Not surprisingly, my advice centers around health reform. I’ve said it before and I’ll say it again, this strategy of promising to repeal is going to be a disaster for republicans.
Let me first qualify what I mean by “disaster”. Historically speaking, the party that wins the white house loses 27.8 seats in congress in the following midterm election. Republicans could pick up as many as 50 seats this time around. I believe that they’re going to pick up around 20 seats. While that’s enough seats to declare “victory” and claim a “mandate”, it would in actuality be a disaster because it keeps them well in the minority.
Republicans are fighting a losing battle if their strategy is to run on repealing health reform during this election cycle. During the course of the next seven months, everything that is good about this bill will have kicked in. Closing the medicare prescription donut hole ensures that republicans will have lost the senior vote, which is their largest voting block. Allowing parents to keep their college students on their insurance plans wipes out that voting block. Losing those two demographics leaves the republican party crippled.
There’s not much they can do about the 2010 elections, but they can salvage 2012. By 2012, some of the ugly realities of this “reform” will have surfaced. Republicans should instead change their tone to promise to fix the problems with the bill, while predicting massive premium increases. We are definitely going to see massive premium increases over the next four years. In the past week, both the CEOs of Aetna and Cigna have already promised that they’re coming. This bill does absolutely nothing to keep premiums down. My guess, based on my experience with corporate premium increases, is that 2012 premiums are going to be 40% – 60% higher than they are today. I’m not trying to be doom and gloom Bitchy, but that’s what I believe is going to happen. If republicans focus in on the problems with the bill, they can clean up in the elections after those problems materialize.
I want to say up front that I don’t believe there’s a snow balls chance in hell that republicans are actually going to fix the cost control problems with this bill. The only means of controlling cost is to force the insurance companies to compete with medicare. Nothing short of that will do anything to chip away at exorbitant premiums. If democrats ran away from a public option with 68% of democrats and 54% of republicans supporting it, there’s zero chance that republicans will make it happen. There is absolutely NO way to bring down costs while still maintaining a for-profit health insurance system. Trust me I’ve looked closely at health insurance systems all around the world. It can’t be done.
I have no idea what republicans can do, within the constraints of what they have become, to fix the problem. But actual solutions are meaningless in terms of winning elections. Republicans haven’t actually solved any problems for our country in decades. This is a fact that inexplicably hasn’t stopped republicans from controlling our government for the majority of the past 100 years.
Getting elected in this country isn’t about what you’ve done. It’s about what you say you’re going to do. If republicans say they’re going to repeal health reform, they’re done. If they point out real problems with this health reform bill, they have a good shot at gaining power again.
On the other side, democrats have until 2012 to get a public option through. They definitely won’t touch the issue before November. I’m not very optimistic that they’re going to move in the direction of a public option at all, but if they do, it won’t be before the midterm election. They backed themselves into a corner with this bill. While they significantly strengthened their position for the midterm election, they insured that 2012 is going to be an unmitigated disaster unless they can fix this bill.
In the meantime, we need to keep the pressure up to get a public option through. Not because I give a damned if democrats keep control of congress, but because we desperately need meaningful health insurance reform. We haven’t gotten it yet. We need to keep the pressure on democrats because we have no chance of getting it under republican control. Trust me, if I though there was a chance of getting something that would help the average American out of the republican party, I’d be out there campaigning for them day and night. Our only hope is to come out en masse to let the democrats know that they’re in big trouble unless they fix the bill. And because democrats are historically obtuse, we need to spell out what those fixes need to be for them.
The Repubs kept Congress, both houses, from focusing effectively on cost-containment. And your point is well-taken: coverage is one thing, cost is another. Interesting article in The Economist how this bill further enshrined the concept that companies bear the lion’s share of responsibility for paying the cost of health insurance. Not sure how the cost issue will play out but that is where the focus needs to be, again, and quickly….