Obama’s health care plan is a step in the right direction
I have yet to hear an articulate and well-reasoned argument for why we should delay in passing significant health care reform. In fact, it seems that most Republicans and right-wingers are motivated by a desire to see this administration fail and so they have decided to, once again, scare Americans into complacency with misinformation and outright lies.
If it ain’t broke, don’t fix it.
Their entire movement isn’t about offering solutions and can be summed up with the image of people who are claiming Obama wants to kill your grandma.
Make no mistake, the people organizing this nonsense (read: lobbyists for insurance companies and hospital conglomerates) know they are full of shit. In contrast, the people on the ground are just easily led. They are simple fools who can’t understand the merits of our President’s plan.
Which begs the question:
Are conservative radio talk show hosts the ones to blame? Or are we at fault for not presenting a clear and persuasive argument?
The answer is as simple as those against health care reform.
It’s our fault, baby. The masses are asses and we must learn that statements like “Keep your government hands off my Medicare” are laughable in private and a teaching moment everywhere else.
As always, Paul Krugman responds with intelligence and clear-headed thinking. I hope it’s not too late.
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I will say this about that. I’m uncomfortable with the notion of “cost effectiveness research” and “appropriate” care. It occurs to me that this is one of the central problems with health care and health insurance currently: Essentially, bean counters are in charge of dictating what a doctor can and can’t do or what treatments a patient can and can’t have on the basis of cost-effectiveness. I am concerned about the notion of this sort of “tore up from the floor up” thinking going on, only at a federal level. That’s less reform and more just cooking the books.
Plus, what’s this I hear about a National Health ID card? And if you’re on the Federal plan, who owns your medical records? More importantly, who has access to them?
I support health care reform and, in general, Obama’s plan, but there are parts of it that don’t sit right and make me wonder, “Well, is it all as vitally necessary as he’s trying to convince us it is? What happened to a phased-in approach?”
And, to be fair, it’s not just Republicans and right-wingers trying to torpedo this one. Blue Dog Dems aren’t on board either.
QJ,
First, what makes you think that having the government with your health information is less secure than a private corporation? The private insurers have access to your info and will deny coverage (pre-existing conditions) or refuse to write the policy in the first place.
Second, as yet there is no “Obama plan”, just a bunch of Congressional plans, from which will come one from a “Reconciliation Committee” where you will see more of the President’s footprint, if it gets that far.
Third, Blue Dog Dems not being on board is five parts posturing and one part principal. There are also “moderate” Republicans that aren’t against coming up with a sensible plan.
Fourth, the plans I’ve seen have an implementation date of 2013. Isn’t that “phased in” enough for you?
Fifth, the “cost effectiveness” committees aren’t any different from other hospital or private health insurance committees have operating now, like the transplant committees that decide who comes first when the next organ becomes available. It will also prevent unnecessary treatments, let you take the blue pill that costs .25 instead of the red pill that costs $40., when both do the same thing (and the only reason the Dr. prescribed the red one was because of the saleswoman with the spike heels and miniskirt promised him a free trip to Hawaii if he prescribes enough of them).
My point is that the things you fear about a National Health Plan are things that happen with the private insurers, except the private insurers are making decisions to ensure a profit for their stockholders. That is their legal, primary fiduciary responsibility. It’s not to keep you healthy.
It’s why they are pouring millions into campaign coffers, to keep getting that yearly bonus.
And you can’t vote them out if you are unhappy with them.
Any plan we get will be flawed in some ways and, at best, will be an interim step to a single payer system (which is the only one that truly makes sense). Private health insurance should go the way of buggy whips.
The system we have now is getting bad results for too much money, so doing nothing is not an option.
Reading top to bottom:
Working for a private corporation, Marc, that has access to health care records, I know how we do it and I know we do it better than the government. This is, of course, anecdotal, and YMMV.
“There is no ‘Obama plan’…”
Someone might want to mention that to Obama, then, because someone’s gone around and plastered his name all over this.
Regardless of ideology, Marc, it is unhelpful in the extreme to turn this into a Republican v. Democrat issue as there are swaths on both sides that are more than willing to gum up the process, either to advance their own agendas or careers. I never said that BDDs were particularly interested in smelling what they’re shoveling, but that doesn’t negate the fact that they are a major roadblock that may prove more damaging than any Republican resistance.
No, actually, it’s not. Phased in implies a gradual amalgamation of effect. Dumping now or four years from now doesn’t solve the fundamental issue, that this is a major overhaul of how we handle a vital organ of this country. It’s comparable to chemo. You don’t infuse the whole round of chemo drugs into a patient all in one go because it would kill them. You do it over time. Why is this such a threatening notion?
Cost effectiveness committees may not be different from what we have now, Marc, but I would point out what we have now clearly isn’t working so exactly how is this revolutionary or paradigm-changing? If the model doesn’t work, simply moving it to the federal sphere of control isn’t going to make it work any better. The notion that beancounters are the final arbiters of health decisions is the flaw, not corporate versus governmental bean counters. And again, the only “unnecessary treatment”, Marc, is the one you personally or your family or your friends don’t need to stay alive and the notion of “preventing” them is part of that broken current model which the plan doesn’t even try to fix. In fact, it just institutes the broken.
So my point, Marc, is pretty much your point: Things that I fear about federal health care are things that are happening now with private insurers…things that don’t work. So it is beyond me as to why they’ll suddenly, almost as if by magic, begin working if they move the broken model to Washington D.C.
“Any plan we get will be flawed in some ways and, at best, will be an interim step to a single payer system (which is the only one that truly makes sense).” Which is close to my point and I’m confused as to why you’re willing to look at the institutionalization of a monolithic debt producer that does very little to actually fix the issues that are currently wrecking our health care system (I think we can agree that it’s more than just 50 million Americans uninsured that’s wrong at the moment) as an acceptable “interim step” yet balk at the phasing in of same. Personally, my problem with the 2013 dump, is that this country hems and haws, finally passes legislation, pats itself on the back and then considers the problem solved. Yet, while all that hemming and hawing was happening, the problem was getting worse and the legislation that’s finally passed maybe solves a problem that was existent five to ten years ago and that’s still a pretty big maybe. Phasing in, however, as part of a bigger transitional plan not only allows for help to go out RIGHT NOW, but it also allows us to see what works and what doesn’t and adjust accordingly. The titration of US Health Care will not happen effectively via brute force and a massive dump of base to neutralize the acid. You have to go drop by drop or you’ll overshoot and have to start all over again.
“The system we have now is getting bad results for too much money, so doing nothing is not an option.”
I don’t think I’ve ever said anything differently. Indeed, working in the health care information technology field, I’ve got a first hand view of how cracked the system is. Which is exactly why I do not relish the notion of the system not being fixed, but just being ported to Washington.
Kate, QJ, and Marc: thank you all for intelligent discussion of this stuff.
QJ,
Of course, everybody thinks that they “do it better”, otherwise you would have to admit that you are part of the problem.
BDD’s are minor players in this reform push. Most can be bought off with a plant siting, development grants, or the like. It’s never the fox outside of the hen house that is the problem. I’m more worried about the ones inside, the Max Backus Democrat who has taken in millions from the Insurance companies and for-profit health care providers. The BDD have little power and can be bought off cheaply and any discussion about them is a red herring.
What is happening now, in the legislative process, is that millions of more people will be required to get private health insurance. I think I saw somewhere that the CBO estimated that, down the road, they see only 5% of people on the proposed public plan – which means that another 10% (assuming that 15% are uninsured now) will be pushed into private plans, which is why the insurance companies will allow reform to go through. All they are trying to do is make it more profitable for themselves when it happens by throwing as many “unprofitable” clients as possible into the “public plan”. Remember, the insurance companies only make money by not paying claims.
As far as phasing in reforms to see what works – another red herring. We know what works…single payer. As far as these interim measures, there isn’t anything in in any of the plans wending their way through Congress that hasn’t been tried in limited ways around the country and world. So the 4 years is ample for program design and testing of any new systems. And why the hurry? Because if it isn’t done in September, it won’t get done at all.
It seems as if you have a vested interest in the existing system. Am I wrong to think this colors your thinking?
Yes, there are more (less important) issues outside of the uninsured, and I don’t know if what comes out of Congress will fix anything. What isn’t happening is the development of an understandable synopsis of the points being addressed in each of the bills. Before I get to the point of supporting anything, I want to know what is in there.
We need a little more illumination and less hysteria.
Reading bottom to top:
“We need a little more illumination and less hysteria.”
Once again, rather my point. However, the hysteria is on both side in this issue. The Obama administration is deliberately attempting to conjure a sense of immanent jeopardy and that we must act now…yet for all their rush rush attitude, as you said, their plan doesn’t begin to hit until 2013.
“Before I get to the point of supporting anything, I want to know what is in there”
And I agree with that wholeheartedly, but again, the notion we are presented with is not one of “Lets make sure we’re doing the right thing” but “WE MUST DO SOMETHING NOW OR BABIES WILL DIE!” To hard sell this like a used car man trying to unload a clunker not only fails to solve the problem but potentially lands us in even deeper difficulties.
“It seems as if you have a vested interest in the existing system. Am I wrong to think this colors your thinking?”
No. In fact, my company stands to benefit greatly from the passage of health care reform as there is a huge amount of money included for EHR and HIT, which is what we do and what we do better than any other company out there (and this I have the benchmarks for as well as the benchmarks for lockdown of patient data…I don’t say either of these things lightly or off-hand).
“We know what works”…no, clearly, we don’t. We know what may work in other circumstances, but the notion of just cannibalizing France’s system and grafting it in to the United States is as preposterous as the notion of exporting Democracy. You can’t export and import process. And, the fact is, that those other systems “work” for a given value of “work”. The question is less, what works and more what solves our specific needs. Saying, “single payer…The End/Period/Amen” is foolish.
“What is happening now, in the legislative process, is that millions of more people will be required to get private health insurance.” Which again moves back to one of my points: This doesn’t “change” the system, it simply forces complete buy in to an already broken system. How does that possibly make any sense? Would you be as supportive of a plan to force everyone in the country to buy a car because it would save jobs and stave off a recession? While I find the “socialism evil” argument ludicrous, what you seem to be supporting is full-blown totalitarianism.
“BDD’s are minor players in this reform push.” But they’re players and when the margins are so close, any play at all can have big effect. Again, to lay this at the feet of Republicans is using similar logic to that used for the last eight years by those same Republicans for why anyone who doubted in Beloved Leader or the eroding of our common rights and responsibilities was a traitor. All that’s being done is changing “traitor” to, if Kate’s Facebook listing is any representative sample, “ignorant” and “crazy”.
Again, as I said, I support health care reform and I do think there is much to approve of in the Obama plan (and as whatever eventually gets passed is going to have his name on it, that’s what I’m calling it…all else is sophistry), but I also think there are big question marks and to ignore the serious consideration of those points because “if it isn’t done in September, it won’t get done at all,” is the worst call to action I’ve heard since, “But the risk of doing nothing, the risk of the security of this country being jeopardized at the hands of a madman with weapons of mass destruction far exceeds the risks of any action we may be forced to take.”