23 January, 2010

(R) vs. (D) on Health Care Reform

The ‘Affordable Health Care for America Act’ created a gaping partisan divide in both houses of Congress. Why? In class, we discussed one reason: the desire of Democrats to see Obama pursue his goals and be successful, and those of Republicans to derail his agenda and presidency.



The second reason for this partisan divide relates to the first reason, but is completely about the party base: the involvement of so many originally partisan issues within the bill. Redistribution, illegal aliens, abortion, federal spending and the deficit, taxation, market intervention, veterans’ care, lifestyle mandates, role of the federal government, are examples of some of the controversial issues within the bill itself or its principles that are dividing congress along party lines. These issues, as pointed out in class, have nothing to do with health care since the bill has made itself much less about actual cost reduction and insurance coverage expansion than about ideology and simply getting something inherently Democratic passed as seen through the methods it seeks to achieve its goals and ongoing media hype: not that the hype is a bad thing.

I agree that these issues may have been over emphasized and made more controversial, in order to derail the bill, but these issues have individually and collectively resonated deeply with the ideologies of each party’s core and have become important issues separate of the Obama presidency.

I will show that the media, appealing to conservative or liberal views on each separate issue, have generated support or resistance to the bill by tying it to these other non-health care related issues.

Taxation

Clips from different media outlets address the health care reform bill on questions of taxation, its impact on the economy, and government spending.

The following video highlights concerns about taxation and the resulting effect of the economy, here discussed specifically with regards to projected impact on Illinois.



Abortion

The question of abortion coverage highlights support and opposition to the bill that, while not entirely divided along party lines, comes from beliefs that were deeply rooted into the Republican base and liberal ideology years before an Obama presidency. The almost unanimous support by Republicans for a controversial amendment proposed by Rep. Stupak in debate, was one reason for party-line divisions.

Watch CBS News Videos Online

Illegal Immigration

President Obama has said that proposed health care subsidies and public option coverage (now dead) would not go to illegal immigrants. As this video discusses, and as mentioned elsewhere by the President, this statement is not entirely true.

Neil Cavuto, host of a FoxNews “Business News Show”, discusses the health care reform bill and illegal aliens.

The party line vote of an ammendement describing provisions to prevent illegals from abusing the system highlights a key political difference between the parties: the belief in the obligation of the US government to financially support all people within its jurisdiction.

This next video is an MSNBC discussion over the responsibility of Americans to provide health care insurance subsidies and coverage to all in the US including illegal immigrants. The response to a question raised by a town hall protester, do we turn away illegals who demand care, again highlights a political division between the two parties.

The question over illegal immigration is a highly partisan issue. The ties between partisan issues of social safety nets and illegals produce even larger divisions within Congress along party lines.

The question over illegal immigration ties into larger questions of principle about obligations of society to support others within it that are somewhat exclusive or alienated. The slide about states’ health spending on illegal immigrants ties in the separate issues of spending and overall cost.

Cost

Something as empirical as costs cannot be easily disputed by either party. However, the view about 'which cost is less worthy' is disputed and has led to a divide between R and D.
This CNN news clip of CNN anchors presenting CBO budget data to the Director of the Executive Office of Health Reform is my case in point. In response to CBO Director Elmendorf’s quote about increases in federal costs, the Health Reform Director mentioned the possible savings for individuals and families, and the possibility savings for the government in the long term. This highlights the partisan divide between the government cost increases emphasized by Republicans and possible personal savings for most Americans advocated by the bill’s Democratic proponents.

The media world is filled with radio chat shows, news clips, speeches, and commentary that support the claim about the different types of cost being a dividing factor in support for the bill.

Individual or Collective Responsibility

An ideological discussion of the role of society to support health care coverage (through the public option and federal insurance subsidies) has divided progressives from libertarians or conservatives, if I may be allowed to generalize here. The divide between individual responsibility and mandated collective responsibility

Fox news shows a clip from a town hall meeting where Senator Cardin (D) discusses collective responsibility in response to a question from meeting attendee Robert Broadus. On the Neil Cavuto Show, Broadus turns the discussion of the health care reform bill into a philosophical debate about the individual and choice, which he believes is threatened by universal health insurance and the health insurance mandate in the bill.

A CNBC show discusses this philosophy, phrased in the context of health care provision (which is what striving to achieve universal health insurance coverage will equate to) being a requirement of the public sector or not.


On the side, the representative from the CATO Institute pointed out Medicare costs and included that monetary cost in the discussion of feasibility of practice. This philisophical question about role of the individual or government to provide for goods has a generally partisan division with progressives being more likely to support government intervention to provide or expand the range of public goods to address a percieved social injustice.

Role of Government

The size and role of the federal government in health care relates to the practical aspect of health care as a right or privilege. The bill is seen by its proponents as a necessary expansion of the government’s obligation to address a perceived social injustice.

Fox news was quick to jump on controversial clauses that would expand the role of government. This segment may be over-the-top, but the response by experts and the channel seems to highlight a valid concern or at least one that Fox believes is valid.


Constitutionality

There have been legal threats to challenge the health care mandates by legal and political groups if the bill is signed into law on the basis that the federal government cannot legislate the purchase of a good under the constitution. Many Republican representatives on the state level have moved to protect individual choice of health insurace due to a percieved threat from the reform bill. These attempts may seek to undermine the bill directly, but true constitutional originalists, which tend to be political conservatives, have raised opposition to the bill solely on these grounds; this ties into the ‘role of government’ idea but with regards to law and not political philosophy.

Misinformation

Yes, we do consider insurance premiums and the cost of Medicare in our debates, but controversy remains over how the bill will actually affect them. I've heard congressmen on C-Span allege that the bill WILL NOT decrease average premiums and does not effectively address the problem with existing government health care programs. Yet I hear another party leader, a day later, announce that it WILL lower household premiums and curb Medicare costs. CBO statistics have been selectively plucked from reports by both Republicans and Democrats to advocate for their ideas. Because of media politicization, we hear what we want to hear, further perpetuating our bias for or against policies in the current bill. Misinformation and data selectivity sends mixed messages to different kinds of Americans, distorting the truth, and futher dividing Americans. Secondly, logical debate about cost, government, and the bill's effects has almost faded from the media; what seems to fire up voters are emotion-tugging stories of American suffering, veterans' care, and Big Brother. Has mass media failed to become a medium for informative and relevant discourse about the bill and the future of the country? Another question for another post, another time.

Talk about 'death panels', 'pulling the plug on grandma', associated with big government and redistribution, have become powerful rhetoric in the debate about the bill. Issues unrelated to insurance premiums, coverage, and Medicare are creating the support and opposition to the bill. The party line division seen in health care reform reflects the greater rift in the American population about these issues.



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