Public Plan
House Health Reform Passes! An Early Start to the Holiday Season
Published November 09, 2009 @ 06:00AM PT
We got an early start to the holiday season during an exciting and historic weekend. Obama reminded House Democrats that they have developed more comprehensive reform than any Congress in the last 70 years, and that it was a historic opportunity to pass it. Democrats responded by passing HR 3962 by 220-215 (two more votes than necessary) and with one Republican to make it “bipartisan”. Like Thanksgiving, though, it didn’t happen without a lot of carnage beforehand. Now the rude and boorish relatives are settling in until the New Year.
First, if you missed the Republican “debate” on the bill, you can see it at the end of yesterday’s post. Apparently acting like a bullying child in response to women exercising their right to free speech is what passes for public representation now. The GOP alternative healthcare reform “plan” was just as hollow, and following an amusing rant by Education and Labor Chairman George Miller, below (“Wanna buy it? Wanna try it? Wanna sell it? Come on America, buy this one. You're guaranteed to be left behind if you're left behind today."), the House duly rejected it 176-258.
Why Do We Need a Public Option Anyway?
Published November 03, 2009 @ 06:00AM PT
Political games are alive and well in Washington, D.C. First the House releases HR 3962, a disappointing bill with an optimistic and completely misleading name – the Affordable Health Care for America Act. Then the GOP decides it’s an opportune time to release its own bill, which House leader John Boehner says will lower cost and expand access by “making the current system work better” with less government intrusion into the private sector. Sounds great John, only, well, there is no system … and that whole government intrusion line? Well, that brings me to my point. Why do we need a public option again?
It seems politicians on both sides of the aisle have lobbyist-induced amnesia on that aspect. Democrats hope including a public option – no matter how weak and ineffective (a more expensive alternative to private plans that covers 2% of the population? Please!) – is all it takes to please the public, even if it’s designed to fail. Meanwhile, Republicans decry government intervention and propose tweaks around the edges of our disastrous healthcare mess that conveniently avoid touching the profit-driven culprits themselves. In other words, the US has heart disease and our D.C. representatives suggest blood transfusions, an artificial knee replacement and a flu shot.
Case in point: the central aspects of the GOP bill are tort reform, insurance pools, and inter-state policy purchases. Two of the three are already in place in many states – they haven’t budged healthcare costs significantly (tort reform achieves 10% reductions in malpractice insurance, per the CBO.) Tort reform is a good idea anyway, but not for cost curve reasons. The third proposal, while useful, doesn’t help much when insurance costs are out of control nationwide.
Douglas Holtz-Eakin, a senior policy adviser to John McCain’s presidential campaign, knows that now. The same man who touted a $5,000 insurance tax credit per family as the answer to our insurance woes now remains unemployed and his $1,000 per month COBRA is running out. He’s shopping the individual insurance market at age 51 and with a pre-existing condition that insurers cite in denying coverage. Think he’s a bit worried? All politicians should be placed in that situation; maybe they would get a clue.
Anyone familiar with T.R. Reid’s body of work on international universal healthcare systems knows that a public option isn’t a part of many of them (gives “socialized medicine” a rather hollow ring, doesn’t it?) There is a single public payer in some (Canada), multiple private insurance payers in others (Germany, Switzerland) and some countries use a combination (England.) What’s the difference then? Very simply, their ‘private insurers’ are non-profit corporations governed by iron-clad regulations: no loopholes, no kickbacks, no lobbyist favors, no profit or surplus beyond required reserves.
Why is that? Insurers are there to provide payment for the care of country residents, with no deliberate and systematized waste and no tricks. Patients are not pawns in a giant profit mill. Now, does this sound like the situation in the US? It seems like the banks and the healthcare industry own Washington, D.C. While Joe Public pays for congressional salaries and benefits (with fantastic health plan choices), lawmakers actually work for Joe Lobbyist. So whatever regulations are placed around the health insurance industry, we can rest assured they will be weak and full of holes by design.
Making sure people are covered and making sure that coverage is affordable are two different things, a distinction neither party has addressed satisfactorily. A strong public option is just one of two methods to keep private insurer prices and practices in line, regulation being the other. But if regulation is to be the answer, we need a representativectomy and a lobbyist exterminator to spray the capital. That seems unlikely. As Nancy Pelosi “mistakenly” left Kucinich’s state single payer amendment out of HR 3962 (as of scheduling this post, it hadn't been reinstated), we can’t vote with our feet by becoming interstate medical refugees. So I’m still pushing for a strong public option.
Photo http://farm3.static.flickr.com/2579/3883236444_edbc207a32.jpg // CC BY 2.0
Understand Healthcare Reform in 2 Easy Steps
Published November 01, 2009 @ 05:00AM PT
If you’re tired of ignorant political sound bites in the healthcare debate, I have the cure. Better yet, it’s virtually free of public and private insurance discussions, with their associated pointed fingers. The film Money-Driven Medicine explores the reasons why the US spends more than twice what the next developed country does on healthcare, with terrible health outcomes. The story is told by in-the-trenches doctors, patients and their family members, a physician healthcare improvement leader, and a medical ethicist. It’s unique, highly educational and fascinating.
Join the Watch-In! for America’s Health now through November 10 for a systemic look at what’s really driving the cost and quality of our healthcare. Find out what’s compelling our healthcare spending, and why tweaking around the edges of our public health disaster won’t change a thing. In a nutshell, our country is unique in turning patients into profit centers.
Why join the Watch-In? Because Money-Driven Medicine:
“help(s) viewers distinguish between structural change and sham reform. It will convince them that a sound, sustainable medical infrastructure is crucial not just to their personal futures but to the economy and society as a whole – why curing America’s healthcare crisis could be a matter of national life and death.”
I couldn’t have said it better myself. Make a pledge to join the Watch-In! for America’s Health today. Of course, if you can stand more discourse on the insurance industry and public versus private insurers and providers, read and watch on.
I made the mistake of watching T.R. Reid’s special, Can We Really Fix U.S. Healthcare?, about his experience exploring international universal healthcare systems, the night before the House revealed its new bill, HR 3962. As a result, I’m feeling a bit underwhelmed by Nancy Pelosi’s hard-fought victory. The LinkTV special is a summary of Reid’s book, The Healing of America, which explores both the how and the why of these healthcare systems. It’s an excellent primer on the 4 main types of healthcare systems, distinguished by who pays for and who provides the care. Watch it and be both entertained and sobered simultaneously, when you consider how far we have to go to even catch a glimpse of the best ones on the horizon.
Reid is also the creator of PBS’ special Sick Around the World, which gives an excellent summary of 5 international universal healthcare systems. No, it’s not just theory: he took his injured shoulder around the world with him, to see how each healthcare system would treat it.
But remember, before you click over to Reid’s insurer-patient-provider view of true developed nations, join the Medicine For Profit Watch-In for a refreshing, insurance-light look at some root problems in American health "care". Thanks to Change.org member CherokeeGirl for Change, who alerted me to both very worthwhile programs.
Photo http://farm4.static.flickr.com/3174/2689975613_187194cdaa.jpg //CC BY 2.0
8 Things You Need to Know About the New House Health Reform Bill
Published October 30, 2009 @ 06:00AM PT
Nancy Pelosi couldn’t have announced the new House healthcare reform bill, the Affordable Health Care for America Act (H.R. 3962), with any more pomp and circumstance. It was certainly more impressive than the Senate’s mouse-like rollout, apparently intended to avoid rubbing salt in the Baucus “bipartisanship” wound. H.R. 3962 is definitely a major milestone in attempting to reform our broken system-less healthcare; it’s historic, certainly. But no, it’s not the best our legislators could do.
To be fair, House Democrats are being predictably attacked for their effort anyway. There’s the usual carefully contrived “It will raise the cost of Americans’ health insurance premiums; it will kill jobs with tax hikes and new mandates; and it will cut senior’s Medicare benefits.” Thank you Republican John Boehner. There’s also a highly amusing senior’s ad running. Check out this two-faced “how dare you cut (read: wring the waste out of) our government-run healthcare – we’re entitled to it! And by gum you young un’s better be scared of a government-run plan” message.
Triggers, Politics and Party Tricks
Published October 28, 2009 @ 06:00AM PT
A public option “trigger” has received a lot of attention lately. Thankfully Harry Reid bypassed it for an opt-out solution instead, because it’s a proven Really Bad Idea. Since the Wonk Room's Igor Volsky thinks it's a fabulous idea to combine an opt-out public option with a trigger, let's put this one to bed once and for all. Following is a quick lesson in political science, so you can recognize this underhanded trick when you see it in future.
Consider: the intent of a trigger is to activate a remedy (a public option) in the event that certain conditions aren’t met by existing forces (private insurers.) Now, we wouldn’t be considering healthcare reform unless there were already significant, long-standing problems in virtually every aspect of our system-less healthcare. That includes $850 billion of waste every year, almost enough to pay for 10 years of reformed healthcare. The insurance reform gun has already fired. So why design a trigger to potentially address this urgent issue sometime in the distant future when things are even worse, perhaps catastrophically so?
The short answer is that doing nothing is the politically safe route. It’s a proven way to get re-elected by not rocking the boat. Olympia Snowe knows that, and probably hoped a trigger would allow her to claim she voted for a public option (what her constituents want) and at the same time kill it (what most Republicans want.) Under the trigger, a public plan would be created only if private insurers didn’t make “meaningful, affordable” coverage available to all Americans within “several years.” Believe it or not, none of these terms has been defined. So what would trigger a public option? You guessed it – nothing.
5 Flavors of Public Option
Published October 26, 2009 @ 06:00AM PT
This week will reveal the frustrations of a representative democracy more than any in recent history. It’s too much to expect our Congressional representatives to vote based on what a majority of their constituents want, a public option that is cost-effective and covers most of the population. Between partisan politics and the measurable effect of even small amounts of insurance lobby money, constituents seemingly can’t make their voices heard. So Congress will be presented with 5 flavors of ice cream from which to choose. Here are the public option flavors of the week, and if you need a little musical flair to get you excited about them, we’ve got that too.
First, from the Billionaires for Wealthcare, who crashed the AHIP annual meeting in Washington, D.C., last week, here is “The Public Option” sung in show tunes:
Meet Medicare Part E
Published October 23, 2009 @ 06:00AM PT
How much time-consuming bluster did it take to get to this simple and obvious option? Open up Medicare to everybody, like Ted Kennedy originally proposed in the Senate HELP bill. Part E does stand for “Everybody.” While it’s only one of the three public options being considered by the House, it’s the strongest. Keith Olbermann gives us a great introduction to the concept in the video clip above. Meet Medicare Part E.
