POLICY/POLITICS: Universal Health Insurance and the NY Times–all hail Jon Cohn (with brief UPDATE)

In recent months, not content with letting Judy Miller transcribe enough Cheney press releases to sink us into a $1 trillion dollar/3,000 lives and counting quagmire in Iraq, whomever runs the New York Times’ health care coverage has essentially handed the keys to the liquor cabinet to a succession of idiots who wouldn’t know anything about health care if they were sober. It’s then printed a series of the most illogical, stupid and plain wrong articles about health care that’s so bad that I’ve run out of ways to describe how if the NY Times were a dog it could not leave its pustilent sore alone.

But Holy Cowdung Batman. Maybe there’s hope, as they’ve this weekend allowed Volvo-driving latte-quaffing liberal Jonathan Cohn—who actually knows something about the topic— to write a long article for the magazine. It’s called What’s the One Thing Big Business and the Left Have in Common? and the answer isn’t too surprising.

But now they’ve taken this timorous first step, what’s next for the NY Times— op-eds from Enthoven or Fuchs? Regular columns from Brian Klepper? Giving Ian Morrison or Robert Laszewski a chance to explain how health care really works? Cutting and pasting from THCB? I’m waiting!

UPDATE: I’ve added a permanent & free link to Jon’s piece so it’s not buried behind the NY Times firewall. He focuses on exactly the correct topic, which is "Do big business CEOs have the cojones to take on the health care industry," in other words to piss off all those drug and insurer CEOs they meet at their Wyoming hunting lodges. And of course can the ones who are losers in the current charade (Safeway, Costco, anyone with a union) persuade enough of their colleagues that they shouldn’t be competing over who can pay the lowest health care benefits–when WalMart seems to be winning that contest too. An excellent piece, so go over there, read it and ponder why the NY Times doesn’t print more like it as compared to the pustilent sore variety for which they seem to have such an appetite.

16 replies »

    Congratulations Comrades – you’ve moved us one step closer to Soviet style health care. You should all be proud!

  2. It is too bad that we do not have a way of witnessing a “dry run” or some model of how a government run or monitored health care system might work. Oh, wait, the H1N1 vaccine distribution, or maybe the FTC’s supervisory role over Wall Street? I guess we do have some examples of how well the government manages things! As they say: How’s that workin’ for ya?

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  4. You make a good point. My only thought is that competitiion amoung insurers is one of the only way to keep profit margins in check.

  5. Why Insurance??
    Why Payer – at all??
    The whole model is premised on companies and profits. How do we get away from the profit motive? Corporations are controlled by greed. They exist to make money for shareholders, and in most cases the lucky few who rise to the executive ranks make a little money too. When we are talking health and health care, why do we have a system that is controlled by anyone who is obliged by definition to making profits.
    Health care providers, doctors, nurses, and other practitioners, have a right to expect a reasonable living given their years of training and skill. But no one should have the ability to make a multimillion dollar fortune on the illness of others. In our system because people get sick, others get rich. That’s flawed. No insurance combination, no payer scheme is going to fix that. At one time health care was a charity work. What happened to our ethics? Are we so collectively greedy that we can’t see the monster we have become.

  6. U.S. NATIONAL HEALTH CARE PLAN: Rather than the hodgepodge ideas for national health care in the U.S. by the candidates (Clinton wants a “combination governmment and private”—Edwards wants a cobbled-together system of Medicare, Medicaid, compulsory employer, and government subsidization of some private insurance). We should have true government-run national health insurance consisting of a compulsory single-payer system based on a percentage of the gross income of each and every American (with a cap). It could be collected on a pay-as-you-go basis by employers, just as they collect for social security and federal income tax. (This would save billions of dollars over private insurance.) The yearly premium total withheld would be included on the W-2 Form and an EZ tax form would be filed with the federal tax return. People not required to file a federal tax return would not have to file anything in April. People with unearned income would file an estimated return with payment quarterly to the government. Everyone should pay based on their ability and everyone would be covered with private medical care (even when unemployed and not paying premiums). The government would simply collect the premiums and pay doctors and medical facilities. EMPLOYERS SHOULD NOT BE REQUIRED TO PROVIDE HEALTH CARE (unless they choose to pay their employees’ share) and TAX DOLLARS SHOULD NOT FUND HEALTH CARE (except perhaps to cover a deficiency as the government once did with the postal system).

  7. I submit for discussion that we drop the name single payer and call it the “everybody pays health care system”. In out political debates language is extremely important. We can also describe the required tax a flat tax. Everyone paying taxes would pay the same rate, around 15% isn’t it. Most who oppose us do not want to pay for someone else. Well the truth is I dont think thats what we are talking about. We are really talking about everybody pays but on a sliding scale. The every body pays title kills the primary objection by its name. We all know there are lots of people who like a flat tax. Well thats what it is so lets get them on board. A very critical point is we make it clear that existing employer provided health insurance is currently part of the compensation package. When the tax starts the employee will get the equivalent boost in pay to what the employer was providing before the tax. Its cost nuetral for the employer. The flat tax also clearly lays out on the table one of the biggest questions everyone has, how to pay for it? Yes I think even minimum wage workers should pay. if its too big of a hit for these folks increase the minimum wage the day the new tax goes into affect. The concept of everybody paying is very powerful I think. If there is one thing this country needs to do is pull together as a team. Thanks for all the great work folks are doing out there.

  8. Hey, sorry I’m a little late to the discussion.
    Barry and Peter, you’ve got good thoughts on single-payer. In general, that’d be a great system – but it’s unlikely to see the light of day in our current political environment.
    The question before is this: Do we wait another 50 years, or do we do something today? Senator Wyden’s plan – supported by business and labor – seems like a reasonable approach to the problem.
    Full disclosure: My company built Senator Wyden’s website – but I don’t speak for him or his staff.
    There’s lots more info about Senator Wyden’s plan for affordable, non-discriminatory comprehensive, high-quality, universal health care reform over here. I invite you to come by and check it out.

  9. jd
    I’m sorry it sounded like that, my auto body reference is not in regards to the elderly or others, it’s in regards to pricing, the fact that you, the consumer, has a tough time shopping for health care and there is not a market out there competing for your business. We often find out that a procedure costs 2X or 3X if done at one facility over another. And then what is with the bill being $25k and the final payments, after discount, being $8k?
    In my solution the 15% would still get service. The overhead and admin cost of a health insurance company is approx 35% on a very lean business. For the most part 40% – 55% is the norm. If we put that money into “health care” instead of the pockets of insurance companies… We could all pay lower rates and have great SERVICE at a much reduced price.
    The average commission on a group policy is 2% – 5% right off the top! Trust me I’m an agent.
    One administrator that I know mentioned that if this plan were implemented they would reduce staff by 6 for insurance billing, reduce office visits to $25 for everybody. Never charge for an in house lab, no charge for ultrasounds, $25 for MRI, no charge mamagrams, $500 birth fee. the list went on and on.
    You see when they have the money in an operating trust their overhead & expenses are guaranteed. There is no reason to charge more for one person or another. Chronic illnesses serviced at their site would increase the operating trust funding.
    We cannot leave out the 15%, my little boy is one of them!

  10. Rhino,
    Your auto body example perfectly conveys what’s wrong with your suggestion: when it costs too much to repair your car, you junk it or sell it and buy a new one. What do you do when it costs too much to repair your body?
    Around 80% of all health care costs go to pay for 15% of the people. These people tend to be older, to have serious chronic conditions, or to have had a major acute event. Few of these people can pay out of pocket for their care without bankrupting themselves and their families. So, shall we just let them all die, or sell them?
    Your solution would work fine for 80-85% of the population. It’s the other 15% for whom it doesn’t work at all.

  11. Anyone thought of doing away with health insurance all together? We have great networks of providers, why not create a system that really works and take the money out of a 4th party system.
    ex. Prefered One network creates a membership program where users pay a network membership fee. The rates for all services are up for review and the members recieve discounted rates and low cost medical visits.
    The members would be paying the network of clinics, hospitals, specialists, etc. directly. Take out the insurance company and allow doctors to decide what is in the best interest of their clients. Make the hospitals charge a “book rate” for services. 2hrs or 4hrs we charge for 3hrs, that’s the rate. Just like auto body. Yea sometimes you pay more, sometimes you pay less.
    Cut out the middle man. In this case it’s just one of several Middle Men that have their fingers in the fishbowl!

  12. Barry, this is not 1974, and neither do unions have anywhere near the political power they had then. As well this is the age of the neo-cons and a well entrenched conservative power base, so that will be the ideology to overcome. I don’t have any delusion that this country will see a true single pay universal coverage system any time soon. If we are lucky it will be a transitional plan but with mostly insurance and some government elements. I don’t think it will work as it will be hard to keep it properly funded when not everyone has the same stake in it and it will not control cots. But maybe the French system would be a good first start, arguably by John Fembup, the best system in the world, and would do as a transition.

  13. Subject: Nurse shortage
    heartfelt, but over long and irrelevant comment on nurse shortage deleted here. If you want to read it go to the website linked in the author’s email

  14. I was interested to learn recently that way back in 1974, we almost got national health insurance. Medicare and Medicaid were enacted in 1965, most others got their health insurance from their employer, but costs were rising rapidly, and 10% of the population remained uninsured. The Democrats’ plan, whose lead sponsor was Senator Ted Kennedy of MA, would have provided coverage similar to what federal employees got with no deductible and a 25% co-pay with an out-of-pocket maximum of $1,000 ($5,000 in today’s dollars). The Republican plan was similar, except that the OOP was $1,500 ($7,500 in today’s money). Do you know why it didn’t happen? It was because organized labor over reached. It anticipated a huge electoral victory in 1974 over Republicans weakened from the Watergate scandal. Then it believed it could push through a single payer system over President Nixon’s veto. Nixon resigned in August of that year, the country was sliding into recession, inflation was picking up sharply due to both the first Arab oil embargo and the end of wage and price controls, and there was no longer any money for new entitlement programs. For a more complete discussion, see Paul Starr’s 1982 book, The Social Transformation of American Medicine.
    Since organized labor still seems enamored with a single payer system, I wonder how it would react this time if something like the Wyden plan looks like it has a chance of passing. Will the public sector unions and the old line industrial unions that still have great coverage balk at trading it their still gold plated coverage for something less? Choice is a hallmark of our culture. Let’s preserve it, as well as a strong role for private insurers, even at the cost of somewhat higher administrative costs. Liberals don’t have anywhere near enough votes to push through a single payer system, but we can certainly do better than what we have now.

  15. The problem with getting a solution from Washington is getting the idealogues out of power. Got war? Is this new approach by the NYT a crack in their mental armour or a smoke screen of trying to look open minded?