By Steve Benen, Washington Monthly
Posted on September 8, 2009, Printed on September 9, 2009
http://www.alternet.org/bloggers/http://www.washingtonmonthly.com/142484/
A few years ago, during Bush's pitch in support of health saving accounts, the LA Times' Peter Gosselin reported a detail that was generally overlooked: "Most conservatives -- including those in the [Bush] administration -- believe that the root cause of most problems with the nation's healthcare system is that most Americans are over-insured."
Ezra Klein added at the time, "Conservatives believe Americans have too much health insurance, that they spend heedlessly and wastefully on care, procedures, and medications they would simply forego if insurance plans didn't pick up the tab."
That, however, was 2006. Is this still how the right approaches the health care system? Actually, yes. Reps. John Shadegg (R-Ariz.) and Pete Hoekstra (R-Mich.) had an op-ed in the Wall Street Journal the other day with a fascinating lede:
When was the last time you asked your doctor how much it would cost for a necessary test or procedure? In all likelihood, you can't remember. That's because your employer-provided health plan or the government "paid for it." In fact, you paid. We all pay for health care.
There's no denying that our health-care system is complex. However, we can trace most of the problems in the current system to the lack of control individuals and families have over their care.
Ah, yes, "control." Let's say you're suffering from some kind of ailment, and your physician recommends a treatment. If you had more "control," you might second-guess whether your doctor's solution is cost-effective. When he/she orders some tests, you should have more "control" about whether those tests are really worth the money.
As Shadegg and Hoekstra see it, that we don't already think about these questions is the problem with health care. For those with insurance, we visit a physician, and follow his/her recommendations, knowing that insurers and our employers will shoulder most of the costs. If we didn't have that pesky insurance, we could, you know, haggle and stuff. Think of the savings!
Josh Marshall explained this morning:
That's the essence of where Republicans want to go. And why Democrats aren't making that a lot more clear is a very good question without any good answers. The problem is that you go to the doctor and agree to take the tests the doctor recommends. Shadegg and Hoekstra want a system where if your doctor suggests a biopsy for a suspicious lump you think about the pros and cons. Is it worth the money? Do you have the money? How suspicious is the lump anyway? Maybe you get the first one. But not necessarily the follow up scan six months later.
This is the essence of the Republican plan: the fact that you're insured and aren't directly feeling the cost of individual tests and procedures is the problem and getting rid of the insurance concept is the solution.... [T]he problem according to most Republicans in Congress isn't that there's not enough insurance or that it's not good enough. It's that there's too much. The problem is that you have insurance. And good policy will take it away from you.
It has something to do with why Republicans have broken their promises about unveiling an official GOP health care reform plan. If they actually spelled out their plans in detail, they'd lose the reform fight -- and most elections for the foreseeable future.
The message for Democrats -- who would benefit from taking the offensive -- seems pretty obvious. Republicans think you're already over-insured. I strongly suspect most Americans would find that ridiculous, but it's the GOP message, and has been for years.
Steve Benen is "blogger in chief" of the popular Washington Monthly online blog,Political Animal. His background includes publishing The Carpetbagger Report, and writing for a variety of publications, including Talking Points Memo, The American Prospect, the Huffington Post, and The Guardian. He has also appeared on NPR's "Talk of the Nation," MSNBC's "Rachel Maddow Show," Air America Radio's "Sam Seder Show," and XM Radio's "POTUS '08."
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