Ted Kennedy’s Health Manifesto
For the coming political battle, the last Kennedy of his generation is sounding the trumpet for health care reform.
“Over the last year,” he writes in a Boston Globe OpEd, “I’ve seen our healthcare system up close. I’ve benefitted from the best of medicine, but I’ve also witnessed the frustration and outrage of patients and doctors alike as they face the challenges of a system that shortchanges millions of Americans.”
In his manifesto, Kennedy hits all the notes of Obama’s proposal for change and, albeit in a somewhat tentative way, for the highest of all. After promising more transparency in health insurance plans, negotiation for lower premiums and regulation to prevent denial of coverage for previously existing conditions, Kennedy writes:
“We’re also hearing that some Americans want the choice of enrolling in a health insurance program backed by the government for the public good, not private profit–so that option will be available too.”
That wording presages the crucial struggle to include a Medicare-for-all provision in the bill that would put pressure on private insurers to compete in the health care market instead of maximizing their profits.
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8 Responses to “Ted Kennedy’s Health Manifesto”
“That wording presages the crucial struggle to include a Medicare-for-all provision in the bill that would put pressure on private insurers to compete in the health care market instead of maximizing their profits.”
There's a curious formulation for you. Market competition is about something other than maximizing profits. Insurers don't currently compete. If only the market had one government-run behemoth, that would foster competition.
I'm a liberal, and like everyone else I'm appalled that health care costs are so high. So here's what we do: we redistribute those costs. We redistribute hard, through industry regulations and government bureaucracies, and by God we keep redistributing until everyone's medical bills are below average.
Snarky comment, Dr liberal. Kennedy did not propose a government-only program, just an opt in. What's the problem? You don't think a “government run behemoth” can actually compete with the svelte efficient private insurers do you?
Now you know I'm as conservative as you are liberal, so I'll just suggest complete deregulation and elimination of any role whatsoever for government. That will obviously set the insurance industry free to innovate us a fast, efficient and inexpensive medical system. It's worked so well already.
If you conservatives had half the vision and courage Senator Kennedy shows in his announcement, you'd be much more popular. He's for choice and affordability, against fraud and abuse.
Deregulate our most heavily regulated industry? Are you mad? Even under the wise guidance of regulation, the market barely functions. Imagine what might happen without it!
I should also point out health care is 17% of our economy, 1 in 6 of our jobs. If we allowed consumers to confront suppliers, costs and expectations might be forced to meet. Voters might have to confront economic reality. Jobs might be lost. The nurses unions and other organizations that fund campaigns for our bold leaders like the Senator might be significantly inconvenienced. How can you even risk such an outcome?
Most heavily regulated? Damn liberals. I knew it. If only insurance companies were free to charge us as little as they wanted, why rates would be dropping like flies in the Padres outfield.
And of course you're right that if only injured or sick people would stand up to those nasty doctors (you're not THAT kind of doctor are you?) they could say “hell no, I won't pay you $400 to sew up this laceration. I'm gonna find cheaper care! It would serve those greedy hospitals right if they bleed all over the floor on their way out.
Right on too about nurses unions. Damn unions again. Always screwing things up. Hell if Chinese nurses can work for $4 a day, so should those slackers here. But I don't know about that universal coverage thing. We may be the richest nation on earth, but dammit, if they can't pay, let em die!
Exactly, GreenDreams. Our doctors and nurses are the salt of the earth, second only perhaps to those in Cuba.
Six figure starting salaries are the least we can do for them, and no one should badger them with impertinent questions about how much they're charging. I'm sure their charges are in all instances just like all the tests they run us through: for our own good. Same with ambulance drivers. If $40 per mile is usual and customary, then by all means that's what they should be paid.
I share your concern about awkward scenes in front of doctors. It would be awful if hospitals became like grocery stores, which are a constant parade of the starving staggering past the checkers to protest the spiraling prices of tomatoes. Or consider those people you see pushing their cars out of gas stations, because the profit-seeking oil companies charge too much. Give me the serenity of the emergency waiting room, where customers know their place: waiting, hour after hour, sick and bleeding, for care whose costs they don't know and dare not ask.
What really worries me is the poor. I'm mortified that we don't have a program like medicare that provides subsidized coverage for them. Well, actually we do here in San Francisco, but I mean nationally. I'm not keen on simply writing them a check, though, because between you and me I don't trust them to spend it well. Uncle Sam knows best, I say. Let's have a bunch of federal programs that “help” them “choose” what's best for them. I'm a big fan of choice.
I'm gratified that as conservative as you are, you can still see through your haze of wickedness that the profitable insurance companies that dominate the market are the source of the problem. The solution is so obvious: a much larger insurance company–one that makes losses so staggering that politicians cannot even speak of them without fearing for their careers.
It's my understanding that the lesson from the broken health care program suggests that the public health is not a matter of option, but a matter of mandate as one of the basic human rights.
Ok, doc, all seriousness aside then, you didn't defend your fear that private insurance can't compete with a government program. You throwing in the towel? Despite your “massive losses” fantasy, Medicare/Medicaid are WAY less wasteful than the for profit model. Don't believe it? Compete then, insurance tycoon wimps! Oh no, can't have that. Better they should spend OUR premiums to bribe OUR legislators to give THEM the money, free of any troublesome nonprofit competition.
I'm clear what I want. The minimum money providing the maximum care to the largest number of people. There is a whole world of data-literally-that the nonprofit model costs less for better outcomes.
Dreamer man, private companies don't enjoy the luxury of accruing tens of trillions of dollars in unfunded liabilities. If you continue to let medicare operate that way, stacking up bills to be paid by future generations, it had darn well better be able to offer better deals to the current generation. Whether you call this “competing” is a moot point; it would certainly undermine the private market.
Not that I have any particular fondness for the role private insurance plays in the current system, attempting to “insure” people against virtual certainties. “My insurance doesn't pay for preventive care!” What sort of nonsense is that? It's like expecting your car insurance to pay for new tires. The role of these companies should be scaled back considerably, to the point where their products are worthy of the name “insurance” and consumers' voices start to be heard in the market.
Your figures about medicare's dramatically lower overhead are unconvincing. Once you compare costs per enrollee rather than costs per dollar spent and account for medicare's laziness about tracking down fraud (http://online.wsj.com/article/SB121944730222565…) and for costs they push onto providers through their monopsony power, the two look pretty similar. Your claim that nonprofit costs less for better outcomes is also heavily disputed, by people living in that same world of data.
In any case, we can debate which part of the beach appears to be a little dryer, but the problem is the tide is continuing to rise. We can't afford what we have, we can't afford medicare as it stands, and we're leaving millions of people high and dry because we certainly can't afford yet more of the same. Even if your figures were true and we could simply wish away 20% of the cost, we'd be right up to our necks in four years.
The real question is what's driving the relentless 5-10% annual cost increases and how we can reverse them, so health care gets cheaper and better every year. I have yet to hear any non-profit advocate explain how their model will accomplish this. And no surprise, because it's they who have to fight their way up the mountain of data about the power of government (or indeed any large organization) to innovate. They seem quite content to locate the driest patch of sand and stick their heads in.