Why I support the Senate health care reform bill
The Senate bill isn’t perfect. It builds upon many things in our system that we’d do better simply doing away with. It isn’t as fiscally sound as many would like, and I’m not at all sure that many of the more fiscally responsible measures in it will ever end up being enacted. Such is the nature of our Congress. When it comes time to make the hard choices they’re often kicked down the road. Unlike Wyden-Bennett, it doesn’t cover 99% of Americans while paying for itself. It neither creates the large cost-sharing pools I’d like to see, or spurs enough competition to make up for the lack of these larger pools (or pool). And while single-payer would probably be more efficient (especially if you think of health insurance as an operating system, which in many ways it is) we’ll likely never get either to single-payer or to a real free market solution anytime soon. We will be plagued with imperfection and compromise because that’s the nature of the beast, and the beast, dear reader, is here to stay.
But this compromise expands coverage to millions of Americans who didn’t have insurance before. Many of these people are low income and have been denied based on their perceived risk – meaning that many are also sick or older (but too young for Medicare). Getting these people covered is undeniably good. Ending preexisting condition requirements which prevent millions of people from getting health coverage is also good. And helping people pay for insurance that is beyond their means, in a more transparent exchange is also, in my book, undeniably good.
Most importantly, I think the creation of an exchange opens the door to moving toward a system more akin to the German model of healthcare, and the tax on “Cadillac plans” opens the door to shifting benefits from employment and making health insurance personal and portable. We’re not nearly close enough to this, but these reforms (along with the individual mandate) put us on that trajectory and clear the road to changing the system in the future. Failing to reform now almost ensures that reform doesn’t happen. Period. Certainly nothing indicates that if the GOP gains control of Congress or the Oval Office they’d do anything at all to alter the status quo. And I’m not sure the Democrats will have the political capital to try again at least anytime soon.
This reform bill isn’t perfect or anywhere near perfect but it’s a start, and I hope it passes. I think it will be good for America and good for Americans who currently face an uncertain economy and the very real risk of catastrophic illness and all that entails.
(If you want to know what will happen right away if this bill passes, read this [pdf].)
This post is cross-posted at my other digs.
(Photo via Daylife)
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Glad someone is being sensible on this (well, I know Mr. Unger here is as well). The fact is, this is a step forward. It’s not as progressive as someone like myself who wanted Public Option would have been, but it will save money, and more importantly, it will save lives and livelihoods. And this will put pressure on the insurers. This bill is saying that more people will be put into the system, which should make a bigger pool and reduce costs at least somewhat given how the business model SHOULD work, and the government is footing the bill on some big risk customers. If the insurers still can’t maintain costs over the next few years with 90% or whatever the projections are for those who will be insured under this, then that is the clear cut sign we need to do away with them or, at the least, incorporate them into government insurance pretty much like the German system, which is the one I’ve come to like the most since this all started and I did some homework.
And, I think the best part about this is, is that it should shut up anyone who still wants to cry “Socialist” about Health Care right now. Or at least show them for a lack of understanding about what the hell is going on. Subsidizing people for Health Care isn’t socialist, it’s socialistic. And doing it so they can buy Private Insurance is pretty much the Capitalistic handcuff.
Well said; I agree.
EverNewEcoN
http://sites.google.com/site/evernewecon
is currently unaware of how
Mr. Obama’s health reform law improves
quality relative to cost in the manner described
below, with the Cleveland Clinic and Duke Medical Center cited as models.
As to whether turning the health insurance
cartel into a utility though with the same sort of offer you can’t refuse as compared with the present practice is desirable, I’m noncomittal.
Simply repealing the cartel’s immunity from the antitrust laws might be preferable, if combined then with simply buying indigents coverage. As to exchanges and medical service (cost) ratios, it will matter as to who (can Jerry Brown do it, whether as Attorney General or Governor?) can police and enforce same.
http://www.newsweek.com/id/224585
The Hospital That Could Cure Health Care
Cleveland Clinic is both highly effective and fiercely efficient.
So why are its methods so rare?
by Jerry Adler and Jeneen Interlandi
Newseek, Dec. 7, 2009 Publication pages 52-56
“…in 2006 Cleveland Clinic abandoned the traditional departments in favor of 25 “institutes” organized by disease or organ system. This works well for patients, who don’t care whether their back pain is cured by a rheumatologist, a neurologist, or an orthopedic surgeon. But, says Regina Herzlinger, an expert in health-care economics at Harvard Business School, it runs afoul of the dominant fee-for-service system of medical billing, which discourages cooperation across fields. When Duke University Medical Center set up a disease-management system for congestive heart failure, coordinating the efforts of cardiologists, primary-care doctors, pharmacists, and nurse practitioners, it drove down the cost of treatment by 40 percent in a single year, while reducing readmissions and improving outcomes.
…
a visit to Cleveland Clinic makes it hard to avoid the conclusion that if you’re looking for “waste” in the health-care system—defined as expenses that do not directly contribute to medical outcomes—a good place to look is the nation’s cobbled-together system of competing private insurers. ”
http://www.newsweek.com/id/224585
I support the Mafia…they are certainly more honest than the Three Stooges, obama, pelosi, reid
EverNewEcoN
http://sites.google.com/site/evernewecon/
is currently unaware of how
Mr. Obama’s health reform law improves
quality relative to cost in the manner described
below, with the Cleveland Clinic and Duke Medical Center cited as models.
As to whether turning the health insurance
cartel into a utility though with the same sort of offer you can’t refuse as compared with the present practice is desirable, I’m noncomittal.
Simply repealing the cartel’s immunity from the antitrust laws might be preferable, if combined then with simply buying indigents coverage. As to exchanges and medical service (cost) ratios, it will matter as to who (can Jerry Brown do it, whether as Attorney General or Governor?) can police and enforce same.
http://www.newsweek.com/id/224585
The Hospital That Could Cure Health Care
Cleveland Clinic is both highly effective and fiercely efficient.
So why are its methods so rare?
by Jerry Adler and Jeneen Interlandi
Newseek, Dec. 7, 2009 Publication pages 52-56
“…in 2006 Cleveland Clinic abandoned the traditional departments in favor of 25 “institutes” organized by disease or organ system. This works well for patients, who don’t care whether their back pain is cured by a rheumatologist, a neurologist, or an orthopedic surgeon. But, says Regina Herzlinger, an expert in health-care economics at Harvard Business School, it runs afoul of the dominant fee-for-service system of medical billing, which discourages cooperation across fields. When Duke University Medical Center set up a disease-management system for congestive heart failure, coordinating the efforts of cardiologists, primary-care doctors, pharmacists, and nurse practitioners, it drove down the cost of treatment by 40 percent in a single year, while reducing readmissions and improving outcomes.
…
a visit to Cleveland Clinic makes it hard to avoid the conclusion that if you’re looking for “waste” in the health-care system—defined as expenses that do not directly contribute to medical outcomes—a good place to look is the nation’s cobbled-together system of competing private insurers. “