There should be an automatic fine of $10,000 for anyone who claims that a dispute between politicians is about philosophy. It should double the second time they say it and go up to $100,000 the third time.
Come on folks, this political science 101. The people that we see in Congress, the White House and elsewhere on the political stage did not get there because of their great philosophical works. They got there by appealing to powerful interest groups. And they stay there by appealing to powerful interest groups. So why are people in the media continually telling us about philosophy.
Glenn Kessler is the most recent sinner in his otherwise fine Fact Check piece on Sarah Palin's effort to bring back her "death panels" claims about ACA. Kessler notes that Palin now claims that her reference to death panels is the Medicare Independent Payments Advisory Board (IPAB), which she argues will be making life and death decisions about what payments to provide for various treatments.
Kessler comments that IPAB is an effort to contain the rate of cost growth within Medicare which is says is not very different from the system proposed by Republicans. The latter would provide beneficiaries with a voucher (which they like to call "premium support") whose growth would be restricted to a pace well below the rate of medical cost inflation.
Kessler then tells us:
"the dispute really centers on a philosophical divide between the parties. Democrats would rely on independent experts ... Republicans would rely on the insurance marketplace to control costs."
What makes this is a question of philosophy? Let's be more concrete. The system put in place under the ACA would put the government in a position where it could squeeze money out of providers. It could specify prices for services and procedures and tell providers take it or leave it. Given the enormous and rapidly growing size of the Medicare market, most would likely take it.
By contrast, the Republican approach surrenders this market power. In fact, it increases by costs by relying on a network of private insurers that we know is less efficient than Medicare. (The Congressional Budget Office and other independent experts have documented this fact numerous times. Like global warming, it is no longer a debatable point.)
Kessler and the Post don't know anything about Republican's philosophical beliefs. They do know that they have proposed a Medicare plan that is likely to leave a higher share of Medicare dollars in the hands of insurers and give providers more money for each dollar of services. The paper should just stick with the facts and leave speculation about philosophy to readers.