4 Thoughts on Health Insurance Reform
Notice I never call it health care reform? That’s because it isn’t. Very little of what is being discussed will change what happens between you and your doctor beyond how (and how much) he* gets paid.
As I see it, there are 4 points of view on the bill currently being rammed through the Senate:
1. It goes too far. This point of view has a problem with anything that might be called “socialized”. They are barely able to tolerate the idea that their tax dollars go towards schools where the people who will eventually sack their groceries attend; subsidies for buying insurance is way out! Let them get jobs that have decent benefits!
2. It does some important things, even if it’s a little too liberal. Hey, at least it’s making those lazy bums buy insurance so they can go to a doctor instead of just sneezing their germs on me! In other words, it’s better than a lot of things and the bad things can be fixed later. Some people I generally respect hold this position.
3. It does some important things, even if it’s a little too conservative. Or, the Ezra Klein position. Hey, we’ll take out that Stupak thing in conference or something. At least there is some money set aside for subsidies to help people afford the overpriced and underfeatured health plans they will soon be forced to purchase. In other words, it’s better than a lot of things and the bad things can be fixed later. Huh, where have I heard that before?
4. It does almost nothing — except give favors to Big Insurance and Big Pharma. Or, the Howard Dean position. Progressives didn’t get anything they wanted or needed out of this bill. No public option. Pre-existing conditions can still be used to set rates. Corporations are still in charge, and because we are legally obligated to do business with them — that’s what mandatory coverage or “the coverage mandate” is about — there is no incentive for them to change their ways.
In short, two points of view say “It’s better than nothing, and far better than it could have been,” and two points of view say “This is worse than nothing and should be scrapped.” While I appreciate where the others are coming from, I generally hold to view 4. What we wanted and needed was a short laundry list that included getting rid of abusive practices such as use of pre-existing conditions for coverage or pricing, rescission, and constantly rising prices, maybe 10 pages of law. What we appear to have is a legal requirement to bend over and take it, a law so long that the Republicans are threatening to make them read the whole thing out loud in open session.
And nobody is talking about not just the elephant in the room, but a veritable zoo: obesity rates raising the amount we spend on health care; baby boomers who will soon be on Medicare; obscene insurance company profits; a looming shortage of primary care physicians and experienced nurses to assist them.
* Um Yeah, that’s right, I said “he.” Not “he or she”, not “she.” Politically correct horsehockey aside, odds are very good your doctor is a dude. Don’t like it? Encourage women in your life to go to medical school. Just don’t get them any books on the subject like House of God. I can’t find the book that made me decide I wanted no part of medical school on Amazon, but this looks like similar content.
Share This
Related Posts
-
Health Insurance and Personal Responsibility
Posted on Apr 16, 2013
-
International Perceptions of Obama’s Second Term (Italy, Poland, The Netherlands, France, Switzerland, China, Brazil, Mexico)
Posted on Jan 28, 2013
-
Perceptions of the U.S. Presidential Race from Poland, China and Germany
Posted on Oct 16, 2012
-
Let ‘Them’ Go to Emergency Rooms
Posted on Oct 15, 2012
So what is the 5th point?
Point 5: It doesn't do enough. No tort reform, no fine (mandate) of any consequence, no controlling costs, no common sense, and no Rep. input of any consequence (I know, but did either side try?).
The elephant in the room no one talked about is that the private enterprise system has failed as a way to deliver low cost, effective health care to the US. The period since we last considered health care reform in 1993 has been dedicated to letting private enterprise take over and prove that market forces can work. And it has been a massive failure with out of control costs, large numbers of people excluded from the system, personal bankruptcies and the redistribution of the nation's wealth to corporate interests.
Yet, without any real discussion, we have decided that decided we must stick with private delivery of health care in spite of its failures because of its considerable purchased political power and its ability to terrify large segments of the population by lying loudly and often.
Count me as a 1 and a 4 (which perhaps is the fifth view the author suggested). It goes too far (1) in imposing individual mandates and failing to take overall economic impact into consideration, and it does almost nothing (4) to solve the most serious of the problems, underlying health care costs…and in turn premium costs.
While the bill is in parts a huge gift to insurance companies, it accomplishes many of the things which I feel are critical to health care reform. There are programs put in place that encourage physician and hospital conglomeration, moving away from the piecemeal billing system we have now. Other programs work toward a move away from the current incentives to provide more expensive and complex procedures in lieu of less expensive preventative care. They may not be powerful enough and may only be present as test programs, but it's certainly a start, and it's a miracle they got passed in the first place with the AMA breathing down Congress' neck.
It is a start. And, inifinitely better than 16 years (or more) of GOP grandstanding, but doing nothing, zero, zilch, nulla, niente, semmi, nada, rien, nichts, niets, one iota–get the message?– towards improving health care (or health insurance) in America.
inifinitely better than 16 years (or more) of GOP grandstanding, but doing nothing, zero, zilch, nulla, niente, semmi, nada, rien, nichts, niets, one iota–get the message?– towards improving health care (or health insurance) in America.
They did do Medicare Part D. Do you think that hasn't improved care at least an infinitesimal iota?
I've pointed out several times before, but I guess not enough. McCarran-Ferguson was meant to reduce competition and stifle free enterprise because many physicians weren't making the big bucks that would be expected PhD. You can't call government supported monopolies and government restricted markets free market. Surgeons making $6,000 dollars/hour are not a sign of competition. When the true free market fails, then you can 'dis it.
My Dear Texas Friend,
That you support this legislation is testament to your enduring hope and your compassionate nature. Were that I were less cynical and could join in your optimism. But, there is no need to be disagreeable. The legislation will shortly move to conference, and we will learn soon enough whether it is a net start to the promised land or a net start toward the abyss. I hope you are right and I am wrong.
May you be filled with warmth and love and joy this holiday season.
I would have expected something a bit more factually demonstrable out of you, Prof.
So, back in '45, Congress was worried about docs not making enough, huh? Have any shred of evidence of that?
You do know that personal lines coverage rates have to be filed and approved by every one of the 50 state insurance commissioners before a policy can be sold in that state, don't you?
So, all 50 state insurance commissioners have colluded on enrichening doctors and insurance companies at the expense of their state constituents?
Including the now Sec of HHS, Katherine Sebelius, who was the Kansas C of I head of the NAIC for many years?
Here's my simple answer: name one state where the AMA doesn't run medical licensing.
Thanks for refreshing my memory. If Medicare Part D was indeed a strictly GOP initiative and accomplishment, then bless their heart.
Thank you for your kind words, tidbits, and I share your hope that this key vote in the U.S. Senate is indeed a net start to better health care for Americans. Perhaps hoping for “the promised land” is a bit unrealistic and premature, but I hope you are right on that one, too.
Have a Merry Christmas.
Politically correct horsehockey aside, odds are very good your doctor is a dude.
My doctor is a dudette.
In fact, almost every doctor that I or my daughter or ex-husband have used has been female. I don't think that happened by conscious decision. It just worked out that way.
Do you live in a rural area, Bridget? Because I live in an urban area, and there are lots of women doctors here.
The AMA supports the health care reform bill.
Certainly, as it stands. I imagine if their support weren't necessary much more substantive decisions could have been made regarding payment and practice structures at the physician level.
“The AMA supports the health care reform bill.”
To paraphrase Doc Holladay in the the bar scene where he first meets Johnny Ringo in the movie Tombstone, “Now I know I hate it.”
DaGoat–
Remind me how Republicans paid for Medicare Part D.
Put me down as a Fiver.
I also agree with this
Actually, my statement is based mostly on the fact that women made up roughly 5% of my husband's medical school class. We have lived in a number of metropolitan areas, and are now in Vegas. The overwhelming majority of his female co-workers are nurses, medical assistants, and clerical staff.
DaGoat–
Remind me how Republicans paid for Medicare Part D.
Hey I'm not saying it's a good program, only that the GOP did do something on medical care and maybe improved health care an infinitesimal amount. Medicare part D does a poor job of controlling costs and adds to the deficit, just like the new Democrats health plan.
There are reform elements in the legislation (still, amazingly), but you need to understand that reform was never sought. What was sought and still is sought is federal takeover of health care. Note well.
I'll probably have to repeat this, since I think this thread is dying. We've covered the fact that the only definite point (that is, not a maybe, hopeful kind of thing) of this bill is the coverage of 30 million new people. Certainly all of use could be happy about that. Well, no, history doesn't support that, because of the law of unintended consequences. We've just recently proved that the student loan program, instead of making higher education easier to afford, instead made it more expensive and therefore harder for poorer people to afford. We also proved that making mortgages easier drove up housing prices to the point where the poor still couldn't afford them. Now we're expanding health insurance to help the poor . . .