• Winning the battle, but losing the war

    One of my greatest frustrations during health care reform was the fact that, while conservative health care reform plans existed, none were seriously offered by prominent politicians. Yes, one or another was bandied about in wonky circles, but none were seriously put forward as the answer to the PPACA. Even the eventual calls for repeal and replace lacked much detail on the “replace” part.

    It’s not that I can’t understand why things went this way. Politically, it’s much easier to play defense than offense. If you want to increase access, as many on one side want to do, then it’s going to cost money. If you want to reduce costs, as many on the other side want to do, then it’s going to reduce access or decrease quality. Proposing what you want means opening yourself to attack. That’s why it’s hard to do, and why it doesn’t happen often.

    But, let’s face it. Opponents of health care reform could just keep attacking and attacking, and watch the bill, and law, become more and more unpopular. If your goal was partisan in nature, then this was absolutely the way to go.

    My problem with that was that I couldn’t care less about the political win; I wanted a policy win. I wanted a better health care system. I firmly believed that honest debate and compromise could get us there. But if one side would offer a solution and then be decimated for doing so, we’d get nowhere.

    That’ why I have to agree with Andrew Sullivan once again. I may not agree with all the aspects of Rep. Ryan’s proposed budget. But I respect the fact that he’s put himself on the line and exposed himself to political harm. There will likely be no end of ads and campaigns attacking him for his ideas; some of those lines of attack may even have merit. But that’s always the way it is.

    One side thinks that spending is too high, and they want to reduce it. Of course, when you reduce spending, you cut programs – many of which are popular. The other side thinks that revenue is too low, and wants to increase it. But raising taxes, even if it means returning to rates from the recent past, can be just as unpopular as spending cuts. Proposing what you want means opening yourself to attack. That’s why it’s hard to do, and why it doesn’t happen often.

    But, once again, I don’t care about the political win; I want a policy win. I want a better economy and a more stable long term outlook, and that’s not sustainable with out current revenue and spending. Rep. Ryan may be in the majority in the House, but Democrats still control most of the government. It may be politically savvy to attack, but it will be in the best long term interests of out country if those who disagree with Rep. Ryan go one step further. They should answer his ideas with their own. If they hold merit, then a real debate can take place, and America can decide how best to improve our long term deficit.

    If, however, opponents take the opportunity merely to attack and demonize without countering with their own plans, then we will lose a valuable chance to use debate and compromise to achieve an optimal solution. Some believe that the Republicans passed up such an opportunity with health care reform. Let’s hope the Democrats don’t make the same mistake. They may win a political battle, but America could lose the policy war.

    • I don’t agree that Mr. Ryan’s proposal is a serious attempt to offer an alternative to our current unsustainable situation. There is way too much magical thinking in it. We are going to reduce tax rates, but increase the total amount of taxes collected. We are going to reduce, rapidly, unemployment to levels that haven’t been seen in generations, but no explanation of how this will happen. We are going to shift the costs of healthcare for the elderly and the poor away from government, and somehow these people without financial resources are going to pay the difference.

      Its not so much that I don’t like Mr. Ryan’s proposal, its that they don’t make sense. I don’t think either side has put forth anything resembling a solution. I wish they would.

    • Perhaps Democrats should respond with a plan that proposes a return to income tax levels in effect before 1980, maybe at the FDR level, and no cuts in Medicare and Medicaid.

      That would be about equivalent to Ryan’s “courageous” plan to raise taxes on the less well off, lower taxes for corporations (who pay little in taxes anyway) and the better off and slash benefits to middle class and poor Americans.

      Just as the wealthy love Ryan’s plan, the poor and elderly might well love this alternative plan. Then, at least, you could no longer say the Democrats had no plan. They’d have a far left plan similar to Ryan’s far right plan.

    • I think we are setting the bar awfully low if we are to conclude that Rep. Ryan’s Path to Prosperity is a serious or courageous “plan.” I expected Andrew, given his deficit fetish and relative lack of understanding of public finance, to swoon over Ryan’s “plan.” But, given that its major components fall right in your wheelhouse, I am a bit surprised by your reaction.

    • Swoon? I’m not swooning. Go read my CNN piece for more.

    • I don’t understand why you don’t think the Dems have already put forward plans of their own.

      As Ezra has pointed out many times, the ACA already reduces the deficit. And that’s without counting many of the potential money-saving ideas in it as saving any money. As it moves forward, many of these ideas will save more money.

      Here’s another idea: it’s time for American doctors to compete with doctors from overseas. Medical spending drops dramatically. See Dean Baker for much more on this.

      If Paul Ryan’s plan counts as serious, then the following should certainly count as serious: we immediately cut per capita health care spending to the average of all OECD countries. Voila: long-term budget gap gone! Poof! (How do we do it? Adopt a typical OECD plan for medical coverage. There are a ton of models out there; let’s steal one. Throw a dart at a dartboard: Germany, Japan, England, France, South Korea, Switzerland, Spain, Canada, Sweden, Norway, Denmark, etc., etc.) Doctors get paid less? Oh well! Shared sacrifice baby!

      More mainstream ideas that have been mentioned many times: Let tax rates return to Clinton-era levels across the board. Remove the cap on income subject to social security taxes. Add a tiny financial transactions tax. Cut defense.

      Again, all of these ideas have been put forward many times. Why don’t they count? Why aren’t they “serious”? I don’t get it.