The Republican Health Plan

Note From Greetings:

No or reduced coverate. Most of the uninsured still uninsured. Ability of insurance companies to cross state lines. INability of states to regulate something the federal government might have. Gee.. um.. what's not to like? (They've had this plan around for years. Why not make it public before? Perhaps to avoid criticism?)

NY Times Editorial, November 6, 2009

House Republican leaders have produced their own health care reform bill. Here is the first thing you need to know: It would do almost nothing to reduce the scandalously high number of Americans who have no insurance. And it makes only a token stab at slowing the relentlessly rising costs of medical care.

Despite that, the Republicans are pitching their bill as far more affordable than the Democrats’ approach. And you are sure to hear a lot in coming days about how it could reduce health insurance premiums. How it compares in that respect with the Democratic proposal is not yet clear. But a lot of the Republicans’ savings on premiums come from reduced coverage. Pay less and get less.

The good news is that this bill has no chance of passing. The bad news is that unless the White House and Congressional Democrats push back with the hard facts, the Republicans could use it to spread false hope of a “cheaper” alternative to scuttle real health care reform.

There’s no question that the Republicans’ bill is cheaper because it does so little to help the uninsured. According to the Congressional Budget Office, it would provide $61 billion over 10 years to expand coverage, compared with more than $1 trillion in the Democrats’ bill.

That paltry effort, the budget office estimates, would extend coverage to a few million people who would otherwise be uninsured in 2019, leaving 52 million citizens and legal residents below Medicare age without coverage or about 17 percent of that population, right where it is today. This is a dismaying abdication of responsibility.

The Republican bill is an amalgam of market-oriented and state-based reforms that conservatives have long proposed, including enhancement of tax-sheltered accounts to help pay premiums and allowing people to buy insurance in other states that might permit skimpier benefits than their home state.

It has some good provisions, such as prohibiting insurers from imposing annual or lifetime caps on what they will pay and automatic enrollment of workers in employer-sponsored group coverage. But it would not prevent insurers from denying coverage or charging higher premiums based on pre-existing conditions.

The Republicans have been railing that the Democratic reforms will do little to slow the rapid rise in medical costs. But neither party has a solution. The Republican bill would cap malpractice awards — a clear infringement of the rights of injured patients. It would get lesser savings by requiring electronic transactions for administrative tasks and opening an approval process for generic biological medicines. The Democratic bills would use both of those for savings and initiate an array of pilot projects to try to find solutions.

The Republican bill’s main emphasis is on reducing the cost of health insurance premiums, a real concern. Compared with current trends, the Congressional Budget Office estimates that under the Republican bill, the average premium would drop by 7 to 10 percent for employees enrolled in group plans at small businesses and by 5 to 8 percent for people who buy their own policies. At large employers, where most Americans get group coverage, the average premium might drop by a modest 0 to 3 percent.

Part of the premium reduction was attributed to savings in the cost of medical services. But much was attributed to shrinking the services covered. The Democrats plan to set minimum benefit requirements to protect people from skimpy policies that leave them without adequate protection when they need it.

The budget office is planning to estimate how the far more complex Democratic bills would affect premiums. Americans need to know that so they can make a full comparison. But there should be no illusions here. The “affordable” Republican health care reform isn’t health care reform. from Greetings:

McCain Losing Support with Working Class Whites in Western PA and Elsewhere

Pittsburgh Post-Gazette, Saturday, October 10

KITTANNING -- The steel mills and coal mines of western Pennsylvania helped fuel the nation's economic engine. Today, old factory shells and boarded-up storefronts stand as bleak reminders of those once-prosperous times.

But the voters in working-class enclaves such as this still are a sought-after prize in presidential politics, and many are belatedly backing Democratic nominee Barack Obama.

In the Democratic primaries, working-class whites consistently backed Sen. Hillary Rodham Clinton. Later polls showed them overwhelmingly favoring Republican nominee John McCain.

Now, driven by fears that their personal finances could further deteriorate, many see Obama as the better choice -- their thinking in some cases driven more by concern about how McCain would handle the economy than any growing admiration for his rival.

"I don't know that there's anything I particularly like about him (Obama), but I dislike McCain, and I dislike the way the country is, and Republicans need to change," said lifelong Republican Ruth Ann Michel, 64, a retiree shopping in a market in Butler on a recent day. She said her vote for Obama would be her first for a Democratic presidential candidate.

While talk in these parts is mostly about the economy, a prominent -- if not unspoken subtext -- is race. A study of the impact of racial attitudes on the election conducted by The Associated Press with Yahoo News and Stanford University found that whites without a college education were much more likely to hold negative views of blacks than those with a college education.

Democratic Gov. Ed Rendell says a drowning man doesn't care what color the person is who throws him a life preserver.

"This election is going to be decided when a husband and wife sit at a kitchen table, or a single parent sits at the kitchen table, looks at their bills and figures out who is most likely to help them with their financial condition," Rendell said. "If the answer's Barack Obama, nobody's going to care whether he's black, green, orange, purple, fuchsia or whatever."

In April, Rendell backed Clinton in the primary and had to answer questions after saying some whites in his state were likely to vote against Obama because of his race.

Darryl Hendon, 50, of Beaver Falls, who is black and on disability, said he thinks some white Democrats are reluctant to back Obama because of his race.

Since early September, growing numbers of whites who have not finished college have been expressing the view that Obama cares about people like them, even as fewer say so about McCain, according to AP-GfK polling.

In early September, McCain had a 26-point advantage among white voters without a college degree who were likely to vote, according to the poll. But by late September, the advantage had dropped to 7 points, with McCain leading 46 percent to 39 percent among this group.

For Obama, that's far better than Democrats have done in recent presidential elections. President Bush carried whites who haven't finished college by 23 points in 2004 and by 17 points in 2000.

In Pennsylvania, a recent Quinnipiac University poll showed Obama with a double-digit lead over McCain, compared with a close race after the political conventions. Clay Richards, a Quinnipiac pollster, said that's because support among working-class voters in the state is growing, and he suspects many former Clinton supporters are moving to Obama's camp.

The candidates' campaign schedules make clear the importance they attach to Pennsylvania's working-class voters.

McCain and running mate Sarah Palin staged a rally Wednesday in the former steel town of Bethlehem in northeast Pennsylvania. On Friday, Palin was stopping in Pittsburgh, then heading for Johnstown in Western Pennsylvania, where unemployment recently topped 7 percent. The self-described hockey mom planned to drop the ceremonial first puck when the Philadelphia Flyers open their season against the New York Rangers on Saturday.

Obama, for his part, will be in Philadelphia on Saturday. And on Sunday, his running mate, Delaware Sen. Joe Biden, will be joined in his blue-collar hometown of Scranton by Clinton and her husband, former President Clinton.

In Western Pennsylvania, Republican and Democratic voters alike tend to be socially conservative, pro-gun and anti-abortion rights. Many are so-called Reagan Democrats willing to vote for a Republican because of social issues.

While some pockets in this region have recovered and flourished after hard times in the 1980s, many never did. Populations have dwindled and many of those left are elderly.

"The ones who can get a good education ... they leave, which I don't blame them because there's nothing here, really," said Georgia Lutz, 55, who was eating breakfast at a diner in Beaver Falls recently with Hendon. "The economy is absolutely horrible and we're going into a depression right now."

The working-class vote is particularly important in the battleground states of Pennsylvania, Michigan and Ohio, where the percentage of adults without a college degree ranks exceeds the national average.

They also are a key voting bloc because those personally affected by the current economic woes appear to be among the more persuadable voters, according to a recent AP-Yahoo News poll. Among them is Michelle Smith, 41, who works retail during the day at a surplus shop in Kittanning and tends bar at night. Combined, she and her husband have six kids.

"Decent working families can't survive. It's very sad," Smith said. "They raised minimum wage, but now you're paying triple in gas to get to work. It evens itself out."

A Democrat, Smith said she's leaning toward McCain. While she said she likes Obama on a personal level, she wonders if Obama has what it takes to fix the economy.

Obama's already won over Don Melochick, 58, a construction worker from Whitehall in northeast Pennsylvania. A registered Democrat who's voted Republican in the past, Melochick said he plans to vote for Obama because he's "somewhat better" than McCain.

If McCain "hasn't changed nothing in his 30 years ... he's not going to change anything now," Melochick said, from the counter of a diner outside Philadelphia. But he adds: "I don't think Obama will either."