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Health Care: Presidential Popularity vs. Constituent Wishes
The NYT published today a fascinating (and somewhat frustrating) look at health care reform’s supporters and detractors in Congress, by FiveThirtyEight‘s Nate Silver and two co-authors. Their thesis:
Critics of the health care reform plan often refer to it derisively as “ObamaCare.” On the policy merits, this is highly questionable: the White House has taken a hands-off approach toward the legislation that recently passed in the House and the Senate version that Harry Reid unveiled on Wednesday. But when it comes to politics, “ObamaCare” could hardly be more apt: lawmakers’ support for or opposition to reform generally has less to do with the views of their constituents and more to do with the issue of presidential popularity.
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10 Responses to “Health Care: Presidential Popularity vs. Constituent Wishes”
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Health care intervention began with the “stimulus” legislation months ago. It was in that legislation (bypassing the “official” health care legislation wrangling in Congress, which Obama has not failed to influence) that the beginnings of health care intervention were made, in the form of “appropriateness” intervention (an issue which has been brought to some people's attention, at least, recently with the release of new criteria for mammography screening for women), or “comparative effectiveness” study, and techno-fun-and-games “IT incentives.”
Does anyone else think that DLS's post makes absolutely no sense, at least on the basis of the facts?
That would require others to join you in being unable or unwilling to face the facts to date. [scowl]
The IT incentives could either be good or bad, but will probably be a mixed bag (lower long-term cost, better chances for legal and illegal snooping). But the comparative effectiveness studies are a necessary evil: there is a limited supply of money and a nearly unlimited capacity to spend. Since the government is in the business of health care, it will have to have some way of prioritizing that spending. This is one of those cases where the Republicans are just plain wrong to oppose it.
“But the comparative effectiveness studies are a necessary evil”
The comparative effectiveness studies are applicable not only to the obvious subject of rationing (and are especially pertinent, if mainly lost in the low-IQ political noise currently over Palin and such, regarding the mammogram-criteria-revision issue this week), but to tort reform and cost growth and control, in some way, eventually. (As well as to overdue Medicare and other entitlement reform that has been deliberately neglected and avoided by Washington, but this, too, shouldn't be surprising to anybody.)
Incidentally, Professor E., someone who made new critical remarks lately about these events is none other than Alain Enthoven. You may recognize the name (it goes way, way back with health care), as opposed to, say, scratching your head and accusing the use of the name as making no sense if you don't understand why his name matters or like what “even” he is saying (as others might react lately).
(His remark has made the news lately, about a global budget being like “bombing from 35,000 feet…”)
http://healthcarecostmonitor.thehastingscenter….
It is unfortunate that our elected officials allow any reasons other than serving their constituents to be the determining factors in choosing which path to follow. With our current definition of democracy, we have little power other than choosing someone else every few years if our representatives don't serve our needs.
I had never heard of him before, but I'll have to look closer now. It sounds like he's put a lot more thought into entire health care system without trying to force it into a pre-made hole. His idea of a prepaid health care system reminded me of this:
http://libertariannation.org/a/f12l3.html
Enthoven (who was quoted recently in disparaging the “health care appropriateness by committee — who lives, who dies” approach to health care command, control, and direction that ObamaCo threatens as well as what was raised by the current news about revision of mammogram criteria) is no neophyte.
The “death panel” concern (which is based on 50+ years of history, not limited to radical and leftist politics since the later 1960s and flirtation with euthanasia as well as elitist command and control, and which was revived currently with the mammogram criteria revision, which offends both feminist sentiment and the trend of increasing expectations of entitlements as well as exposes again the concern about rationalization of denial of care or rationing of it) is far from the only thing Enthoven has touched. He is at least one of the few honest people, for example, who views what is the subject of everyone's interest, which never has been true insurance, but which is pre-paid, comprehensive health care (often including preventive or routine care as well as screening and tests).