If at first you don't succeed, try, try, try, try again.
With Plans A, B and C having failed miserably, President Obama yesterday unveiled his latest "new and improved" version of health-care reform. He says that this incarnation "incorporates the best ideas from Democrats and Republicans — including some of the ideas that Republicans offered during the health-care summit." Unfortunately, its fundamental premise remains exactly the same — a government takeover of the health-care system.
Start with those "Republican ideas": Though mostly not bad, they're hardly game changing.
- Increase the financial incentives for states to experiment with malpractice reform by $50 million. Wow — a million dollars per state! That undoubtedly has the trial lawyers quaking in their boots.
- Undercover stings to help root out Medicare and Medicaid fraud. Fine — but when fighting fraud in government programs becomes a major concession, it shows just how out of touch Washington has become.
- Increase Medicare reimbursements. OK, higher spending for a program that's already going broke may well be a Republican idea, but it doesn't exactly make Obama's better.
- Allow health-savings accounts to be sold through the government-sponsored exchanges. This could be a positive step — but the details are key, and they remain to be seen.
HSAs have been proven to reduce the cost of health care and have added nearly 3 million people to the ranks of the insured since their inception. But they only really work in conjunction with high-deductible insurance — if your policy already pays for everything, there's not much point to saving for health expenses.
And every version of ObamaCare to date has restricted high-deductible insurance and/or mandated low-deductible policies. Unless the president is prepared to make major changes in those areas, the HSA concession is just bait-and-switch.
All in all, saying that these changes represent a "compromise" with Republicans is a bit like saying that Yankee speedster Brett Gardner is a home-run hitter. It's technically true (he hit three dingers last year), but no one's going to mistake him for Babe Ruth.
The president has also touted the new plan as "smaller" and "leaner." Smaller and leaner than what? This version may actually cost more than the last one — breaking the $1 trillion mark even under the White House's rosy assumptions.
At its heart, ObamaCare hasn't changed. It still represents a top-down, centralized, command-and-control approach to reform.
The government would require everyone to have health insurance, would determine what benefits that insurance must include, would regulate insurance prices and physician reimbursement and would micromanage how medicine is practiced.
All this would be accompanied by higher taxes and, most likely, higher insurance premiums.
It is a plan that says the government knows best — when it comes to a sixth of the US economy and some of the most important, personal and private decisions in people's lives. A few cosmetic concessions can't fix that basic premise.
Obama also made it clear yesterday that he wants Congress to use an obscure parliamentary gimmick known as "reconciliation" to bypass a Republican filibuster and force the bill through the Senate. Democrats will likely manage to get the 50 votes needed in the Senate to use this tactic — but the vote will be far closer in the House, where deaths, defections and resignations have erased the three-vote margin of victory Democrats had last November.
The president was right about one thing yesterday. As he said, "Every argument has been made. Everything there is to say about health care has been said, and just about everyone has said it. So now is the time to make a decision."
Reportedly, as many as nine House Democrats who once voted against ObamaCare, including Rep. Scott Murphy of upstate New York, are now open to supporting the latest version. If they do, in the face of overwhelming public opposition, this new version of health reform could turn out to be Plan L — for "loser."