Saturday, January 14, 2012

I like being able to fire people

I didn't like this video from the Democratic Party, when I first saw it. "I like being able to fire people"? That was taken completely out of context.

Here's what Mitt Romney really said:
I want individuals to have their own insurance. That means the insurance company will have an incentive to keep you healthy. It also means if you don't like what they do, you can fire them. I like being able to fire people who provide services to me. . . . You know if someone doesn't give me a good service that I need, I want to say I'm going to go get someone else to provide that service to me.

OK, true, Mitt Romney has done far worse than that, himself:
From Barack Obama, in Mitt Romney's latest ad:
If we keep talking about the economy, we're going to lose.
What Obama actually said, campaigning against John McCain on October 16, 2008:
Senator McCain's campaign actually said, and I quote, "if we keep talking about the economy, we're going to lose."
Just out of curiosity: How flat-out, knowingly false does something have to be before the press is willing to just call it a lie? We're about to find out!

Now that was bad! And the Romney campaign actually defended it:
You may recall a couple months ago, when Mitt Romney released an ad showing President Obama in 2008 quoting John McCain, but presenting it as if it were Obama describing his own position now. Romney’s campaign fiercely defended the violent wrenching of Obama’s words out of context, arguing at one point, “He did say the words. That's his voice.” 

And, of course, it's Republicans who think that corporations are just people, too. Romney himself has claimed that "Corporations are people, my friend." Aren't Democrats just taking him at his word? If corporations are people, then Romney clearly said that he likes firing people.

So it's hard to think that Romney deserves better. He doesn't. However, we deserve better.

And the thing is, Romney was wrong, anyway. They didn't have to distort what he said. They could have just explained why he was wrong. Admittedly, that wouldn't fit into a sound bite nearly as well.

Here's Jonathan Cohn:
But the argument that Romney was trying to make, about health care policy, deserves some scrutiny of its own, because you’re going to hear it again. Conservatives frequently claim that the health care system will be better off if people act more like consumers, shopping around for the best insurance plans. The best way to accomplish this, they say, is to transform Medicare into a premium support system and to repeal the Affordable Care Act, putting in its place a deregulated market with more insurance options. Romney has endorsed all of these ideas.

But unfettered choice is not a good thing in health care policy. One reason is that getting good, reliable information about insurance plans is difficult – as anybody who has ever tried to buy coverage on his or her own can attest. Another is that, even in a world with perfect information, the insurance market is prone to a particular kind of failure. Insurers don’t want to pick up bad risks and will do whatever they can to avoid them. Absent regulation, that makes it virtually impossible for people with serious medical conditions to get coverage. As Ezra Klein put it a while back, when Republicans were talking up this idea, "It's a great proposal if you don't ever plan to be sick, and if you don't mind finding out that your insurer doesn't cover your illness. And it's the Republican plan for health-care reform."

The thing is, you generally don't want to "fire" your health insurance company until you've got reason. When you're healthy, you don't have a reason. It's only when you get sick that you might discover how bad your insurance is.

But when you're sick, insurance companies want to be fired. Sick people cost them money. They only want healthy people as customers. In fact, before the Affordable Care Act ("Obamacare") made it illegal, health insurance companies would fire you when you got sick with something expensive, like cancer.

And then, it was good luck finding another health insurance company which would cover you at all, let alone cover your "pre-existing condition." They don't make money from sick people, they make money from healthy people.

This was the crazy thing about the House Republicans' plan to end Medicare. (And yes, PolitiFact be damned, giving the elderly vouchers and telling them to find their own insurance, if they could, is "ending Medicare." That might have been a health care plan of sorts, but it wasn't Medicare!)

Anyway, how many health insurance companies would be wanting to insure my 85-year-old mother, do you think? At any price, pretty much. There's no way they could make a profit from that! That's the whole point of Medicare, in fact. Health insurance companies never were clamoring to cover the elderly, for obvious reasons.

Right-wing ideologues have their pie-in-the-sky theories, but they're not backed by evidence. Conservatives just believe what they believe. Well, they're faith-based, not evidence-based.

Here's Igor Volsky:
Conservatives have long claimed that giving Americans more “skin in the game” — that is, increasing their sensitivity to prices — would encourage individuals and families to make more informed health care choices, avoid costly treatments and eventually lower health care costs. But there is very little evidence to suggest that asking people to pay more out of pocket would actually reduce health care costs, particularly since most of the spending is concentrated among the sickest Americans (those who suffer from multiple chronic conditions and cannot choose to forgo care).

As Yale professors Theodore Marmor and Jerry Mashaw pointed out in the Philadelphia Inquirer last year, “if free medical care led to more reckless overuse, countries like Canada and Germany, where patient costs are either zero or minimal, would suffer disproportionate inflation in expenditures or severe access pressures. They don’t.” Indeed, the theory doesn’t even hold up in the American health care system, where individuals with higher cost sharing in the employer based system with higher cost sharing don’t seem to spend less than Medicare enrollees with smaller cost sharing.

Derek Thompson makes a good point, too:
Romney says "the insurance company will have an incentive to keep people healthy." That's not true. The insurance company, as Romney knows, has an incentive to make a profit. One way to make a profit is to have way more healthy clients than sick clients. But that's not the easiest way. The easiest way is to rescind coverage when your healthy clients get sick, or to refuse coverage or discriminate on the basis of preexisting illnesses to ensure your group has only healthy people. Without regulation to prevent insurers from discriminating against or pushing off the sickest policyholders, healthy patients would all belong to cheaper plans and sick people would all get stuck in the same insurance program that death-spirals toward bankruptcy.

An individual market that moves away from company-defined health care requires group-underwriting regulations to prevent these kind of death spirals. But once we require insurance companies to accept all comers, we risk driving up premia unless we also compel all adults to buy health insurance whether or not they're sick. Otherwise, all healthy people could abstain from insurance until they contract an illness, knowing the insurance companies would accept them. Thus, you have the case for an individual mandate to make up the third leg in health care reform after government regulations and an "exchange" market for individuals.

Romney wants to give families the power to choose and fire insurance companies. That's commendable. It's also unworkable in a market where "people [only] own insurance if they wish to." That's the real gaffe from this morning.

I'm not sure if that was the "real gaffe," because I think the whole thing was wrong. But yes, that's another problem with Romney's new plan. (Obviously, his "old" plan is "Obamacare.")

Now, I realize that these arguments don't make a good political sound bite, not compared to "I like being able to fire people." And I also realize that Republicans seem to do very well by lying through their teeth like that (indeed, worse than that).

But do Democrats really have to choose between being inept and being dishonest? I don't think so. But maybe that's just what I want to believe, I don't know.


Jeff said...

The only thing I can come up with on this one is the Democrats were just playing the game the way the Republicans set up the rules (or lack thereof). That is, never let context get in the way of a good attack ad.

This is at the feet of Romney. It was a bad take to begin with. He suffers from a Republican affliction I call "open foot, insert mouth."

After all, they are the party of "say anything, do nothing."

WCG said...

Open foot, insert mouth? Sounds even more difficult than the other way around! :)

But speaking of which, did you see this guide to "Mitt-isms" at Talking Points Memo? I thought it was both funny and accurate.

I wanted to include it here, in fact, but this post was too long already.

Jeff said...

Mitt-isms.....oh, dear. Sounds like he was channeling his inner G.W. Bush.

He might as well have gone the whole nine with classics like "putting food on your family" or "where would this country be without this great land of ours." (palm slap)

WCG said...

Jeff, I was just reading about another one, clear back in 1994:

...he approached a reluctant woman on the street to shake hands and said, “I know, you haven’t got your makeup on yet, right?” (Dumbfounded, she replied, “I do!”)