As featured on p. 218 of "Bloggers on the Bus," under the name "a MyDD blogger."

Sunday, August 30, 2009

Bill Bradley's Model Congress

In 2000, angered by the rightward, DLC-led turn of the Democratic Party, I became interested in Bill Bradley's candidacy for the Presidency and voted for him in the California primary. Needless to say, he didn't win that year, and he retreated to the world of speeches and occasional op-eds as an eminence grise of politics. During that 2000 campaign he would say very adamantly that all Americans should have access to quality, affordable health care. It was a pillar of his campaign. Now a member of the punditocracy, he can imagine some grand compromise between the left and right on the issue.

Since the days of Harry Truman, Democrats have wanted universal health coverage, believing that if other industrialized countries can achieve it, surely the United States can. For Democrats, universal coverage speaks to America’s sense of decency and compassion. Democrats also believe that it will lead to a healthier and more productive country.

Since the days of Ronald Reagan, Republicans have wanted legal reform, believing that our economic competitiveness is being shackled by the billions we spend annually on tort costs; an estimated 10 cents of every health care dollar paid by individuals and companies goes for litigation and defensive medicine. For Republicans, tort reform and its health care analogue, malpractice reform, speak to the goal of stronger economic growth and lower costs.

The bipartisan trade-off in a viable health care bill is obvious: Combine universal coverage with malpractice tort reform in health care.

On what planet does Bill Bradley spend most of his time? Let's grant him for a second the possibility that Republicans want to reach a compromise at all on health care reform, something they have not at all shown in every single day of this debate. Mike Enzi, one of the "bipartisan" negotiators, is still referring to death panels and has been quoted as saying he's only participating in talks to stop a bill from getting passed. So you have to waive a lot to get to Bradley's notion of a model Congress.

But tort reform, which is one of those conservative buzz words which has been drained of most of its meaning, has been a state issue, at the behest of Republicans, for many years, and 38 states have enacted it in one form or another. It would be curious for Republicans to compromise on universal health care in exchange for something most states already have. What's more, given that we have this evidence from over 75% of the country, we can pretty quickly determine that medical malpractice suits are at best tangential and more accurately completely meaningless to the health care debate. Josh Richman, a very good journalist in the SF Bay Area, rounds up that evidence:

From Bloomberg News:

"(A)nnual jury awards and legal settlements involving doctors amounts to “a drop in the bucket” in a country that spends $2.3 trillion annually on health care, said Amitabh Chandra, a Harvard University economist. Chandra estimated the cost at $12 per person in the U.S., or about $3.6 billion, in a 2005 study. Insurer WellPoint Inc. said last month that liability wasn’t driving premiums."

The Congressional Budget Office in 2004 concluded that medical malpractice tort reform wouldn’t have a significant effect on health care costs:

"Malpractice costs amounted to an estimated $24 billion in 2002, but that figure represents less than 2 percent of overall health care spending. Thus, even a reduction of 25 percent to 30 percent in malpractice costs would lower health care costs by only about 0.4 percent to 0.5 percent, and the likely effect on health insurance premiums would be comparably small."

And Americans for Insurance Reform, a coalition of nearly 100 consumer and public interest groups around the country, issued a report in July which found:

• Medical malpractice premiums, inflation-adjusted, are nearly the lowest they have been in over 30 years.
• Medical malpractice claims, inflation-adjusted, are dropping significantly, down 45 percent since 2000.
• Medical malpractice premiums are less than one-half of one percent of the country’s overall health care costs; medical malpractice claims are a mere one-fifth of one percent of health care costs. In over 30 years, premiums and claims have never been greater than 1% of our nation’s health care costs.

Democrats like Bill Bradley validate conservative claims on things like tort reform despite all evidence to the contrary, then decide that honest men can strike a wonderful compromise despite having no negotiating partner on the other side.

Just in case you were wondering why Democrats lose national debates.

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