Comment of the day:
A great comment in a Kevin Drum post
. Great because it says what I've been arguing for a while now, regarding the piss-poor Senate bill. Here it is: (emp add)
Did I miss something, or was this excise tax the centerpiece of John McCain's and the Republican's health care plans in 2008? I seem to recall many Democrats and a Senator from Illinois criticizing that approach, and rightfully so. Now, virtually every Democrat, and every "liberal" pundit is suddenly in favor of it.
Now, I get the theory, but I'm not at all convinced that it will work the way it's proponents think it will in practice. Isn't it the Republicans who think the main problem with health care is that people just get too damn much of it. As I understand it, that is the argument that people are making in favor of the excise tax now. That with more out of pocket payments, people will be more discriminating on the health care that people purchase.
Wasn't the criticism with the Republican approach the notion that medical care isn't like buying a TV. Most consumers are not knowledgeable or objective enough to discern what treatment is actually in their best interest or not. If my doctor recommends an MRI, for example, who am I to question him/her? The main reason I wouldn't get the MRI is that, with my less generous employer based health care plan, I wouldn't be able to afford the MRI. Is that really the recipe for bending the curve?
So, I can see that the excise tax could (note, *could*) reduce what we, as nation, spend on health care, because with the inability to come up with the out of pocket payments, people will simply *use* less health care. I don't really see how this will actually reduce the cost of that health care, however. Drugs will cost what they used to, people will just not have the money to buy as many. MRIs will still cost what they used to, but people will not be able to afford to get as many. Etc.
So, why is the Democratic party now in favor of the centerpiece of the Republican plan circa 2008? And why is the Republican party against it? What am I missing?
"Less health care" is good---as long as it's pointless care, of which there's a lot.
Relying on pressure on consumers will just as likely reduce care that isn't pointless.