The View from Right Field

Health Care: A Good Plan

At last Republicans have a health care plan they can support, a plan that will help people both get health insurance and take more control of their medical care. I am not talking about Mitt Romney’s plan in Massachusetts or Arnold Schwarzenegger’s plan in California. I am, and I am amazed to be saying this, talking about the plan President Bush announced in his State of the Union address last Tuesday evening.

President Bush’s domestic policies have too often been contrary to conservative principles of limited and modest government. (A "modest" government is one that does not think it knows everything and should decide things for its citizens. A modest government lets people decide for themselves because it realizes individual people know more about what is best for them than the government does.)

For example, while "No Child Left Behind" does, at least, establish the principle that schools must be held responsible for the job they do, it is not the federal government which should be doing it. Elementary and secondary education is a job for state and local government. Too often in the 2000 and 2004 elections it seemed like George Bush and the Democratic candidate du jour were running to be president of their local school board instead of President of the United States.

The huge expansion of Medicare that was the prescription drug program for seniors is another example of Bush’s lack of conservatism. While Part D is working better than anticipated, the program itself makes Medicare an even bigger burden, an even bigger unsolved problem, for the future. (The only thing that can be said for Part D is that, because it lets people choose what drug plan works best for them, it is costing less and working better than expected.)

Which brings me to President Bush’s health care proposal. It is breathtaking both in its simplicity and in the way it addresses the health care problem.

The plan has two parts. First, families get a special new deduction for health insurance of $15,000 per year. Singles get a $7500 deduction.

Second, people who are presently getting health insurance at work will have the cost of that health insurance considered taxable income for them. For most workers, the value of their health insurance coverage at work is less than $15,000, so they will not pay any additional taxes. In fact, they will get a tax cut. The only people who will pay more taxes are those who have super-expensive health insurance (i.e., the kind that covers everything with no deductibles and no limits). This combination of deduction and taxability will help people realize that health insurance is not free and will encourage them to get involved in making sure they get real value for their health insurance dollar – because if they do not, it will cost them money, either in a lower refund or a higher tax bill.

By providing real tax relief to people when they buy health insurance, the plan will make it easier for people to buy health insurance. This is especially true since the plan provides that the $15,000 deduction applies not just to income taxes but also social security taxes. This will be a real tax break for many low- and middle-income workers.

One of the beauties of the plan is that it both helps address the health insurance problem and gets rid of a tax break that unfairly favors employed workers over everybody else.

Also, by getting people involved in making their own decisions about health insurance and their health care, instead of delegating it to another new government bureaucracy, as the Democrats would do, we have some hope that medical costs can be kept down while care does not suffer. Getting people involved in making decisions about their own health care is part of what has been responsible for the success of Medicare Part D. (It pretty much says everything about the Democrats that we finally have a government program that people are satisfied with and which costs less than expected, and the Democrats want to impose more government controls.)

President Bush’s new health care proposal helps people buy health insurance; it gets rid of an unfair tax break; and it enables and encourages people to take more control of their own medical care and health insurance. I am glad there is finally an intelligent health insurance program that conservatives can support.

Scott Eyre

Professional athletes are often seen as selfish prima donnas who think of nobody but themselves. But that is not always true.

At the Cubs Convention last weekend my wife and I were walking around when we saw somebody, obviously a Cubs player, in a corner, surrounded by people trying to get his autograph. I, too, got out my Cubs calendar and Sharpie and slowly worked my way to the front of the crowd as other people left after getting an autograph.

When I got there, I saw it was Scott Eyre. Two crowd control people were with him, but he was not trying to leave. He was just standing there, signing autographs. He said he had left his room to go see something about an hour earlier, but he never got to where he was going because he was mobbed by fans. But he didn’t mind. He said he would rather do this than just sit in his room watching TV.

Scott Eyre is not only a good ball player; he is a class act.

Speaking Truth to Power

When Secretary of State Condoleezza Rice appeared before the Senate Foreign Relations Committee earlier this month, Senator Barbara Boxer said this to her:

"Now, the issue is who pays the price, who pays the price? I'm not going to pay a personal price. My kids are too old, and my grandchild is too young. You're not going to pay a particular price, as I understand it, within immediate family. So who pays the price? The American military and their families, and I just want to bring us back to that fact."

When Senator Boxer was challenged on her statement, she said that she would not apologize, that she was "speaking truth to power."

Obviously, there are lots of things wrong with what Senator Boxer said, but I especially have a problem with her use of the phrase "speaking truth to power", just like I did when John Kerry said the same thing in 2004 about his criticisms of President Bush.

Senator Boxer is making it seem like she is taking a courageous stand, that she is risking something, by saying this to Secretary Rice. But what exactly is she risking? Most of her party (at least the vocal part) agrees with her. The news media (except for one network) agrees with her. Leaders all over Europe (in their public statements) agree with her. What’s the risk? Where’s the courage?

If you want to talk about "speaking truth to power," talk about Vaclav Havel speaking out in Czechoslovakia in 1988, knowing he would be sent back to jail if he did. Talk about Natan Sharansky; talk about the White Rose movement in Nazi Germany; talk about Lech Walesa; talk about Andrei Sakharov.

These people are heroes. These people risked their freedom, their lives, to "speak truth to power."

Please, Senator Boxer, don’t try to compare yourself to these people. Don’t try to compare making a statement in a Senate committee room to what these people did. It’s not the same.

Iraq: Thoughts on a New Strategy

The new strategy and, it would appear, tactics that President Bush announced last Wednesday look good. It is too bad that we did not try them earlier. While it is easy to second guess, there were people calling for more troops and these tactics a while ago. It should have been obvious that clear-and-abandon does not work. If we did not have enough troops for clear-and-hold before, then we needed to send more troops then. It took Bush too long to start questioning his generals and their bosses on the results we were achieving in Iraq. Others saw that things were not going well a while ago. It is too bad that it took Bush so long.

Which brings me to my concerns:

1. Will we have enough troops? We certainly are not adding many. There may be too much to do for the troops we can send. The limit on the number of troops we can send would seem to be a result of two things, the size of the Army and Marine Corps and the fact that it has taken us so long to start this strategy. If we had done this earlier, we would have had more troops (certainly, more reservists) that we could have sent.

2. Will the Iraqis cooperate? Previously Prime Minister Maliki has stopped Coalition troops from going into Sadr City to shut down the Shiite militia operating from there. If things such as this do not change, we will not succeed.

3. Are the Iraqis good enough? It takes time to train soldiers. It takes even more time to train officers. Have they had enough time? I do not know. (For that matter, to the extent we will be expecting our own soldiers and Marines to be following the new Counterinsurgency field manual, how much new training are they going to need?)

4. Most importantly, do we have enough time? Beating a counterinsurgency takes a long time. It seems probable that the most time we have is two years (the remainder of Bush’s term), and that may not be enough. It is possible the insurgents can just hunker down and wait us out. Too many Americans: (i) don’t care about Iraq; (ii) don’t think the consequences will be that bad (they are wrong, but they will not realize it in time, if they ever do); (iii) don’t care about the commitments we have made to the Iraqi people because Bush is not their President (for an elaboration on this point, see here); and/or (iv) say it is not their war (see (iii) above). These Americans may will us into defeat before the new strategy has a chance to work.

Health Care: Single-Payer

I do not understand why, when it has become so obvious in so many places that government is not good at running things, so many people in the United States want the government to run our health care system.

I understand our health care system has many failings, but why do people think that a government-run system would be better? Look at FEMA, at Amtrak, or at the public school systems in many of our big cities. What is it in the operation of these entities that gives one any confidence the government can run a decent health care system?

What seems to be happening is that the people who favor a government-run health system, are comparing the promise of a government-run single-payer system with the reality of our current system. Obviously, any time a real system is compared to a proposed system, the proposed system will look better. The proponents of a government-provided system are saying, "Look at all of the problems and inequities in our current system. A single-payer system will solve these problems, and get rid of the inefficiencies, so it will be better and cheaper." Of course what these people ignore are all of the new problems a single-payer system would cause and all of the new inefficiencies it would have.

Proponents of a single-payer system point to Canada as having a fair and equitable medical system. But in 2005 the Canadian Supreme Court held that Quebec’s law prohibiting people from buying private insurance for health care procedures covered by the public system was unconstitutional under the Quebec Charter of Rights because the public system was not providing adequate health care itself.

In New Zealand, when the Labour government was running for re-election, one of its campaign promises was to increase the number of cataract operations and knee and hip replacements that the health care system would provide. It was not a matter of how many people needed such operations; it was a matter of how many operations the government would pay for – and since an election was coming up, the government was willing to pay for more.

In Illinois the state government is chronically slow in paying its Medicaid bills. The situation has gotten so bad at times that hospitals and doctors have threatened to, and in some cases actually did, stop serving Medicaid patients because they were not getting paid for the services they performed. Do we really want our medical care contingent on politicians like those in the State ofIllinois deciding whether to pay our medical bills or to pass more pork?

The common response to concerns about a single-paper system is that while our health system might work for rich people, or at least middle class people with jobs and health insurance, it does not work for poor people and people without health insurance. When I needed a cataract operation, I did not have to wait in some government queue. I just talked with my doctor and scheduled it. Liberals would say that the only reason I could do this was because I had health insurance and that poor people would not be able to do that. Even if this is true, the solution is not to follow the Canadian or New Zealand model and make me wait for my operation. The solution is to figure out a way to make medical care more available for poor people, not import the problems of systems in other countries.

Look at Medicare Part D. When it was originally passed, people said it would be a failure: it was too complicated; it would be too expensive; it would reduce coverage. But the actual results have been quite different. It was complicated at the beginning, but people are happy with it now. And it is costing less than was predicted.

What we need is some real down-to-earth analysis and research into how other systems operate, what their good points are and what their problems are. We need to look at how other health care systems operate in practice, not what they promise in theory. Then we might be able to figure out some ways to make our system better, without making it worse, something a single-payer system will not do.

Iraq: A Plan, Not Just a Surge – Update

This article in Tuesday’s The New York Times indicates that President Bush, in deciding to increase the number of troops in Iraq, will be not only sending more troops but also changing the strategy and the commanders implementing it. According to the article, when Bush visited the Pentagon recently, he told the people there, "What I want to hear from you is how we’re going to win, not how we’re going to leave."

I am encouraged Bush seems to understand it is not just a matter of sending more troops to Iraq. We need to send them with a new plan.

We will have to wait to see how the new strategy (and tactics, I hope) works in practice, but at least there is hope.