John Edwards and Health Care
John Edwards came out yesterday with a plan for what he calls “universal health care through shared responsibility”. As he put in in an e-mail to supporters: “47 million people are uninsured, while uncertainty grows and costs spiral for nearly everyone else. To fix this crisis, we don’t need an incremental shift, we need a fundamental change.”
47 million people are uninsured: This is truly one of the great American embarrassments, an injustice on such a vast scale that I wonder when I think of it how America can claim to be a great nation at all.
Edwards offers a comprehensive “plan to strengthen America’s health care system and insure all Americans by 2012″. This is what separates him from Clinton and Obama, not to mention the Republicans. How do they intend to remedy this problem? Perhaps they intend not to. Perhaps they have no plan at all. Not yet anyway. Or perhaps, if they’re on the other side, they oppose any plan at all. We shall see.
This is another good reason, if you haven’t yet done so, to give Edwards a serious look. (Obviously, as you can surely tell, I like Edwards a great deal, but I won’t get into the endorsing business here.)
There will be powerful forces lined up against him, tp be sure, forces that have an interest in perpetrating and perpetuating this injustice. Edwards has the courage and conviction to stand up to them.
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You can read all about his plan here.
Amanda Marcotte of Pandagon, Edwards’s new blogmaster, posted on it here. As well as here, where she linked to Ezra Klein, who analyzed the plan here. WaPo covers the story here.
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12 Responses to “John Edwards and Health Care”
Ezra’s analysis is (imho) the best. I have, however, some major indigestion — and one big problem for me is that this plan keeps the link between employers and health care benefits.
These need to be de-coupled.
It reads like somebody’ school research paper after they have read a few articles in Newsweek or the NY Times.
The first thing to do would be to stop using the term insurance since their is no “insurance” functions going with the plan. It is basically a government mandated pay as you go plan for healthcare payments. As soon as the government starts dictating “fair” prices many heathcare organizations will go out of business or move into the cash and carry medicine that will not be part of the plan.
The electionic medical records is an incrediblty complex system that the Department of Defense has been trying to do for 15 year and cannot get to work. Why does someone how knows nothing about IT like Edwards think that he can make it work.
I will trust any healthcare reform when I see the children of the elites in DC going into medicine instead of going into television and the media or law school.
As a general rule, when reviewing any of these plans, ask yourself the question: Will this cause my children/family to want to pursue a career in healthcare or make them want to avoid it. Since the Edwards plan is just a gateway to semi-single payer, I would say that it would make people to tell their children to stay out of the healthcare industry.
Look, I’m favor of universal health coverage but there are some awful truths that need to be recognized:
1. The federal budget is in deep, structural trouble because we have too many commitments for spending (mostly healthcare) and not enough revenue.
2. Repealing the Bush tax cuts and using the revenue to create more commitments will exacerbate that problem.
3. If you have more money chasing the same amount of product (as you will with universal coverage), prices will go up.
4. If prices go up as a consequence of any plan, political support for universal coverage will become weaker rather than stronger.
5. In health care the amount of product is (more or less) fixed because it’s controlled by a cartel.
6. Reducing health care costs = doctors and hospitals take a pay cut
These sad truths are the reasons that reforming healthcare is a difficult problem: most easy solution just make the problem worse.
“Ezra’s analysis is (imho) the best.”
Yeah, it really pays off to visit his site regularly. He’s one of the most thoughtful left wing commenters. Too serious to become a celebrity like Atrios, but always worth reading.
“commenter”? Sry, nonsense, he’s a blogger, of course. I’ve had too much rum, I guess.
“The first thing to do would be to stop using the term insurance since their is no “insuranceâ€? functions going with the plan. It is basically a government mandated pay as you go plan for healthcare payments.”
You sure you really read the plan, superDD? Because I can’t find this in it.
Gray,
In an economic sense, Edwards is not proposing any form on an insurance in any form but instead is proposing a health care finance system along with some government mandates on health care management.
What Edwards is proposing is that all Americas will be force to pay directly into a health care finance system managed at the state level with general revenues making up the difference.
The rest of the proposals are government mandating the standard of cre (will lawyer enforcement), government regulating the practice of medicne, government dictating how medical records are maintained and what IT platform they will be maintained on (something that the DoD has been unable to do), and establishing another level of medical guidelines on top of the current state law/JCAHO model.
There is also hints that the government will force healthcare workers to work in certain areas, perform certain procedures, and endure endless lawsuits.
“In an economic sense, Edwards is not proposing any form on an insurance in any form but instead is proposing a health care finance system along with some government mandates on health care management.”
Uh huh. Well, without doing too much reasoning about this, I have some questions:
- Why is it called Health market when it’s not an economic approach?
- Health care insurances are a finance system, what else?
- What do you mean by government mandates on health care management? That there will be regulations? D’oh.
The rest of the proposals are government mandating the standard of cre (will lawyer enforcement), government regulating the practice of medicne, government dictating how medical records are maintained and what IT platform they will be maintained on (something that the DoD has been unable to do), and establishing another level of medical guidelines on top of the current state law/JCAHO model.
- What do you mean with “the standard of cre”?
- Where does it say the government will micro manage the practice?
- Government alredy has laws on record keeping for business, what’s the problem with regulation medical records?
- Where does it say something about the platform, isn’t this about specs?
- Since the customer is in a weak position to successfully decide on the quality of HOs, wouldn’t an extension of JCAHO evaluation actually force bad organisations to rise up to industry standards, hence reducing the gmble experience for the customer? What’s not to like here?
Gray,
If you look up Insurance at Wikipedia is says: Insurance, in law and economics, is a form of risk management primarily used to hedge against the risk of a contingent loss. Insurance is defined as the equitable transfer of the risk of a potential loss, from one entity to another, in exchange for a premium and duty of care.
There is no risk management and no hedging in Edwards plan. It is just a government plan to create a fund to pay current years medical expenses with. All of the proposals take all of the risk management aspects out of the program. I personally believe that it would be better to call it a health care finance program and certainly not a risk management system. The real question is hot is everyone going to pay in a couple thousand dollars a year and get $100,000′s out of at the end of life? That is not an insurance program but a Ponzi scheme.
If you also read the parts about evidenced based medicine, it means that the government will set the what types of care are provided, how it is provided, and it what setting it is provided. That is nothing more than a government mandated standard of care.
It says that the government will set standards of errors, to set medical record standards, to dictate what type of IT is used and how it will be used. That far exceeds the current level of medical regulation and means that the government will manage how care is provided.
If you can provide a reference that shows that JCAHO actually raises the level of care I would love to see it. I have never seen one.
Now, looking at Edwards plan would you recommend any relative to go into healthcare or would you recommend that they go into law so that they can sue healthcare providers for failure to comply with the tons of new regulations and mandates.
Dave Schuler,
You post the usual arguments including:
If in fact anyone will come up with some original ideas, who says it will be the same product? Any meaningful reform should actually involve some changes in how things are done. Small clinics with health care professionals other than doctors, possibly a new class of health care provider between a doctor and a nurse? It seems everyone who really objects to things like this just can’t get their brains out of the rut of the past.
You also post
Have you paid any attention to what Bush is proposing in his current budget? He already wants to cut payments to doctors and hospitals. In addition many of the private insurance companies screw around for months, often almost a year before paying doctors, a behavior they wouldn’t tolerate from someone who owed them money.
In other words the things that you believe stand in the way of reforming the health care system depend on us not really reforming or reorganizing health care in any meaningful way for their existence.
superdestroyer is correct. This has nothing to do with insurance. His idea is hardly new. Mitt Romney started Massachusetts along the way to a similar proposal which is doomed to fail. The idea equates health insurance with auto insurance. But people can get around auto insurance by taking public transportation. There is no alternative to a mandated health care plan other than dying. The projected costs have risen to $400 per month. People living at or below the poverty level will pay nothing while others will pay on a sliding scale. Anyone opting out will pay a penalty. The reality of this situation has caused those developing the program to consider reforms which would cap the amount paid and allow for high deductibles. This would end out leaving many underinsured . But the problems don’t end there. Absent from the books are many people who choose not to work for one reason or another. Still others who work off the books will try to take advantage of the program. They will simply claim a small amount which keeps them below the poverty level this qualifying for free health care. Add to this the increase usage and you will see the costs rise even more.
I have other reservations with the government mandating health care. Some of those mentioned by superdestroyer are just the start of massive government intrusion into peoples lives. Already several politicians are trying to outlaw certain foods. Since obesity is a major factor in high blood pressure, diabetes, and other maladies look for heavy taxation on certain foods and the outright banning of others. That kind of nanny state is not to my liking.
People should eat well and exercise to keep fit. They should also not have to be told to budget well and purchase insurance. Life has risks and consequences and it is not governments job to eliminate them. Also, health insurance has not really increased dramatically from the 50′s and 60′s. In fact, we get a bargain today in terms of the quality of care we receive. People fail to factor in the fact that people live through illnesses which would have killed them just a short time ago. I
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