Why Reforming Health Care Can Help Heal The Economy
Mar 10th, 2009 | 7 responses
The two biggest lies being told by opponents of President Obama’s health-care reform plan is that it will be financed entirely on the backs of the rich and that the depths of a protracted recession is no time to go forward with such a bold and expensive initiative.
If you believe, as I and a majority of Americans do, that health care is a right and not a privilege, then the first lie is easy to answer and the second only somewhat more difficult.
If you believe that getting adequate care when illness or disease strikes should continue to be predicated on your ability to pay and don’t care that several million children remain uninsured even after the S-CHIP program was expanded by raising the federal cigarette tax (cough, cough), then kindly take your curmudgeonly self elsewhere.
As it is, half of the $634 billion cost projected over a 10-year period for the Obama plan would come from raising taxes on the rich, which translates into about $7,500 more from everyone making in excess of $500,000 a year, or approximately one-tenth of the cost of a new BMW 7-series luxocruiser.
The other half would come from a key component of reform: Squeezing much of the waste out of the health-care system. This includes subsidies for private plans that participate in Medicare, exorbitant payments to drug companies, hospitals and other health-care facilities and rooting out the billing fraud that is all too pervasive among big hospital chains.
With so much in need of repairing as the recession enters its 15th month, an argument can be made that this is no time to tackle the task of insuring 46 million Americans, providing adequate care to others who are underinsured and reining in the waste and fraud that is at the heart of a maddeningly complicated and dysfunctional system that spends much more per capita than other industrialized nations.
Yet America’s gravely ill health-care system is the greatest threat to social stability and fixing it will go a long way to begin to heal a very sick economy.
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In 1993 when Hillary Clinton pitched her disastrous reform plan there was neither the will nor the way. Fast forward 15 years and a lot has changed — and very little.
While out-of-control health-care costs and a recession have had a clarifying effect for the many Americans who now support some form of universal coverage, the huge pharmaceutical and insurance companies want to keep costs high because they profit from the very waste that undermines the system.
Their lobbying groups are more or less making nice with the Obama administration, but their “commitment” to reform is only skin deep. When you read the fine print of the insurance industry lobby group’s policy brochure it is obvious that it wants the government to assume the cost of treating the sickest — which is to say the most expensive — people while offering their own watered-down policies with no cap on premiums.
Reform, my ass.
As a reporter, I covered the Clinton reform initiative full time in 1993 but had forgotten that there is a key difference in what she proposed and what Obama wants to do.
ClintonCare, as it was called, was not a government takeover of health care but rather a handover to HMOs that would provide managed care.
In retrospect, that was a recipe for more pain and suffering. This is because for HMOs, “managing” care has been more about denying care, and almost everyone has a personal tale of woe or knows someone who could not get treatment for the flimsiest of reasons. Meanwhile, costs have continued to spiral out of control despite the supposed efficiencies of HMOs.
The Obama plan, to the extent that it has been delineated, will be a hybrid system in which private plans coexist with a greatly expanded but temporary federal role — if 10 or 20 years can be called temporary.
The devil, of course, is in the details, mostly notably what the role of employers will be. While providing a general framework, the White House is leaving most of those details to Congress, which is exactly what Clinton did not do.
I myself favor a middle ground, although I do not doubt that the president will step in if a Democratic congressional majority more or less receptive to reform dithers in the face of crisis and caves in to special interests and the Republican opposition, which is stuck on the false notion that government needs to butt out of insuring people because that would be anticompetitive. Anyone who believes there is true competition now needs to have their meds upgraded.
Only a fool would predict that elements of real health-care change will be in place by year’s end. But failure is not an option.
Shaun Mullen is a former The Moderate Voice columnist. Over a long career with newspapers, this award-winning editor and reporter covered the Vietnam War, O.J. Simpson trials, Clinton impeachment circus and coming of Osama bin Laden, among many other big stories. He blogs at Kiko’s House.
7 Responses to “Why Reforming Health Care Can Help Heal The Economy”
This is because for HMOs, “managing” care has been more about denying care
You realize Medicare, Medicaid, the VA system and Tri-Care are HMOs? There is no reason to think a government-run HMO is any better than a privately-run one, in fact they are sometimes worse.
And Obama is going to cut waste in the health care system, something that all politicians in the past two decades have suggested. The devil is in the details – how will he do it and why should we think he will be any more successful than anyone else? The suggestions pointed out in the articles are all very broad.
[...] Yes, and a majority of Americans want a pony with that too. [...]
DaGoat:
Good observations all. Waste and fraud have been intractable problems and I don't know that Obama will succeed where others have failed, but previous efforts were half-hearted at best. Incentivizing cutting down on waste and eliminating fraud seems to be the way to go.
You are correct that my suggestions were very broad and the absence of links was quite intentional. It was my intention to provide an overview, not a detailed blueprint.
What I hope the post does do if provoke arguments from people who don't want the system reformed and why.
Failure is always an option, and in this case the likeliest outcome.
This is a not a country of Communist Socialist who would care about their fellow man. This is good christian nation in which the only thing we need is a belief in our lord Jesus Christ and where a man can stand on his own two feet, if he can't, it's cause its time for him to meet our Lord and Savior Jesus Christ.
DaGoat
I agree with your assessment of HMOs. They are exactly the wrong way to provide health care. Their very definition requires limiting services.
Medicare and Medicaid fraud is one area that needs to be addressed. In 2007, it was estimated it cost taxpayers $60 billion dollars a year. I believe that number was low.then.
My real fear is detailed in this article. Private health care will throw billions in lobbying to “help” shape any government plan, and legislators are all too willing to take the bribe that guarantees inefficiency and waste. I agree a hybrid system must be developed, but the new system must require private businesses to change equally with the current government system. The solution will be complex, but no more complex that what had to occur in every other Industrialized nation in the world.
This might surprise people but I think if the government truly wants to provide health care for all it has to be an HMO model, and a very restrictive one. The only way to contain costs while increasing access is limit choices. As I said in other posts I don't think the American public is ready for it though because most people are used to convenience and many choices. There would still be inequality and some special interest groups would be very unhappy.
What I would do is have a bare bones plan for every American which provides a “floor”. All medications would be generic with very few exceptions. This will make the drug companies unhappy. No benefits for chiropractic, homeopaths, or alternative medicine. This will make them unhappy. Strict guidelines for expensive tests like MRIs. This will make the MRI owners unhappy. No experimental treatments. This will make a lot of people unhappy. Any physicians following the established guidelines would be exempted from lawsuits as long as guidelines were followed. This would make the lawyers unhappy. All labs would have to go to contracted labs like Quest or LabCorp. This would make people with in-office labs unhappy. There would be limits on dialysis and end-of-life treatments. This would make everybody unhappy.
What WOULD be covered is cancer treatments (within established guidelines), all trauma/accidents, all emergent cardiac and other emergent problems, all routine problem visits (diabetes, high blood pressure, etc), all emergent surgeries, all prenatal and OB, all well-child care and all accepted vaccines. I'd have to think about preventive care (much of which is not currently covered under medicare and medicaid). Long term care (nursing homes) I'd have to think about.
Physicians would be paid at current medicare rates which hopefully will be enough to keep them in the program. Employers and insurance companies could offer supplemental plans with expanded benefits, and of course people could pay out of pocket for whatever they want.
The problem of course with this plan is that almost everyone will be unhappy with something. This would require politicians to actually say no to some people. There is probably no way my plan could be passed currently because too many special interests would be left out, too many people would be unhappy and it involves a lot of hard decisions. However it would probably work.
Such bold and expensive reform will be worth it if it proves to be more beneficial than the previous ways. I do hope that their assessment is precise in this matter, otherwise they'd end up wasting cash that could've been invested in other beneficial means.