President Obama was re-elected last night with an impressive margin in the electoral college. The popular vote margin was much narrower, but it looks like he’ll be over 50% with roughly a 2 point margin.
I’ll have much more to say about this, but most of us will acknowledge that this was a very important election. The pundits liked to mock both campaigns for not discussing big issues, but that truly missed the point. Both sides offered very different paths for our future, and most voters understood the profound differences.
With an Obama victory, his signature accomplishment from his first term, health care reform, will now be fully implemented. Mitt Romney would have either repealed or gutted Obamacare, but now the notion of universal health care will be cemented as part of the social compact. We’ll all have to wait and see how Republicans react to Obama’s victory, but hopefully on health care we’ll see a shift away from a reflexive attempt to overturn Obamacare to constructive negotiations to improve it and cut medical costs in general. We’ve heard Republicans pontificate for years about malpractice reform. Perhaps now we’ll actually get some constructive proposals.
We may have a continuation of the political wars, but now we know that any deal will have to be more balanced than the GOP plan of just hacking away at spending on the elderly and the poor. We’ll see how that plays out.
It will also be interesting to see if some conservatives will break out of the right wing media bubble. Conservatives were told to ignore the poll numbers that pointed to an Obama victory, and that the “real” numbers would lead to a Romney landslide. These projections were pure fantasy, just like the Romney/GOP budget numbers that claimed you could miraculously balance the budget by slashing taxes. We live in a divided country and many on both sides are guilty of just listening to their own partisan news sources, but the dogma and partisanship on the right has become absurd. Even respectable pundits like George Will and Micheal Barone drank the Cool Aid and ended up looking just as clueless as partisan hacks like Dick Morris with their predictions of the Romney landslide.
Finally, conservatives and Republicans need to stand up to the lunatic fringe. You can’t encourage the crazies on your side, and then lament when idiot candidates like Richard Mourdock and Todd Akin say stupid things about rape and abortion. You can’t cater to the haters who demonize illegal immigrants and then complain that you got crushed by the Latino vote. We’ll see if there’s anyone in the GOP who has a spine. Chris Christie is an obvious candidate as he’s called out the crazies before, but now he’s on serious probation with the right for saying something nice about President Obama. Perhaps Marco Rubio can help on that front. We can expect serious fireworks within the GOP as they hash out these issues. If they don’t work it out, I’ll be happy to see them forfeit the Latino, African American, Asian and much of the female vote in future elections.
The Democrats certainly took a beating in the Midterms, but soon reality will set in for the GOP as well.
As usual, the Republicans are going to over-interpret their “mandate.” This fact about the public’s opinion on the health care reform law in instructive.
A majority of Americans want Congress to keep the new health care law or actually expand it, despite Republican claims that they have a mandate from the people to kill it, according to a new McClatchy Newspapers-Marist poll.
The post-election survey showed that 51 percent of registered voters want to keep the law or change it to do more, while 44 percent want to change it to do less or repeal it altogether.
Driving support for the law: Voters by margins of 2-1 or greater want to keep some of its best-known benefits, such as barring insurers from denying coverage for pre-existing conditions. One thing they don’t like: the mandate that everyone must buy insurance.
The fight over health care reform will be one of the defining battles over the next two years. Expect the Republicans to overplay their hand.
Many are extremely frustrated by the slow progress in the Senate Finance Committee, but it looks like one reason for the delay is the serious consideration by the committee for an excise tax on health insurance companies for gold-plated health care plans.
A proposal to tax insurance companies on their most expensive health-care plans may help lawmakers seeking a bipartisan solution for financing President Barack Obama’s $1 trillion health-care plan.
The plan, offered by Democratic Senator John Kerry of Massachusetts, would impose an excise tax on insurers that could generate tens of billions of dollars. Making the companies pay may help break a deadlock in Congress over funding. Obama opposes taxing health benefits for middle-class Americans and many Republicans and Democrats have said they won’t accept a plan to tax the policies of the wealthiest.
“We’re taking an intense look at it,” Senator Charles Grassley of Iowa, the ranking Republican on the Finance Committee, said in an interview yesterday on Bloomberg Television’s “Political Capital with Al Hunt.”
The measure would help end “perverse incentives to over- utilize and have high-cost care,” said Grassley. “We’re interested in it as a discipline within health care.”
Senator Olympia Snowe of Maine, another Republican on the Finance Committee that is drafting health-care legislation, said she was also open to the proposal.
“That may be a practical option, as a way of attacking future costs in health care and driving them down and creating disincentives for the most expensive policies,” Snowe said July 23. Earlier this week, Senator Kent Conrad, a North Dakota Democrat on the Finance Committee, said the idea is under consideration by the panel.
The Kerry proposal is similar to an amendment that Senators Bill Bradley, a Democrat, and John Danforth, a Republican, floated in the 1994 effort to overhaul health care. Obama has said he wants his plan to remake health care, which accounts for 17 percent of the economy, to have bipartisan support.
“It might be a way of accomplishing our goals,” Kerry said.
Grassley agreed. The proposal, he said, has “been a subject of discussion for two days of the last four or five” in the committee.
This is an excellent option given that any proposal to limit the health care deduction for individuals who have gold-plated plans went nowhere for political reasons. The delay must relate to the various ways this can be structured and the need to have it scored properly by the Congressional Budget Office. If the numbers work, this will go a long way towards getting a bill that can achieve broad support and even bring along some Republicans.
Anyone wondering how the health insurance companies have been increasing their profits at such a rapid rate should read this recent article from BusinessWeek. It appears that large health insurers completely dominate the market in many states.
The insurance industry is up in arms over congressional proposals to create a publicly financed competitor in an effort to bring down health-care costs. That may be because it doesn’t have to face much in the way of competition now: Most regions of the U.S. are dominated by just one or two health insurers.
Each year the American Medical Assn. (AMA) surveys the commercial health-insurance landscape and finds little if any competition. Its latest report says that, out of 314 metropolitan markets, 94% are controlled by one or two companies, or fewer. In 15 states, one insurer has 50% or more of the entire market.
Such market concentration has become a potent argument for supporters of a public insurer, President Barack Obama among them. With no need to generate profits, a public plan could offer lower premiums, thus bringing competitive pressure to bear on the private insurers to do the same.
Ezra Klein makes a similar point in the Washington Post.
In the modern health-care system, there is no higher power than the insurance market. And the insurers who populate that market have grown all the stronger. The Justice Department judges an industry “highly concentrated” if a single company controls more than 42 percent of the market. By that definition, 94 percent of statewide insurance markets are highly concentrated. A recent study by the advocacy organization Health Care for America Now showed that in Indiana, WellPoint controls 60 percent of the insurance market; in Iowa, Wellmark accounts for 71 percent; and in Alabama, Blue Cross/Blue Shield holds 83 percent. In the past 13 years, there have been more than 400 corporate mergers involving health insurers.
Economics textbooks tell us that concentrated markets reduce the competitive behavior that benefits consumers and lead to outsize profits for the dominant firms. Predictably, health-care premiums shot up more than 90 percent between 2000 and 2007, while the profits of the 10 largest insurers increased 428 percent over the same period.
We have a system that is not sustainable. This isn’t capitalism – instead we have several large insurance companies practically stealing money from American taxpayers.
Right now, President Obama is trying hard to get a bill with the help of all the major players, including the insurance companies. Therefore we’ve seen him go after costs and premiums, but he has not taken on the insurance companies in a direct manner.
If the current effort at reform fails or stalls, expect to see a full-throttled attack against these companies that informs the American people just how much money they are making and the tactics they are using to deny coverage to pad profits.
Anyone who wondering why health care premiums are exploding just needs to take a look at the insurance industry.
Schumer pointed to the profits of the 10 largest insurance companies — which shot up 428 percent between 2000 and 2007, from $2.4 billion to $12.9 billion — as a reason health care reform is needed.
The insurance industry has not been playing ball on reform, and now Senate Democrats are getting fed up.
With other industry groups pledging savings to help pay the cost of health care reform, Senate Finance Committee Democrats slammed insurers for holding out — and threatened to impose new fees on the industry that could cost it as much as $100 billion.
The Finance Committee members are currently hunting for hundreds of billions of dollars to help finance reform, and with the hospital and pharmaceutical industries having pledged $235 billion, the senators said it was time that the insurers paid their share.
“We need the insurance companies to step up to the plate and be part of the solution. Most of the negotiations so far, the insurance industry has been at the table but you can only sit there at the table with your arms crossed for so long,” said Sen. Chuck Schumer (D-NY).
Schumer and Sens. John Rockefeller (D-WV), Debbie Stabenow (D-MI) and Robert Menendez (D-NJ) pounded the insurers, who they portrayed as unwilling to help pay for reform even while they have enjoyed exploding profits.
“The insurance companies are the people who are just rapaciously, greedily and unstoppably making money by underpaying the patient, by underpaying the provider and by overpaying, therefore, themselves,” Rockefeller said.
We’re seeing a new urgency from the White House and other Democrats on the health care reform issue, and it’s refreshing to see them ratchet up the pressure on the insurance industry.