Tuesday, May 17, 2011

A good week for the GOP

As far as I'm concerned any week in which the GOP no longer has to worry about a Donald Trump candidacy or a Huckabee run and in which Newt Gingrich has so totally discredited himself that his candidacy is over before it begun is basically a good week for the Republicans.

Mike Huckabee might be an appealing guy and have the full support of social conservatives but he was iffy in 2008 on economic issues and isn't the guy to carry the economic arguments against Obama. He can carry on his show on Fox and stay out of the political race.

Donald Trump has always been an annoying distraction. He's not really a Republican as his past support for prominent Democrats has made clear. He's just a loudmouth whom the media loved to portray as if he were truly the face of the GOP. His carrying of the birther flag was a totally embarrassment.

Newt Gingrich's self immolation puts a period to the very slim chance that he had to capture the nomination. He has often toyed with running. He should have stuck to his previous playbook.

The WSJ rightfully trashes Gingrich's history on health care.
Our guess is that a politician as experienced as Mr. Gingrich knew exactly what he was doing and that as he runs for President, he wants to appear to be more moderate than he has sounded over the last, oh, 20 years, by suddenly triangulating against the GOP House he once led.

Mr. Gingrich's charge of radicalism is false in any case. Mr. Ryan is proposing a "premium support" model for Medicare of the kind that already governs health plans for federal workers and public employees in California and other states. The government would pay a set annual fee (starting at $15,000 per senior and rising with inflation) to private Medicare plans that would then compete to attract seniors. With consumers paying the marginal costs of their own care, providers and insurers will begin to compete on price and quality.

The irony is that Mr. Gingrich's own history of political failure on health care has made Mr. Ryan's proposals all the more necessary. In 1995, Mr. Gingrich pushed a "Medicare Plus" reform through Congress that shared many of the same features as Mr. Ryan's. It would have cut $270 billion from Medicare over seven years, while giving seniors a premium-support choice to join HMOs. President Clinton vetoed it, which along with Mr. Gingrich's refusal to compromise helped precipitate the government shutdown.

In 1997, he agreed to a balanced budget deal that planted the seeds for future spending increases by creating a new entitlement for children's health insurance but offering no fundamental Medicare changes. A formula was created for phony cuts in physician payments, hiding the program's true costs. And the difficult choices were deferred to a bipartisan commission, which in 1999 recommended—yes, premium support, like Mr. Ryan.

After retiring from the House, Mr. Gingrich next lobbied for the GOP's 2003 Medicare drug entitlement, though three-quarters of seniors already had some kind of private prescription coverage. In these pages, with his usual restraint, he called it "the most important reorganization of our nation's health-care system since the original Medicare bill of 1965 and the largest and most positive change in direction for the health system in 60 years for people over 65."

Mr. Gingrich's policy conceit was that the bill's health savings accounts would revolutionize health care. The bill's minor market reforms have worked better than expected, but ObamaCare has undermined HSAs, which were never by themselves enough to introduce consumer-driven health-care reform.

Yet now he is trashing Mr. Ryan for thinking far more deeply about health care, and in a far more principled fashion, than Mr. Gingrich ever has. The episode reveals the Georgian's weakness as a candidate, and especially as a potential President—to wit, his odd combination of partisan, divisive rhetoric and poll-driven policy timidity.

In his recent campaign book, "To Save America," he describes Mr. Obama as bent on leading a "secular–socialist machine" that "represents as great a threat to America as Nazi Germany or the Soviet Union once did." Mr. Ryan speaks softly but proposes policies commensurate with America's problems. Mr. Gingrich speaks loudly but shrinks from hard choices. Who's the "radical" and who's the real leader?
I also like this quote from Dick Armey on Gingrich.
“It’s typical of Newt to be whimsical,” Armey said in a phone interview with POLITICO on Monday. “We always say: Newt always has so many great ideas. Well yeah, but then he shifts between them at such a rate it’s pretty hard to track it let alone keep up with it.”
But the coup de grace was this quote from a Dubuque Republican to Newt.
“Get out now before you make a bigger fool of yourself,” Fuhrman said directly to Gingrich.
Too late.

Yes, his words hurt the Republicans, but at least we won't have to worry about Newt much longer.

The entire dust up about Gingrich and the withdrawals of Huckabee and Trump distracted coverage from Paul Ryan's speech yesterday. James Pethokoukis highlights this section from Ryan's speech as setting up the contrast between Ryan's plan and Obamacare.

The President’s plan begins with trillions of dollars in higher taxes, and it relies on a plan to control costs in Medicare that would give a board of 15 unelected bureaucrats in Washington the power to deeply ration care. This would disrupt the lives of those currently in retirement and lead to waiting lists for today’s seniors. … The disagreement isn’t really about the problem. It’s about the solution to controlling costs in Medicare.

And if I could sum up that disagreement in a couple of sentences, I would say this: Our plan is to give seniors the power to deny business to inefficient providers. Their plan is to give government the power to deny care to seniors.

… That’s the real class warfare that threatens us — a class of governing elites picking winners and losers, and determining our destinies for us.
Pethokoukis recommends that Republicans memorize that argument and use it in their defense of their support for Ryan's plan. Republicans would also do well to use these facts about Obamacare.
The latest Medicare report shows tens of trillions of dollars in unfunded promises, but Rick Foster, the program’s nonpartisan chief actuary, says it’s actually worse than that because the report counted savings from a planned 29 percent cut in doctor’s payments.

"That's pretty unlikely to happen,” Foster says. "Congress has overwritten smaller payment rate reductions every year in 2003 through 2011. And they're almost certain to override these again."

Robert Reischauer, one of the Medicare trustees agrees. "When faced with smaller reductions in the past, Congress blinked and cancelled the cuts," he said.

Both men appeared with others at a conference sponsored by the American Enterprise Institute in Washington, D.C., to discuss the latest report on Medicare's fiscal health.

Beyond the planned cuts in doctors’ fees, the new health care law will cut $500 billion from Medicare.

Foster and others worry that steadily falling reimbursements will make it more difficult for seniors to find anyone willing to treat them.

"Currently Medicare payment rates to physicians are about 80 percent of the private sector, private insurance rates," he says. They would go to 60 percent if the doctor payments were cut.

But that isn't the only spending cut the program faces, and Health and Human Services Secretary Kathleen Sebelius, another trustee of Medicare, argued last week that the new health care law has saved the program by reducing costs.

Skeptics say that assertion relies on controversial assumptions. For instance, a doctor's office may not function with the rhythms of an automobile production line, but the administration is assuming, and actually counting on, doctors and other providers adjusting to lower reimbursements by increasing their productivity or efficiency at the same rate manufacturers do. If they don't, the lower payments might well make it harder for seniors to find providers willing to treat them.

That is one reason Foster has more than a little doubt. "The productivity adjustments are unlikely to be viable in the context of today's health care world," Foster says. "If today's world continues without major change, they just, I don't see how they can work."

The administration has dictated that Medicare spending not rise faster than levels close to the GDP. If it rises faster than that, the new law has a failsafe -- a board that would have only one power, to arbitrarily lower reimbursements even further if spending gets too high.

“Their hands are tied, their feet are tied and they're gagged," Reischauer said, laughing. "You know, in the sense that they can't raise premiums, they can't change deductibles" -- they can only lower payments to providers.

House Budget Committee Chairman Paul Ryan told the Economic Club of Chicago on Monday that the president's plan "relies on a plan to control costs in Medicare that would give a board of 15 unelected bureaucrats in Washington the power to deeply ration care. This would disrupt the lives of those currently in retirement and lead to waiting lists for today's seniors."
And the way the Obamacare bill was written, the decisions of that unelected board are not subject to either administrative or judicial review.

Think about that - Obama has created this unelected board and then tried to remove any constitutional ability to curb their efforts. That is why the fight against Obama in 2012 is so crucial. And Gingrich, Huckabee, and certainly not Trump were not the men to lead that fight. The sooner that we get them out of the way, the better for concentrating on finding a leader who can frame these arguments.