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The Weirdness Of Health Care Reporting

There's something very strange about the reporting on the compromise House health care pooh-bah Henry Waxman reached with the Blue Dogs yesterday. On the one hand, the headlines and ledes all talk up the savings the Blue Dogs managed to squeeze out of Waxman. On the other hand, the pieces are almost entirely about concessions that would ... raise the cost of the plan. Take this from the Times story:

Efforts to pass sweeping health care legislation took a big step forward on Wednesday as House Democratic leaders reached an agreement with fiscally conservative party members that would cut the bill’s cost and exempt many small businesses from having to provide health benefits to workers. ...

Under the House agreement, the federal government would still establish a public insurance plan to compete with private insurers, but the public plan would not use Medicare fee schedules to pay doctors and hospitals, as envisioned in the original House bill. Instead, the public plan would negotiate rates with health care providers, as private insurers often do.

Representative Mike Ross of Arkansas, the chief negotiator for the fiscally conservative Democrats known as Blue Dogs, said the changes were “a huge win for us.”

Blue Dogs said the change reduced the likelihood that the government plan would compete unfairly with private insurers by forcing doctors and hospitals to accept below-market rates. ...

“We have cut the cost of the bill substantially,” Mr. Ross said. ...

The House negotiators, including Mr. Ross and aides to Mr. Waxman, said they had agreed to make these changes in the bill:

Most employers would still be required to provide health insurance to workers or pay a new federal tax, but more small businesses could qualify for the exemption, which would be available to businesses with annual payrolls of $500,000 or less, compared with a threshold of $250,000 in the original House bill. The maximum tax rate, 8 percent of wages, would apply to employers with payrolls exceeding $750,000, rather than the original threshold of $400,000.

Huh? So we're going to pay doctors and hospitals more (the Medicare schedule is less generous than what private insurers typically pay), and we're going to exempt more small businesses from taxes, and yet we're congratulating ourselves on lowering the price tag? Granted, all the stories have vague allusions to lower subsidies, but the vast majority of ink gets devoted to measures that raise the cost of the legislation.

I don't mean to pick on the Times here. All the coverage basically reads the same way. And the reason, I suspect, is because that's how the Blue Dogs have been arguing their case. That is, they claim to be most concerned about costs, which becomes their chief macro talking point. But, as others have pointed out, they're really most concerned with taking care of their own--rural doctors and hospitals, small businesses in their districts. And so, when it comes to specific accomplishments, those are the ones they tout.

--Noam Scheiber