Re-conciliation

File under “Great Fucking Idea” from Ezra Klein:

Democrats could scrap the legislation and start over in the reconciliation process. But not to re-create the whole bill. If you go that route, you admit the whole thing seemed too opaque and complex and compromised. You also admit the limitations of the reconciliation process. So you make it real simple: Medicare buy-in between 50 and 65. Medicaid expands up to 200 percent of poverty with the federal government funding the whole of the expansion. Revenue comes from a surtax on the wealthy.

[…]

If health-care reform that preserves the private market is too complex and requires too many dirty deals with the existing industries, then cut both out. But get it done. Democrats have a couple of different options for passing health-care reform this year. But not passing health-care reform should not be seen as one of them.

And that’s it. Harry Reid walks out to the podium (with Nancy Pelosi maintaining a stately distance, naturally) and says: Fuck all y’all below the age of 50. Move to Massachusetts if you’re so fucking concerned with your fucking lack of health coverage. Go die in the streets and see if we fucking care. Rest assured: we do not fucking care. Not anymore. Coverage is for closers only. It’s the American Dream!

Instead, the Democrat will most likely commence to explaining why 50 votes can’t even be mustered even for this little change and the Democrat should sit quietly in a corner somewhere, execute only GOP-sourced initiatives discussed only using GOP talking-points and rhetorical frames, and otherwise do absolutely nothing between now and the 2010 midterms. Whatever you do, don’t rock the boat.

Don’t, under any circumstances, swing for the fences on bank and Wall Street reforms, jobs packages, and other such heady initiatives that force would the GOP to go along or (the vastly more likely possibility) just shut the whole government down for the next 8 months giving you, the Democrat, 24/7 talking points about how the GOP just loves them some Banksters and hates, hates, hates the common man and his/her ability to get a job. Whatever you do, don’t allow a Medicare buy-in such as the quoted paragraph suggests, because then you might have to repeatedly pummel your GOP opponents with why, exactly, are they so afraid of adding a little competition into the market. Why, exactly, they are so beholden to the concept of care costing 4-5x what it would cost in any other Western nation while delivering a fraction of the benefit with regard to outcome, as measured almost any way you want to look. Whatever you do, 59 vote majority, don’t start doing things. That way lies destruction.

Cost Benefit Analysis (Result: Go Die in the Streets)

Total spending on health care, per person, 2007:

United States: $7290
United Kingdom: $2992
Italy: $2686
Spain: $2671

We must be getting the best outcomes, right? Think of all our technology!?! Think again:

As of the 2006 data (the most recent I can find), we ranked 27th in infant mortality, just behind the Slovak Republic, with Mexico nipping at our heels. Life expectancy at 65 for females (compared among the relatively wealthy nations) ranks 14th, males 18th. We perform similarly poorly in almost all metrics you look at, perennially trailing countries that spend 4 or 5 times less per person than we do; hell, we trail countries that people would otherwise routinely mock as sadly “backward” or “economically stunted.” Dread France beats us on costs and outcomes. Repeatedly. (This data and much more available here. Use it. Please.) So, just to summarize in the simplest, clearest terms possible:

we pay 2.4 times more per person on healthcare than our next nearest competitor and get substantially worse outcomes than countries spending even less than that.

But, by all means, GOP: don’t mess with such a powerhouse of efficiency. Well, beyond your proposed “solutions” of blowing up the existing employer-based system and putting everybody out on the streets to fend for themselves.

Today’s GOP can effectively be summed up by the phrase “Go Die in the Streets.” Seriously, it applies to every position they have. Clearly, they’re working backwards from it to form whatever passes for policy in their lairs.

Just to review, I give you the 2010 GOP Platform:

Social Security: Go Die in the (Wall) Streets

Welfare: Go Die in the Streets

Immigration: Go Die in the Streets (preferably of your home country, but we’re not picky)

Healthcare: Go Die in the Streets

Military Spending: Go into the Streets so you can Die

Firearms/Gun Control: Go Die in the Streets

Abortion: Go Die in the (back) Streets

Prove me wrong, children. Prove me wrong.