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The Silver Lining

Brian Klepper Massachusett’s voters’ stunning rejection of Democrat Martha Coakley, in favor of a not-very-impressive Scott Brown, should be exactly the splash of cold water that the Democratic party – and Congress as a whole – needed. The defeat can be understood in two ways: one large and one fairly small.

First, the large one. This will probably send reform back to the drawing board. Health care is too much in crisis and too pressing to be pushed completely off the table until certain issues – including both access AND cost – are addressed.

Second, this election marks the loss of a single critical Senate seat, but it is also very loud warning shot. The mandate received at the end of 2008 was a resounding call to throw out the Republicans who for more than a decade had ridden roughshod over American values. Yesterday, the Democrats, in one of their most secure strongholds, received the same message. Whatever people in DC think, rank-and-file Americans – not those on the right or left, but the swing voters in the middle who actually determine election results – are very unhappy with the gaming that’s been vividly displayed over the last year under the guise of health care reform.

The distaste expressed yesterday probably has little to do with the specific provisions of the bills, except for the largest generalities: that they expand coverage while avoiding a commitment to changes that could significantly reduce cost. But along the way, voters have witnessed — with an immediacy and transparency that has only been available as a result of the Web — lawmaking in its worst tradition. There was the White House’s deal making with powerful corporate interests like the drug manufacturers even before the proceedings began. And the tremendous lobbying contributions by health care and non-health care special interests in exchange for access to the policy-shaping process. Or the outright bribery of specific Senators and Representatives in exchange for votes. Last week’s White House deal with the unions that exempted them from the tax on “Cadillac” health plans until 2018 must have seemed like a perfectly OK arrangement to the people in the center of all this activity, but to normal people who read the paper, it was emblematic of the current modus operandi: If you have power and support the party in power’s muddled agenda, you get a special deal.

The most tempting mistake now for the Democrats would be to dig in. President Obama’s most appealing characteristic — the one that got him elected — was his embrace, his embodiment even, of approaches that would revise the traditional kinds of politics we’ve seen for the last year throughout the health care reform process. Of late, the most telling complaint about this Presidency so far has been disappointment that, once in office, he seemed to cave in so easily.

Undoubtedly, many Republicans are now rejoicing over the Democrats’ loss and the possible defeat of any health care reform legislation. That’s unfortunate. The health care crisis is real and remains unaddressed. The pressures it creates, particularly for powerful interests like business, will force Congress to return to it and develop meaningful solutions. Hopefully (though probably unlikely), Congress and particularly the Democrats, will be chastened and wiser. There’s a big opportunity here to make lemonade.

There is a new, bipartisan movement in Congress, highlighted on NPR two weeks ago, that would revisit the rules around the relationships between special interests and lawmakers. This is an issue that trumps and is more important than all others, because if every policy is ultimately shaped by those with enough money to buy Congress’ favor, then our democracy will be unable to hold.

The silver lining in yesterday’s election was that it was a mild, if critical, reminder that, whatever DC thinks, America’s center is just as displeased with the current governance as it was with its predecessors. Faced with a much larger rejection in the 1994 elections, President Clinton went on TV, took full responsibility, and then spent his time rebuilding. The good news is that today is a new day, and that, if they’re interested in what’s good for America over the long term rather than simply themselves over the short term, Congress has the ability to start again in ways that could please the American people and actually work to our collective advantage.

Brian Klepper and David C. Kibbe write together about health care technology, market dynamics and reform.

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Dr. WilsonhenrylowJames BertschPeterarchon41 Recent comment authors
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Dr. Wilson
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Dr. Wilson

I agree w/ this

henrylow
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henrylow

Often we forget the little guy, the SMB, in our discussions of the comings and goings of the Internet marketing industry. Sure there are times like this when a report surfaces talking about their issues and concerns but, for the most part, we like to talk about big brands and how they do the Internet marketing thing well or not so well.
http://www.onlineuniversalwork.com

James Bertsch
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James Bertsch

The Health Care market is not a free market it is a controlled Market. Since Ronald Reagan began his trickle down economics in the 1980’s, the entire American system has been relaxing government controls which enforce financial integrity and stimulate competition thereby reducing competition to create higher profit margins for our corporate stakeholders. Corporate malfeasance combined with poor government oversight in the laste decade created economic bubbles in IT, Energy, Banking & Finance and now Health Care. The whole economic pot is boiling. The main cost driver in the health care bubble is fee-for-use (The doctors, hospitals and drug companies… Read more »

Vikram C
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Vikram C

Nate- you wanted name of free markets that collapsed so here they are- Argentina, Brazil, Malaysia, Indonesia. They all collapsed at some point and what went with that was free exchange convertibility to help them recover.

Margalit Gur-Arie
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Margalit Gur-Arie

Well Nate, it’s all semantics isn’t it? It depends what “free market” really means and what “collapse” really means and to whom…. I agree with Peter.
When you have large numbers of people thrown out of their homes (2008), or jumping out of windows (1929), or crowding debtor prisons (1819), something surely collapsed somewhere…..

Vikram C
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Vikram C

Nate- if you don’t provide insurance someone else will. Although if you have built up your portals where your high deductible consumers can compare doctors cost, you have made arrangement to pay based on outcomes, built model to pay for telemedicine, you pay for alternative therapy, you provide premium incentives for being healthier, you encourage your patients to maintain electronic health records, you set example of maintaining physical and mental health in your organization, you shifted to vegeterian food and are not ashamed of espousing same to members despite the risk of lawsuit and being branded weak…. hey then count… Read more »

Peter
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Peter

“The private insurance system will not collapse.”
Probably not as the financial system did not collapse – due to massive taxpayer bailouts. No, the insuranace industry will just lobby congress to get those health insurance subsidies out to people who increasingly can’t afford coverage. Who’s going to cry, “get government out of my life” then.
Unfortunately (or maybe not) the federal system of printing money to cover deficits may collapse, especially if our foreign lenders decide to up the interest rate or stop lending altogether. Good times are not ahead.

Merle Bushkin
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Merle Bushkin

Thanks, Nate. Now I get it. Anyone who challenges your infinite wisdom and bluster is an idiot. I’m delighted to be in that category since it clearly includes most intelligent people!

Lisa Lindell
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I appreciate Nate’s posts.

Nate
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Nate

Name a market that has collapsed, if you can then I was wrong and they can but I can’t think of one. I can think of a ton of heavily regulated markets that collapse, some multiple times, but never a free market. I will throw you the bone that markets for specific goods collapse when the good is outdated and no longer needed. Merle your still an idiot and FYI I am the person in position to do something. Unlike worthless people such as yourself sitting on blogs talking I go out in the world every day and do. Thousands… Read more »

Vikram C
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Vikram C

Another silver lining will be the emergence of complementary and alternative medicines- accupuncture, homeopathy, meditation, nutrition, yoga etc. The side effect of insurance has been consumers yielding the turf to physicians and industry and let them decide what’s best for us. Industry and high deductible peddlers such as Nate have already let those people loose.In words of Nate, the only way to prepare them is to throw them into it. So now here we are gleaning the mother earth for herbs and fellow people for knowledge on how to keep ourselves healthy. You just might discover, poor garlic in your… Read more »

Peter
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Peter

“my cleint’s average deductible to the employee is around $500.”
After the company has purchased a HD plan? “Average” can be a huge gap and not represenative of anything.

Actuary
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Actuary

Would appreciate response from the authors, Margalit, maggiemahar, or anyone else —
Why wouldn’t something that the CBO says will save $54 billion and certainly not cause more uninsured be left out of an alleged “reform” bill?
What is that something, you ask — Tort Reform.
Pelosi, Reid, Obama spend all their energy ripping on insurers (3% profit margin) while making a deal with Pharma (12% profit margin) and keeping quiet about runaway malpractice costs(John Edwards and his ilk).
I guess some “special interests” are more “special” than others.

Merle Bushkin
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Merle Bushkin

Nate,
Your posts takes the prize for arrogance and rudeness.
Since you believe you have all the answers — and yes, your answers as to what you think will work are subjective, not fact — don’t you ever wonder why no one in the position to do something doesn’t ask your opinion?
To paraphrase an old joke: Those that can, do. Those that can’t, rant on blogs!

Margalit Gur-Arie
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Margalit Gur-Arie

Nate, Medicare and Medicaid have not been fixed because they didn’t collapse….. yet. Spending too much on something is not an emergency unless you can’t afford it. Sometimes you need to go bankrupt in order to realize that you can’t afford it. Medicare will be fixed eventually. As crazy as it may sound, I think it would be easier to fix Medicare if everybody was on some form of Medicare (not necessarily single payor). And Nate, are you sure you want to make that statement that “free markets don’t collapse”? Maybe qualify it a bit, like free markets only rarely… Read more »