, ideologically conservative interest groups are organizing the protests. Finding pockets of activist-oriented arch-conservatives in places like Texas, Missouri and Indiana is easy, especially if the set goal is to defeat Obama-care, which is being sold to these people as the approach of government-run health care, something that these folks have been worried about for years. Add to the mix a desire to hand the progressive President and his agenda a decisive defeat.
And there’s an interesting question about pushing back on the left – where are its activists and organizations?
The more troublesome question for Democratic strategists is why the major Democratic groups, including Organizing for America, the labor unions, Health Care for America Now, seem to be flatfooted and unable to match the much smaller conservative organizing capacity in these critical districts. One answer is that the media pays attention to the loudest voices, which are coming from the right. The other is that organizing around major — even popular — reforms of existing institutions is tough. The Democrats don’t have a single bill right now, and the elite left is worried about what’s not in the cards — a public plan — and is therefore fairly unenthusiastic. If the liberal elite isn’t enthusiastic, the liberal base — less knowledgeable — will be as well.
And of course, there’s the media – which, it seems, leans mostly toward helping the administration. For instance, the conclusion of the article from which I’ve been quoting from Mark Ambinder at The Atlantic:
To focus minds, Democrats are coordinating TV and radio ad blitzes, including the biggest expenditures by the Democratic National Committee to date. President Obama, his cabinet and his vice president will be ubiquitous. Quickly responding to disinformation will be a key goal, an administration official said, pointing to this morning’s release of a video from Linda Douglass, a former television and print reporter who serves as a key White House health care adviser, which rebutted a misleading video posted on the Drudge Report.
Linda Douglass “rebutted” nothing. She made a bunch of claims she’d have difficulty substantiating. But that is how it is being reported. The implication is that what is coming from the right is “disinformation” and the only true source of factual information is the White House.
I think we all know that dog won’t hunt.
But this should be a very, very interesting August.
[Welcome RCP readers]