Republican Health Care Bill Doesn't get Good Marks from the CBO

A few of the primary criticisms that those in the Tea Party movement and those in the Republican Party have leveled at the Democrats and single-payer advocates is that so-called "free market" solutions should be implemented to reform the health care system.

Two specific points that I have heard from these groups is that the U.S should implement "common sense reforms" including allowing insurance companies to sell coverage across state lines and passing tort reform. You can hear these points discussed at the recent "We Surround You" event that I covered on Fountain Square here in Downtown Cincinnati.

Yesterday, House Republicans had their health care reform bill (which contained many of these so-called "common sense reforms") scored by the Congressional Budget Office (CBO) and it wasn't a pretty story.

From an LA Times report:

...the CBO analysis also concluded that under the GOP plan, 52 million nonelderly Americans would have no insurance in 2019 -- even more than the 50 million in 2010. By comparison, the House Democratic bill would reduce the number of nonelderly Americans without coverage to around 18 million over the next decade.

The GOP bill is an amalgam of market-oriented measures that would limit medical malpractice lawsuits, expand the use of tax-sheltered medical savings accounts, let people shop for insurance outside of their own states, and make it easier for small businesses and hard-to-insure people to get coverage. The ideas reflect conservatives' suspicion of sweeping new programs, federal spending and additional regulation.

Unlike the Democratic plan, it does not include subsidies or other provisions that would make coverage more affordable to people of modest means.

"What we've learned over many, many years is that the reason people don't have insurance is that they can't afford it," said Drew Altman, president of the Henry J. Kaiser Family Foundation, an nonpartisan health policy research group. "You can't make much progress toward helping the uninsured unless you help them buy it."

Ezra Klein helps to break down what this means:

The Democratic bill, in other words, covers 12 times as many people and saves $36 billion more than the Republican plan. And amazingly, the Democratic bill has already been through three committees and a merger process. It's already been shown to interest groups and advocacy organizations and industry stakeholders. It's already made its compromises with reality. It's already been through the legislative sausage grinder. And yet it saves more money and covers more people than the blank-slate alternative proposed by John Boehner and the House Republicans. The Democrats, constrained by reality, produced a far better plan than Boehner, who was constrained solely by his political imagination and legislative skill.

This is a major embarrassment for the Republicans. It's one thing to keep your cards close to your chest. Republicans are in the minority, after all, and their plan stands no chance of passage. It's another to lay them out on the table and show everyone that you have no hand, and aren't even totally sure how to play the game. The Democratic plan isn't perfect, but in comparison, it's looking astonishingly good.

This is cross posted here.

The Fairness Doctrine, the Broadcaster Freedom Act, and the Expansion of Public Discourse

Martha Zoller has a new column that I happened to run across today that voices its support for the "Broadcaster Freedom Act". The "Broadcaster Freedom Act" will effectively bar the FCC from making any new rules or regulations that would reinstate or re-implement standards once set in the Fairness Doctrine. The Fairness Doctrine was established in 1949 to provide for a more balanced discourse on controversial issues that were discussed on public airwaves. The belief was that there were fewer broadcast licenses than there were people who would like to have them, therefore licensees accept certain public responsibility for the use of the airwaves. Given this acceptance of public responsibility, the Fairness Doctrine required broadcasters to devote some of their time to discussion of issues in the public interest and to give airtime to opposing viewpoints. Broadcasters could air opposing views in many different formats (news segments, editorial spots, etc.) but were not required to air the opposing views within the same program. The Fairness Doctrine also didn't require broadcasters programming to be split down a 50/50 line, but merely provide a balance in discussion of issues in the public interest.

The Fairness Doctrine stopped being enforced in the mid-1980's when then FCC Chair Mark Fowler expressed the belief that the view of broadcasters as community trustees should be replaced with the view of broadcasters as marketplace participants. In other words, Fowler advocated the position that content being broadcast on the airwaves should be left to the "free-market". Fowler would also argue, as does Martha Zoller, that the Fairness Doctrine limited free speech by giving the government control over a station's editorial content. Zoller states:

We must protect the free market everywhere it is being assaulted, and talk radio is a free speech market that should be left alone by regulation.

We must remember when discussing this issue, that the airwaves belong to the public and that broadcasters should serve the public interest. Since the end of the Fairness Doctrine we have seen continued concentration of the media into the hands of just a few companies. Though some would argue that we have more channels now with the existence of cable, I am reminded of Senator Byron Dorgan's observation that this is like many voices coming from the same ventriloquist. We have seen opinion and viewpoints become more limited on the airwaves, not expanded since things have been turned over to the "free-market". You can see this firsthand in the coverage in the lead-up to the Iraq War and in the "post-9/11 world" where dissenting opinion was suppressed. Zoller further claims in her article:

The marketplace doesn’t want liberal talk radio. There have been some shows that have done well, but the numbers are not in their favor. This year at the Talkers New Media Seminar, there were more liberal/progressive/independent hosts represented, but the bread and butter still goes to conservative talk because conservatives are so under-represented in the rest of the media market.

When we discuss topics such as the public airwaves, which are owned by the public and should serve in the interest of the public, it is not productive to speak about such topics as "products" subjected to the "marketplace". Public forums for debate, discussion, and the expansion of ideas are fundamental to democracy and speaking about different viewpoints as if we are choosing between brands of soda pop, is grossly missing the point. Simply stating that the public "doesn't want" the other view is no excuse for its suppression and in a society that benefits from debating all viewpoints, it is completely necessary to further open up the level of discourse.

Media consolidation has hurt democracy and it is not productive to think about the issue in terms of a "liberal" or a "conservative" media, but rather recognize that our media outlets are largely stenographers to power. Our media outlets produce sanitized infotainment that passes as news and keeps advertisers coming back for more. Perhaps it is more beneficial to look at this issue of "Fairness" through the eyes of a 1969 Supreme Court decision that upheld the Fairness Doctrine:

A license permits broadcasting, but the licensee has no constitutional right to be the one who holds the license or to monopolize a...frequency to the exclusion of his fellow citizens. There is nothing in the First Amendment which prevents the Government from requiring a licensee to share his frequency with others.... It is the right of the viewers and listeners, not the right of the broadcasters, which is paramount.

— U.S. Supreme Court, upholding the constitutionality of the Fairness Doctrine in Red Lion Broadcasting Co. v. FCC, 1969