Will Health Care Reform Fall Short?
The administration wants a bill that can pass Congress. But what will it actually contain?
Confused about what's happening with health care reform? Join the club. After months of buildup, neither Congress nor the administration has produced a clear plan. Instead, the picture seems to get fuzzier every day. This doesn't bode well for President Barack Obama's commitment to create a "health care system that works for all of us."
At the American Medical Association convention in Chicago on Monday, Obama called health care expenditures a "ticking time bomb" and related eloquent—but familiar—stories of families, small businesses, and doctors crushed by spiraling costs. The rest of his speech catalogued the most uncontroversial elements of any potential health care fix—instituting electronic medical records, cutting down on junk food, encouraging more preventative care, promoting "best practices," eliminating waste. Who could possibly object to any of that, except maybe the manufacturers of potato chips and Wite-Out? Meanwhile, Obama offered only ambiguous clues about how he plans to resolve the most contentious and vital issues that will determine whether his attempt to overhaul health care succeeds or fails.
In fact, the White House's battle plan for passing legislation could best be described as one of calculated vagueness. Last Wednesday, Obama called together a group of key senators from both parties to hash out their differences. Afterward, the group touted the fact that nothing had been settled. Sen. Chuck Grassley (R-Iowa) told the Associated Press, "The president, I thought, was very flexible except on one thing, and that was getting it done. When the president is flexible on controversial things...I think that that's good news." Thanks to all of this flexibility, ranking Democrats and Republicans from the Finance Committee and the Health, Education, Labor, and Pension Committee agreed they could bring a bill to the Senate floor in July.
But what will the bill actually contain? So far, the administration's maneuvering suggests that its primary concern is not what kind of health care system we end up with, as long as we get something that looks like reform—preferably before the end of Obama's first year in office. Given the disaster that ensued last time Democrats tried to pass health care legislation, the administration's careful attention to the politics of the issue is understandable. But the danger of this approach is that it could ultimately produce a law that is uncontroversial, weak, and expensive.
One disturbing possibility is that health care could become a replay of the credit card legislation. The pattern goes something like this: First, we get a propaganda blitz heralding sweeping changes. But although the final legislation corrects some of the most egregious abuses, it doesn't change the system's underlying flaws. So, for example, insurance companies may be required to cover people with preexisting conditions—a need Obama illustrated vividly in his AMA speech with moving references to his mother's battle with cancer. We might see what the president called "more efficient purchasing of prescription drugs," which presumably means faster approval of generics and giving the government greater power to haggle with Big Pharma over drug costs. We will likely see incentives for health care providers to offer more cost-effective—and, hopefully, better—treatment. These things are not meaningless, and they will provide a modicum of relief to some struggling Americans. But they do virtually nothing to strike at the deeper problems of the for-profit health care system. And they offer only a fraction of the savings that a single-payer system would provide.
With no clear vision emanating from the White House and no bottom line, everything is up for grabs when it comes to the all-important details. It's no wonder, then, that new balls keep coming out of left field every day. As Obama prepared for his AMA speech, Washington scuttlebutt held that he would seek to reduce costs by accepting limitations on malpractice suits. In the speech, Obama said he was "not advocating caps on malpractice awards," but nevertheless wanted to "explore a range of ideas" to reduce the malpractice threat. As Mother Jones' Stephanie Mencimer has reported, the notion of crippling malpractice costs is essentially a conservative myth. But, according to the New York Times Obama sees addressing medical liability as "a 'credibility builder'—in effect, a bargaining chip that might keep doctors and, more important, Republicans, at the negotiating table."
Perhaps most important, Obama has not yet demonstrated how hard he's prepared to fight for the so-called "public option"—a government-run alternative to private insurance—or what such a reform might entail. At the AMA, Obama reiterated his position that one of the choices available to Americans "needs to be a public option." But could this position be a straw man, set up only to be knocked down? The public plan has certainly served as a panacea to single-payer advocates and other critics of medicine for profit, including important Democratic constituencies like labor unions. One health care advocate told me that the speculation around town was that the administration could eventually abandon the public option in order to win bigger concessions from its opponents.
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Obama's ambiguity makes one thing clear
That is, that he has no intention of advocating for meaningful change in the current system. He is telegraphing that by statements he makes on a regular basis. "If you like your current plan you can stay with it". This means that the current employment-based private insurance system will remain intact. "Our reform must retain the unique character of the American system". That means that single payer is off the table.
I suspect that Mr. Ridgeway is right on the mark with his suspicion that what we will get is a lot of propaganda, noise, and then a crummy bill that does not fix the system but throws us a bone. We'll get something like the requirement to cover "pre-existing conditions" (a lovely insurance company concept) and then the Obama team will declare victory over the evil insurance industry and walk away.
Senator Grassley is from my state and he is up to his eyeballs with health insurance industry donations. (Des Moines is a health insurance center for some odd reason). Reports say that the insurance companies have donated $2 million to his campaigns. There is a movement afoot here to oppose him in his next election cycle, but he is dug in deeper than a west Texas water well and there is little hope of prying him loose from the seat he's had since 1981. Before that he served as one of Iowa's House delegation, and from 1958 to 1974 he served as a state senator. So, you see, he's kind of like a state institution, like swine and corn.
It's heartening to me that critics are beginning to emerge from Obama's group of supporters. I worked on the campaign here during the Iowa Caucus, which arguably propelled Obama to victory. It wasn't long afterwards that I noticed subtle but key calibrations in his message that convinced me that he was just playing us here in Iowa. I've known for a fact that he wasn't a progressive on any issue since May of 2008, when I left the campaign in disgust and went to work for Nader.
I think many Obama supporters are now admitting that they were voting against McCain more than for Obama. Instead of "Change You Can Believe In", Obama has turned out to be "Change You Can Forget About".
-Wexler
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If I would have known I was going to live this long, I would have taken better care of myself.
~~~ George Burns
Obama is Lost As If In a Paper Bag
Mr. Orszag said hospitals could figure out ways of treating patients more effectively..."a nurse coordinator instead of an unnecessary specialist,”
Mr. Horseshack Budget Director.... This is the scariest part of being you. How dare you suggest people be treated by "nurse coordinators"? The next thing you will suggest is that nurses be replaced by aids, which is already being done.
Obama’s health care plan is not going anywhere, fast. The lobby groups are going to destroy it and well they should. Not for the reasons THEY say, but because it does NOT represent the only fair, affordable, moral and potentially successful reform there is, single payer. And because it contains idiotic ideas like this one of Horseshack's...
In order to counter these strong lobbyist groups, Obama would need grassroots support. Since he has already screwed his “grassroots” on issues from war to privacy to bailouts, he is alone arguing with the lobbyists and nuts. (cricket sounds).
I wouldn’t defend him on anything, even if you paid me. Let him think it was the lobbyists that killed it. He is totally lost on this issue as if in a paper bag.
No to ObamaCare
Any doctor that supports Obama’s plan deserves worse than what the public is going to get; which is an authoritarian government rationing of health care based on political favoritism and one's "worth" to society. So according to President Obama's idea of universal health care the heartless and greedy will get their free coverage at the expense of the poor and elderly.
The doctors have been FIGHTING to have MRI’s, CT’s and ultrasound tests covered as preventative as well as diagnostic medicine for years yet President Obama wants to cut that while at the same time saying he wants to provide superior care for 47 million MORE people when droves of doctors will be leaving their field precisely because they will have "no skin in the game" aka profit to induce them to remain in the game.
What a mess. Anyone who supports this crazyness is well plain crazy.
I am so tired of people
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I am so tired of people talking about "Obamacare" or "Obama's plan." The president DOES NOT HAVE A PLAN OF HIS OWN. The White House has NOT COME OUT WITH A PLAN. There is NO SUCH THING as Obamacare.
The President has endorsed/rejected several ideas, but has not proposed a formal plan whatsoever. Is it that hard to understand?
47 million uninsured is a moral issue
NoBamaCare...
We live in "the best nation on earth" and we have 47 million citizens who can't go to the doctor when they get sick; they wait until they have to go to the ER.
This is bullshit, it's a moral outrage, it's unconscionable. The solution to this is a single payer plan. Health care should be eliminated as a profit center, just as we've eliminated law enforcement, fire departments, and other such public necessities from being profit centers.
Since there are a gazillion people employed in health insurance companies I don't expect this to happen overnight. However, I won't be happy until I see the last health insurance company close its doors. They are despicable people who seek to take money from a captive audience who either pay to play or risk financial ruin... or even losing their lives.
-Wexler
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If I would have known I was going to live this long, I would have taken better care of myself.
~~~ George Burns
re:Will Health Care Reform Fall Short?
Health care should really eliminate as a profit center. Isn’t it as a health care provider, they have given an oath, to help other people but then, there is something wrong with this oath. If it is their duty, then why do they close doors to the people who needs help but do not have any money. Many of us are not yet insured. So being sick is really difficult today. So, they should really eliminate being the profit center because, it is their duty, it is in their oath that they will serve people in need. I was really lucky that I received a debt relief when I was hospitalized. But what about people who have no insurance, or who are not lucky to be offer a debt relief? What will become of them.
Obama & healthcare 'change' talk, talk, talk, and more talk
I'd like to add that Obama, who
I agree, was voted for by an awful lot of people mainly as AGAINST John McCain, rather than for his policies, ideas, beliefs, etc. He has shown that he's more or less NOW represenetative of 'Change you CAN'T believe in', unfortunately. 'Tis a pity he's a status-quotician--you'll never see him actually on any side that would mandat or necessitate 'change' as in the balance of power & wealth, anyone aside from the rich or powerful having ANY 'voice' in this country's future or destiny--IF we dare believe in such a thing anymore
We can fix this
I think Obama's strategy is brilliant. He's giving us room to come up with our answers, what real leaders do, instead of telling people how they're going to fix everything that's wrong. Want to know how to get single payer and cover 47 million without raising taxes? Check out TheFiveDollarRevolution.com
Correction
The5DollarRevolution.com
Does anyone think this is accidental?
Really, how likely is it that the dreadful mess churning its way through the Senate (and why the Senate) is an accident? Opacity is not a bug, it's a feature! The corrupt and notoriously un-democratic Senate is originating a bill that normally would start in the House. It is assigned to Baucus' committee instead of Kennedy's. And, we are all supposed to have house parties and get on board.
Last year I volunteered, donated, and otherwise worked primarily to change health care. I was unhappy with a most of what the Bush years had produced, but what got this former Republican and independent to register as a Democrat and become part of the campaign for Obama and other Democrats was health care. What I am seeing does not meet any test of reasonableness, and it is no accident. I am getting mad. Mad at Obama, mad at my Congressman and Senators, and mad at a system that falls so far short of democracy. All those folks in the streets of Iran are on to something.
Its No Accident!
Its the same way business has always been done in America. Congress will agree to a "government option". And it will be touted in their home districts as the long awaited reform. And health industry money (aka; free speech) will flow into their coffers unabated. A few members of the "free press" will disclose that it was a sellout to the industry and is purely a dumping ground for the chronically ill, the acutely ill, and the rest of the "unisurables. Government costs will soar inversely to insurance industry profits. Conservatives will point with pride to the demonstrated free market efficiencies. Embarrassed, the "liberal" Democrats will rationalize that bad legislation is better than none at all and that they will fix it later.
Its all happened before. Remember Medicare Part D? That was six years ago. Anybody out there know where its fix is on the congressional docket?
"Great spirits have always found violent opposition from mediocrities. The latter cannot understand it when a man does not thoughtlessly submit to hereditary prejudices but honestly and courageously uses his intelligence." -- Albert Einstein (1879-1955) P
Health Care Reform
And this Administration backing off to trade a so called public option for other "concessions" would be a surprise? Let's face it, unless a public single payer plan is strongly, frequently and fully pushed by someone with a bully pulpit, and the public gets to hear what it really would be about it, at least as much as they hear the right and it's MSM friends and "experts" calling it the loss of personal choice, not much will happen to realize the goal of health care for all in the U.S. This seems to me to be a vivid example of more government by "corporation" that one of by and for the people.
Comments on healthcare reform of state vs federal
I sit on the board with Utah association of Health underwriters and http://www.BenefitsManager.net as well as http://www.HealthInsuranceSource.net for health insurance reform. Several interesting changes took place with H.B. 188 passage earlier this year that seems all too familiar on the federal level. The spirit of the bill allows private market place remedies. It essentially guarantees insurance providers a "no loss" or "no gain" over competing carriers in the insurance exchange portal which is http://www.UtahInsuranceExchange.info. On the surface it seems not to be attractive to participating carriers (voluntary at this point). But you have to understand the carriers’ goal is to cover their administration fees. That can be accomplished now. The other half of the equation is providers and their billing practices that need to be reformed. That is on the agenda. Keep an eye on Utah because the national health care debate seems much the same ground we have already covered.
In http://www.UtahInsuranceExchange.info which is the beginning of a state sponsored program addresses issues on a local state level that the federal level might look at. Coming from an underwriting background I know where the dime falls. I am of the opinion that large waste occurs from providers billing for procedures that developed "no outcome". Insurance carriers are not the only bad guys on the block. In most of our purchasing decisions....don't we pay ONLY when we know that we will get a desired outcome? Why is it if you ask the doctor how much a particular test or procedure is he doesn't know? Shouldn't providers be held to a transparent cost standard?
You must be in the health care business from some interaction point to make statements of fact in the face of historical changes. When you are in the system from any touch point (insurance, provider, hospital, Medicare or patient) you get the “real issues” because of real time experience.
I often quote the Switzerland health care system as an example of tough questions that we will have to face at some point down the time line. Did you know that premature babies are not resuscitate upon birth if they cannot draw breath? Did you also know that is the same with “senior care” experiencing system failure or failures? They don't extend life of a senior with multiple failures like intubation as example. Anyone in the business of paying claims knows that the single most expensive bills in what we call “shock loss” is within NICU for newborns and seniors in acute / intensive care / hospital.
The Swiss apparently made decisions made based upon cost vs. quality outcome. Are we as a nation prepared to make that type of decision or to define when to incubate, resuscitate a newborn or a senior? To define the conditions and rules of practice? With a litigious society I think not. This is why we need tort reform. Without tort reform medical provider costs will never drop. Liability costs with medical providers are nearly half of operating expenses. With health insurance carriers it translates to about 10% of every premium dollar collected.
I don't think we are hearing about tort reform because most of the house and senate on the federal level are lawyers and have practicing law firm interests / ownership. In the healthcare system there is no total innocence. Insurance executives with bonuses, doctors overbilling, hospitals overbilling because the street gang thug got dropped at their door with no insurance. The lawyers are there to stir the pot and promise lavish fortune at the end of the PERCEIVED misery chain. Am I saying we don’t need them? No, but I am saying there is clear and documented abuse of the legal system that awards outlandish claims in the millions for a $20,000 mistake. Ambulance chasers being the most abusive. What about those that educate their clients on defraud and then use the legal system to pirate insurers?
Questions
It seems like so many people are having questions about what is going on with health care reform, especially since Obama has promised so much. I would rather hear some details versus ambiguous clues from Obama on what he is really going to do about it. casino en ligne
Remember that the global
Remember that the global crisis originated in one of the most progressive country in the worlds the U.S. And now another sort of conflict arise when Obama propose the Obamacare. There were lots of things that has to be considered here, first and foremost the budget. Along with that issue is the Conservatives for Patients Rights, or the CPR, is headed by one Rick Scott – who isn't a doctor – but used to be the CEO of a hospital, and under his watch, his medical administration defrauded Medicare of $1.7 billion through a practice called upcoding, wherein a Medicare patient gets treated, but Medicare is billed for additional tests that never took place. .) Realistically, Conservatives for Patients Rights and Mr. Scott will never need short term loans, and the only reason why they oppose the bill is that they want the money from the program for themselves
