We got our guvment back. And blog too

From Mike King


The confederacy of extreme right wingers of the Republican House caucus — aided by their new bestest buds Ted Cruz and a Mike Lee in the Senate — got what they have been begging for the last couple of years — a government shutdown and a chance to make even wilder-than-usual, fact-challenged claims about Obamacare, which they failed to repeal, shutdown or even significantly alter as a price for their ransom of the U.S. economy. But enough about that now. Because these folks long ago detached themselves from rationality, we might have to go through the whole thing again after the first of the year. So no need to waste time about who won and who lost, as the media is likes to do. Mostly, that’s because the media doesn’t have the stomach to actually analyze whether one side was really right and the other side was really wrong to think that sucking $24 billion out of the economy with the shutdown, and putting the credit of the country on the block by threatening not to pay some of our bills, was worth it.

Let’s return instead to some of the discussion points that got lost — as John Boehner may say — while the hot air was still in the room during the shutdown. There are many that need more airing, like whether the individual mandate should be delayed; whether the faulty, horribly-rolled out sign-up process for the exchanges is indicative of other problems administering the new law as it is implemented; whether Congress really did “exempt” itself from the law by providing staffers a special subsidy when they sign up for insurance on the exchange, and whether some of the taxing mechanisms for paying for the insurance subsidies should be repealed.

We’ll deal with one of those — the medical device tax — today. It’s worth a closer look, not because it is all that controversial — although the K Street lobbyists in Washington would have you believe it is — but because it almost got included as part of the ransom demand for Obamacare changes during the shutdown. Thankfully, the White House help firm on it, despite some weak-kneed Senate Democrats who wanted to repeal or delay it and justified their position by claiming they and the White House had to give the House hostage-takers something to claim as a win.

The best analysis of the medical device tax issue is presented in this op-ed in today’s NYT. 

I can only add with 20 to 30 million more Americans now eligible for insurance coverage — and presumably a bigger market for their wares —  it’s a little disingenuous for these manufacturers to be crying wolf that a small tax on their profits will kill the industry.

And lastly, there’s this: Anyone who has ever dealt with filing claims or purchasing a needed piece of equipment directly from device manufacturers or suppliers — from sophisticated, implantable, life-sustaining devices like insulin pumps to simple technology like CPAP –has figured out the incredible markups they get on these devices. Moreover, they understand how manufacturers collude with doctors and insurance companies to limit choices of what kinds you can purchase or lease if you want to claim coverage.

So don’t expect a lot of sympathy for these health care providers. They don’t deserve it.