Tag: health care

Terrance Heath, writing on Ourfuture.org (the Campaign for America’s Future site), explains why the healthcare reform path we are taking represents “a particularly worrisome turn.”

Suddenly we’re in a place where passing something kind of like reform may be more important than getting to reform itself. In the name of “compromise” and in interest of getting something passed, we could get a health reform bill that helps fewer people than originally intended, and preserve more of the status quo than almost anyone wants.

And the status quo is something that can no longer be sustained. The issue here is our own misplaced expectations. Arguments against the public option — let alone a single-payer plan — always focus on the notion of rationing and choice. The assumption is that a public insurance plan will place medical decisions in the hands of a government bureaucrat. The American public, it is argued, would never stand for that.

The reality is that we already allow bureaucrats to make those decisions — but instead of being guided by what is best for the patient or the public, those decisions are made with profit in mind. Hence, we end up with a system designed to deny care.

We all know someone who has been in this boat, whose insurance company has denied coverage for what he or she thought was a necessary treatment. And yet, our health care premiums go up and up and up. If this is not rationing, then I don’t know what is.

We need to be honest. To get universal coverage, we are going to have to pay more in taxes and we are going to have to ration care. In exchange, we — or our employers — would no longer have to pay premiums to insurance companies. To me, that seems a fair tradeoff.

It is time for President Barack Obama to make a stand.

His speech earlier this week clearly outlined the need for a public plan as part of healthcare reform, but if he doesn’t step up and play hardball with Congress his words will come back to haunt him.

The latest on healthcare reform is that the man originally tapped to lead the president’s reform effort, former Senate Majority Leader Tom Daschle, wants the public plan scrapped in an effort to move legislation forward:

Former Senate Majority Leader Tom Daschle said on Wednesday that the Obama White House would likely have to scrap a public option for health insurance coverage
if it wanted to get the votes needed to pass systematic change.

“We’ve come too far and gained too much momentum for our efforts to fail over disagreement on one single issue,” the Senator and one-time HHS Secretary nominee said, according to ABC News.

The remarks came after Dashcle, along with former Senate Majority Leaders Bob Dole and Howard Baker introduced his own proposal for health care reform that. That plan actually included a pseudo-version of a government-run option. The Daschle proposal calls for (among other things) public insurance pools to be administered by state government, not the feds.

In coming out against a public plan, Daschle adds kindling to an already roaring debate on health care reform. On Thursday morning, former Vermont Governor Howard Dean repeated the mantra that you cannot have effective legislation if it does not include a public option. At the White House on Wednesday, several state legislators who had met with current HHS Secretary Kathleen Sebelius argued the same point.

Certainly, the public seems to be weighed in Dean’s favor. An NBC/Wall Street Journal poll conducted on Wednesday night showed that 76 percent of respondents wanted a choice between a public option for insurance coverage and private providers.

The public, of course, understands this issue far better than the politicians, most of whom are beholden to the quartet of special interests who control this debate — the insurance industry, drug companies, doctors and hospitals. While I’d like to believe that at least some of them — doctors and hospitals, in particular — have patients’ and consumer’s best interests at heart, the reality is that a public plan could cut deeply into their profits. And that’s what this is all about.

The reality is that a single-payer plan would be the most efficient and effective way to fix health care in the United States, but a host of myths and political considerations stand in the way. In the meantime, Ezra Klein offers some interesting thoughts on the next steps toward reform and some stronger alternatives than the perpetually cautious men on Capitol Hill seem ready to embrace.

Those options, for the most part, have been excluded from the debate, as he notes. The public plan, however, remains on the table, though it is under seige. People like Gov. Dean, former Labor Secretary Robert Reich and Sens. Sherrod Brown (D-Ohio) and Bernie Sanders (I-Vt.) are making it clear that, without it, any reform legislation would be a sham.

Time to step up Mr. President and spend some of that political capital you’ve been storing.

Opponents of healthcare reform like to pretend that the system we have right now is full of choice, that we can get in to see doctors whenever we want, that we have access to every and any treatment under the sun.

Patients, however, know better.

David Leonhardt, in The New York Times, pretty much explodes the open-access myth in this important analysis story. Rationing, he says, exists in a big way — in “three main ways”:

The first is the most counterintuitive, because it doesn’t involve denying medical care. It involves denying just about everything else.

The rapid rise in medical costs has put many employers in a tough spot. They have had to pay much higher insurance premiums, which have increased their labor costs. To make up for these increases, many have given meager pay raises.

This tradeoff is often explicit during contract negotiations between a company and a labor union. For nonunionized workers, the tradeoff tends to be invisible. It happens behind closed doors in the human resources department. But it still happens.

He continues:

The second kind of rationing involves the uninsured. The high cost of care means that some employers can’t afford to offer health insurance and still pay a competitive wage. Those high costs mean that individuals can’t buy insurance on their own.

The uninsured still receive some health care, obviously. But they get less care, and worse care, than they need. The Institute of Medicine has estimated that 18,000 people died in 2000 because they lacked insurance. By 2006, the number had risen to 22,000, according to the Urban Institute.

The final form of rationing is the one I described near the beginning of this column: the failure to provide certain types of care, even to people with health insurance. Doctors are generally not paid to do the blocking and tackling of medicine: collaboration, probing conversations with patients, small steps that avoid medical errors. Many doctors still do such things, out of professional pride. But the full medical system doesn’t do nearly enough.

That’s rationing — and it has real consequences.

So, please, enough about the long lines and rationed care elsewhere. That is the reality we face right here in America right now.