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Tevi Troy's Blog

Scylla, Charybdis, or My Way

By my count, President Obama's health-care speech today was at least his 40th speech focusing on health care; as part of his effort to push his health-care plan, he has had seven major "stop the presses" events on the subject: his White House health-care forum last March; his ABC infomercial with Charlie Gibson and Diane Sawyer in June; the joint session of Congress speech in September; his State of the Union address in January; last Monday's release of his new eleven-page proposal; the health-care summit last Thursday; and now his 1:45 pm speech today.

Unsurprisingly, given how many times we have heard him on this subject, the speech today did not provide any new revelations. He asserted that all agree on the problem, but then tried to triangulate the fix by saying that he did not support a government-run system, nor did he support giving "the insurance industry even freer rein to raise premiums and deny care." (Note: In case you were wondering who supported giving the insurance companies "freer rein," he probably meant you, dear reader, since only about 40 percent of Americans back the president's approach.)

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By Tevi Troy  |  Wed, March 3, 2010 3:54 PM  |  Permalink

Jogging Through History

Bill Bennett's A Century Turns is out this week, and it is an entertaining read. The book will especially reward those who peruse the footnotes at the bottom of the pages (marked by asterisks throughout) as they contain Bennett's funniest, most personal, and often most biting asides. My favorite is about Bill's experience jogging with Pres. George H. W. Bush. After the jog, reporters shouted questions at Bennett, but he was too out of breath from maintaining the presidential pace to reply, so Bush — 19 years older but fresh as a daisy — jumped in and saved him with a non-gasping answer while Bennett recovered.

By Tevi Troy  |  Tue, March 2, 2010 1:36 PM  |  Permalink

March Madness

After two and a half months of relatively light Congressional activity on the health-care front, Democrats are apparently gearing up for a hyperactive March. According to Inside Health Policy (subscription required), the period between now and Easter will be filled with a series of complicated steps that will all need to work perfectly in order for the Democrats to pass their health plan before Congress leaves for its spring break. First, the president will be issuing his revised new proposal, which will be converted into legislative language and then scored by CBO. By March 19, the House would then pass the health bill that the Senate passed back in December — and that the House has repeatedly said they did not like and would not pass — with the assurance that the Senate would go forward and fix it in accordance with some type of bicameral compromise. The House would then have to act again, by March 21, and pass a reconciliation bill amending the Senate bill that the House would have just passed.

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By Tevi Troy  |  Tue, March 2, 2010 9:18 AM  |  Permalink

The Power of Small Ideas

The New York Times ran only one editorial in the Sunday paper this week, called "Small Ideas Won't Fix It." The point of the piece was to say that Republican ideas on health care are insufficient to address our health-care problems. As two people who have been hawking an alternative health-care approach called the "small bill," we are happy to note that four of the ideas that the Times looks at are explicitly part of the plan — medical-malpractice reform, purchasing insurance across state lines, the expansion of health savings accounts and increasing reliance on high-risk pools. The Times claims that the ideas it reviewed "would barely make a dent in the most critical problems threatening the health care system," but the truth is that the small-bill approach will go a long way towards making health insurance more affordable, accessible, and portable, at a fraction of the cost of either the House or Senate-passed Democratic alternatives. The Senate bill, for example, would spend about $2.5 trillion in its first ten years of providing subsidies — the period from 2014–2023 — and would actually increase the cost of insurance premiums. The small bill would cost $180 billion over its first ten years, and would lower the cost of premiums. It would also newly insure approximately 1.1 million Americans per $20 billion spent. The Senate bill, in contrast, is far less efficient, and would only insure 260,000 Americans per $20 billion.

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By Tevi Troy and Jeffrey H. Anderson  |  Mon, February 15, 2010 10:38 AM  |  Permalink

Fairly Well Developed

The New York Times actually has a pretty fair piece today on Republican health-care ideas. The opening graph reads:

When Republicans take President Obama up on his invitation to hash out their differences over health care this month, they will carry with them a fairly well-developed set of ideas intended to make health insurance more widely available and affordable, by emphasizing tax incentives and state innovations, with no new federal mandates and only a modest expansion of the federal safety net.

"Fairly well-developed" is high praise from the Times, I suppose. Of course, it took President Obama to acknowledge that such ideas exist by calling for a bipartisan health-care summit for the Times to run such a story. Still, it is good to get these ideas in front of the shrinking number of people who see the Times as their only news source.

By Tevi Troy  |  Tue, February 9, 2010 1:25 PM  |  Permalink

'Not Starting Over'

A White House official told the Washington Post that President Obama's Blair House summit on health care "is not starting over . . . Don't make any mistake about that." The official added that "we are coming with our plan. They can bring their plan." If they are not willing to start over, I am not sure what they hope to accomplish substantively from the summit. Politically, however, the intent is clear: The president is looking to reprise his Baltimore debate with the Republicans, but not to give any ground on substance. If this is the case, Republicans should treat the upcoming exercise as a debate, and come prepared with arguments in favor of their own plans, as well as rebuttals of the Obama plan.

While it would be great if the president and the Democrats were serious about finding a bipartisan alternative, they do not appear ready to take those steps yet. Still, it was not long ago that even a bipartisan summit was unexpected, and the White House is effectively acknowledging, after a long "party of no" campaign, that there are other ideas on health care out there besides their own. Republicans should bring their A game on the 25th, and be prepared to show — politely, but with conviction — why their ideas on health care are superior.

By Tevi Troy  |  Mon, February 8, 2010 12:54 PM  |  Permalink

The Tipping Point

The Wall Street Journal reports that the government share of health spending in the U.S. will pass 50 percent next year, even without passage of the Democratic health bills. This is an important and unfortunate milestone, and it is coming five years earlier than the 2016 date previously predicted. Other depressing tidbits in the article, which come from a new report from the Centers for Medicare and Medicaid Services, included the projection that one fifth of U.S. spending in 2020 will be on health care — up from 17.3 percent of GDP in 2009 — and that overall health spending will hit $4.5 trillion a decade from now.

Given our aging population and the rising cost of health care, this movement of federal spending over 50 percent is unlikely to retreat anytime soon. Liberals understand the significance of the 50 percent milestone — namely additional justification for greater government control over the system — and are not bothered by it. As Charlie Rangel told the Journal, "There is nothing inherently wrong with crossing this threshold, especially in light of the recession. These data show that government programs are working as intended." Were the stalled Democratic health-care bills to pass Congress, and the federal share of health spending to go even higher, no doubt Rangel and his allies would see this as additional proof of the system working as intended. The rest of us, however, would have good cause for alarm.

By Tevi Troy  |  Thu, February 4, 2010 10:14 AM  |  Permalink

No Rush?

The New York Times has an article about Harry Reid's sudden decision that "There is no rush" to pass a health-care bill. While the Reid turnaround is interesting — it was not that long ago that he compared those who took a slow down approach with proponents of slavery — the really informative aspect of the article is the light it sheds on why he feels he needs to put on the brakes: He does not appear to have the horses to get health care done. According to the article, Blanche Lincoln and Evan Bayh — both of whom are up for reelection in 2010 — came out against the use of the 51-vote reconciliation technique. Charlie Rangel is adamant that the Senate bill cannot pass in the House, saying: "We are not passing the Senate bill period." And the Times quotes a "Congressional aide who worked closely on the bill" — presumably a Democrat — who, when asked about a way forward on the bill, replied, "If you find it, let me know." Given these developments, it's no surprise Reid is suddenly in "no rush" and saying the Senate is "not on health care now." As we get closer to the 2010 election and Democrats get increasingly nervous about their prospects, he is unlikely to find the path getting any easier.

By Tevi Troy  |  Wed, January 27, 2010 12:00 PM  |  Permalink

Renewing Higher Ed

The Chicago Tribune has an article about Shimer College's new president, Thomas Lindsay. I worked with Tom in the Bush administration, where he was deputy director of the National Endowment for the Humanities. He was instrumental in developing the Picturing America project, a smart initiative to place some of the most iconic American images in schools, libraries, national parks, and Head Start Centers.

Shimer is a great-books school in Chicago with a small student body and faculty — 102 students and 11 full-time faculty. It has been facing some financial difficulties, and Tom is its third president in three years. He is working to get Shimer's financial house in order, and has come up against the expected grumblings from liberal students and faculty. I recently wrote a cautionary tale in City Journal about the problems that emerged at Cornell when students began dictating matters of administration. Lindsay should keep these lessons in mind as he moves forward with his efforts.

By Tevi Troy  |  Wed, January 27, 2010 9:04 AM  |  Permalink

Slap That Hand

The New York Times' Joseph Berger watched Face the Nation yesterday and reported that Senator McCain has reached across the aisle to offer a bipartisan way forward on health reform. McCain told Bob Schieffer that "we'd be willing to sit down and start over from the beginning with genuine negotiations," adding that "there are things we can agree on." Even with Scott Brown's victory last week, McCain knows that Republicans have only 41 votes, and that an all-Republican bill is not going to happen, so he is presumably sincere in his offer to work together with the Democrats to craft a new bill.

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By Tevi Troy  |  Mon, January 25, 2010 1:21 PM  |  Permalink