Over the next few weeks the national debate over reform of the system of paying for health care will intensify and its focus will sharpen as one or two bills emerge from House and Senate Committees and proceed to the floor of each chamber. In today's posting I will briefly describe the goals that we all want to achieve, and in future postings I will describe the various proposals emerging from Congress and I will analyze the principal features of each bill. I invite any questions or comments you may have about this critical issue facing our country.
There are three goals that everyone wants to achieve in reforming our nation's system of paying for health care. We want medical care to be cheaper – we want it to be of higher quality – and we want everyone to be eligible to receive heath care. All of us – liberals and conservatives, Democrats and Republicans, hope to reduce costs, improve quality, and expand access to medical care.
Here is an excerpt from a website of Republican Congressman Roy Blunt explaining the goals that the House Republican Health Care Solutions Group seeks to achieve:
Republicans are promoting commonsense reforms that make health care more affordable, reduce the number of uninsured Americans, and increase quality at a price our country can afford – while making sure that Americans who like their health care coverage can keep it.
Compare that expression of general goals to those expressed by Democratic Senator Edward Kennedy on his website describing his proposed legislation, the Affordable Health Choices Act:
In July 2009, Senator Kennedy’s Health, Education, Labor and Pensions (HELP) Committee passed The Affordable Health Choices Act, landmark legislation that will reduce health costs, protect individuals’ choice in doctors and plans, and assure quality and affordable health care for all Americans.
The legislation builds on the existing employer-based system and strengthens it. If people like the health insurance they have, they get to keep it.
Needless to say, the Republican plan and the Kennedy bill contain very different provisions regarding how to achieve these goals. But in analyzing and discussing the various options we should keep in mind that we are all in this together – that this issue has implications for each and every one of us – and that we share common goals.
{ 8 comments… read them below or add one }
RE: "I invite any questions or comments you may have about this critical issue facing our country."
OK, let's start with your basic assertion:
"We want medical care to be cheaper – we want it to be of higher quality – and we want everyone to be eligible to receive heath care.
I don't think the drug marketers, the stockholders of medical insurance groups, or physicians in general are too interested in lowering their profit margins.The only people really concerned with costs are those who have to pay them. I look at this issue as I do higher education. How many of the faculty in the UA Law School are willing to cut their salaries so more students can afford a college education?
Bottom line is there are two prime factors keeping Americans from good health care.
1) The deep seated greed of those who control the 'costs' of healthcare.
2) The deep seated laziness and lack of will power of the tens of millions of Americans who choose to be obese, use tobacco, read blogs instead of exercising, and routinely ignore every warning about their self-destructive lifestyles.
I believe about 2/3 of health problems are a direct result of lifestyle choices. Should we really attack the 'cost' of healthcare without considering the self-inflicted portions of it?
I believe that the high cost of health care delivery is the cost of manual billing processes. Banks and insurance companies get along with IT spending at a level of 3% of transaction levels, while for health care the cost of billing is at 65 to 70% of the total transaction cost. This is a relatively easy thing to fix by implementing automated process and this needs to be done. One of the nice things is that increased billing automated process does not reduce spending on care delivery.
Health care is not the real issue…….CONTROL is the real issue…….control of every facet our lives….If this country wants an economic recovery, it would let capitalism work. Nothing else will bring it about. Obama does not understand capitalism. He has never met a pay roll….has never produced a salable product…..never administered a corporatiion…..never paid business taxes….never owned a business…..does not understand business…..
This is silly. Last time I checked, this was the 21st century. Science and empirical evidence should direct our course. The most efficient method for providing health risk coverage is one big pool of Americans covered by a single payer, not-for-profit, government run, universal health care plan.
Not reductions in or elimination of existing health professionals in any way…..simply elimination of the unneccessary, parasitical health insurance industry and a demand for the lowest bulk purchasing rights of pharmaceuticals by the government for not only Medicare but for the single payer plan as well. That's what a 21st century American health reform plan would look like.
But no,….we must settle for an early 20th century plan. One that mandates windfalls for insurers and pharma and pushes health care costs up to satisfy the needs of Wall Street. No single payer, those protesting for single payer representation in House Committees, sadly, were arrested. And now, no public option.
First the defense complex took a piece of our government.
Then it was Big Oil, followed by tele-communications.
Next came the banksters.
Now it's the health complex profiteers.
I can agree with your goals. But I do not think you can have it both ways, higher quality and cheaper. At best case you choose one or the other. My fear of a government run plan is to be lower quality and more expensive.
I guess it is fun to pretend that insurance companies are making tons of money. Insurance is a heavily regulated business. It is not a license to print money, in spite of the demagoguery that goes on. They provide a service, and they should get paid for that service. They have done a lot to keep costs down, ask a doctor about how they are getting squeezed to keep prices down. They have managed shorter hospital stays.
If we squeeze the pharmacy companies on pricing, where is the incentive to develop the next miracle drug?
Hello? Anybody there? Does anybody remember what a MONOPOLY is and what it does to private business enterprise?
I can't remember the last time I heard the word "monopoly" used in the current push toward what WILL be a GOVERNMENT MONOPOLY.
Since when does a monopoly of any kind improve efficiency, cost-effectiveness, or faster, more timely service??? Since when do the employees of a monopoly CARE whether the "customer" gets served at all, much less served well??
I thought we had laws protecting competition in this nation. The government using a "public option" insurance plan to "compete" with private insurance plans is a farce.
The government controls and approves, thru 50 state insurance departments, every single policy and price that is allowed to be sold/charged by companies.
Since when do marketplace competitors have the power and authority to control and approve what their competitor sells and what price they sell it for??
Worse yet, the federal government can use/abuse taxpayer money it does not HAVE yet, to "compete" and wipe out its competition.
Think Wal-Mart "competing" with local mom & pop owned businesses . . . except WalMart cannot impose state/national taxes to make up for revenues they have not earned, and WalMart cannot print money when it lacks it.
As distasteful as they often are to patients, insurance companies cannot vote in new or increased taxes, and companies cannot print money to cover drunken spending as the U.S. government does.
Government is not a monopoly. Government does not have an incentive to generate profits.
Like the Reverend said, the models that provide the best care all have single payer for at least basic services. There are many variations and combinations of private/public insurance, but they all have a few things in common, they provide better health care for far fewer dollars than we spend.
Honestly, saying the free market will solve health care is bording on idiocy. For a free market to function all actors must have equal information and knowledge. Do you know whether or not a procedure is required? What alternatives there are? What the going rate for the procedure is? Do you know what advantages/disadvantages a generic may have as opposed to a namebrand perscription? When you've been hit by a car or your kid has a broken arm, are you going to take the time to negotiate with the doctor/ER for the cheapest price? Are you going to choose a different ER because the one the ambulance brought you to is too expensive? Are you willing to let those who cannot pay go without life-saving treatment? ALL of these are required for a free market to function.
No, you just go to the doctor and do what they say. Maybe get a second opinion. It is a service. Like the electric company, you just shut up and pay. Its a service as integral and basic as roads and a solid Universal Health Care program would be a huge national asset.
PS – to the poster above who mentioned it – Smokers, diabetics, and obese people are actually cheaper in the long run because they have a significantly shorter lifespan and don't incur the massive end of life costs that a relatively healthy person who lives to 100 does.
All of the necessary information is available and ALL of it indicates that the most efficient and cheapest system of healthcare involves single-payer. It is a shame that people's inability to understand or lack of desire to read that data leaves so many people's opinion woefully misinformed regarding healthcare.
If government "single payer" universal healthcare is not a monopoly, I don't know what would be.
And while "the government does not have an incentive to generate profits" . . .
. . it also has no incentive to keep its expenses less than its income, and THAT is the problem.
And what does the federal government do when it overspends its means?
It BORROWS and INCREASES its expenses by adding billions in interest payments that suck money away from what is available for providing the services such as healthcare.