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Vote Yes

Brian-klepper One of us was at a local diner yesterday, when a good friend and health plan broker walked up to say hello. This guy delivers premium increases every day to employers, and understands how broken things are. “I hope Congress votes yes,” he said flatly. “We’ve got to finally move beyond the status quo and try to change the system.”

As conflicted as we are over it, we agree and we hope the reforms pass. The die is now cast, so there is no point in continuing to urge a different approach. As terribly flawed as it is on cost controls, the bill represents two very important things that, in our opinion, the nation desperately needs.

First, it will significantly open access, bringing America much closer to universal coverage and making personal financial distress a much less likely outcome of sickness or injury. As Nicholas Kristof pointed out Wednesday, that alone will dramatically improve the health of the nation. Widespread uninsurance and under-insurance have been a national disgrace for decades. Passing this bill would be a commitment to move beyond that shame.

Second, we believe the President is attempting to deal with many difficult problems thoughtfully and in good faith within an extremely toxic political environment. We want to see him succeed, because we think that his approach is good for America.

The bill is not what we hoped for. We’re disappointed in the behaviors of both parties. But after a year of wrangling, it is what is possible now. There is no reason the bill’s inadequacies can’t be revisited.

We hope Congress votes Yes on this bill. Making care and coverage more accessible and more fair would be a momentous and long overdue achievement.

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

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  1. Wow, talk about a hot topic. Okay, so is healthcare a right or a privilege? The older I get, the more cynical I get. I believe both sides of the aisle want something done, and Lord knows, something needs to be done, I just think they allow their political positioning to get in the way of what we would like to call real progress.
    Thanks for listening.

  2. It’s great to see this post.
    The simplest thing you can say is it gets us one step closer to a country where the way to make money in healthcare is by making and keeping people well instead of screwing them.
    This bill helps make that true for insurance companies. Hopefully future bills will make that more true for hospitals, doctors, DMEs, pharmaceuticals, etc., next.
    To me, putting incentives in the right direction is all government can excel at and this bill is a step in that direction.

  3. speaking of lies and propoganda;
    http://www.sfgate.com/cgi-bin/article.cgi?f=/n/a/2010/03/19/national/w131302D40.DTL&tsp=1
    President Barack Obama would give federal authorities the power to block unreasonable rate hikes.
    Yet when Democrats unveiled the final, incarnation of their health care bill this week, the proposal was nowhere to be found.
    Ditto with several Republican ideas that Obama had said he wanted to include after a televised bipartisan summit last month,
    And those “special deals” that Obama railed against and said he wanted to eliminate? With the exception of two of the most notorious — extra Medicaid money for Nebraska and a carve-out for Florida seniors faced with losing certain extra Medicare benefits — they are all still there.

  4. “we believe the President is attempting to deal with many difficult problems thoughtfully and in good faith”
    Exactly how many broken promises before you question the good faith? CSPAN? What about those 4 Republican ideas? Cornhusker and LA purchase. Mayeb the questions should be how exactly do you define good faith?
    ” “the political process is inadequate and has become fundamentally flawed, and therefore unable to reach a successful solution.”
    Only if your will is to impose a socialistic structure on America it doesn’t want.

  5. WRONG
    “This country is in sad, sad shape right now, let’s hope on Monday it starts getting better.”
    Wrong — thanks to Harvard Law bumblers — USA healthcare has gotten w-o-r-s-e.
    Who would risk funding medical innovation, when your work can be STOLEN by arrogant lying politicians? So — for a year — nothing.
    And in the future — more taxes, more deadwood, more MESS.
    Nov. 2 — this MESS is cleaned up.

  6. Great article, I too look forward to living in a healthier country (one where I’m not filing bankruptcy because I couldn’t afford my medical bills and one where my wife can get the medical attention she needs for the tumor behind her eye). For us, this really is a life or death vote, and we already lost one child because we couldn’t afford insurance, make too much money for anyone in our state to help us, and our hospitals refused payment arrangements. This country is in sad, sad shape right now, let’s hope on Monday it starts getting better.

  7. W.M. NEEDS A BRAIN
    Trolling boards to find business. How common. Tsk, tsk.
    ++++++++++
    ” .. Not an English PhD and apparently also brainless, as is Mr. MyMillionSite ..”

  8. I like the big O but ” we believe the President is attempting to deal with many difficult problems thoughtfully and in good faith within an extremely toxic political environment. ”
    Kidding right? Or are you succups?
    Kibbeee and Skleper ought know that Obama has been an athlete of hypocrisy. He has contributed to the toxicity with the innumerable conflicted people he has apppointed or are in his regime to write laws. He too gets his education from lobbyists and uses useless anecdotes to make a point affecting the entire nation.
    However, it is an improvement since Bush does not know what an anecdote is. lol

  9. Not an English PhD and apparently also brainless, as is Mr. MyMillionSite. Where do these people come from?
    At least archon41 is a good writter, albeit without saying much of substance, and presumably Nate knows something about something, although it is hard to tell what that something might be, but the comments from these two belong in WSJ commentary.

  10. FUNNY
    ” .. this it not the end of the reform process, just the beginnning.”
    There are so many legal flaws in this piece of dreck, it is a “Paycheck for Life” for a 1,000 law professors.
    Barking-mad insanity that will enrich only the bureaucrats. Great job, Obama, you one-termer. You have no one to blame but yourself.

  11. THIS IS A PETITION TO THE UNITED STATED FEDERAL GOVERNMENT
    FOR A INDIVIDUAL OPT OUT REQUEST FOR HEALTH CARE
    We The Undersigned Wish To Convey By Their Signatures Below That They Wish To Have The Same Rights Under The Current Health Care Legislation. That Allows The Individual States That If This Would Place An Economic Burden On That State They Have The Option To Opt Out Of This Mandate.
    Currently Over 35 Of The 50 States Have Or Will File A Legal Action Against Washington To Claim This Is An Unconstitutional Bill.
    If The States Are At 35 against and 15 Not Yet Heard From, It Would Seem That
    “We The People” Are More That 51% Against This Health Care Bill.
    THIS WOULD BE A CLEAR STATEMENT THAT IF AN UP OR DOWN VOTE WAS HELD TODAY BY THE GENERAL POPULATION OF REGISTERED AMERICAN VOTERS THIS BILL WOULD NOT EVEN SEE THE LIGHT OF DAY AND ANY LEGAL ACTION FILED BY THE INDIVUDAL STATES WOULD NOT EVEN BE REQUIRED.
    IF THIS BILL WOULD Place A ADDITIONAL ECONOMIC BURDEN ON THE STATE,
    If Would Seem Logical That It Should Also Be AVAILABLE TO THE INDIVIDUAL PERSON AS WELL.
    We the Undersigned Wish To Opt Out Of The Average
    $12,000.00 Per Year Price Tag
    The Current System We Have In Place by Law Already Mandates That Any Hospital Cannot Refuse Medical Treatment to Anyone That Is In Need Currently Any One Who Asks For Help Will Receive It
    This Bill Will Be Imposed By A Federal Mandate On Each Man, Woman, Child, And Even Unborn Children That Live In This The United States If This Bill Passes.
    That This Mandate Is Actually an Unconstitutional Bill in Many Ways
    The Federal Government Does Not Have the Right to Mandate that it’s Citizens Will Have to Purchase a Product Such As Health Insurance Policy.
    To Mandate That An Unborn Child Will Have To Purchase This As Well Is The Same Taxation Without Representation.
    We As Citizens Are Now Already Over Taxed the Federal Government It Takes the First 4 Months of Our Income
    The States Take Another Two Months Of Our Income.
    If You Live You Pay Sales Tax on All Purchase’s And Even More On Other Taxes Such As Property Taxes, City Taxes, Cigarettes, Alcohol, Death Taxes, And Soon Even A Carbon Tax On Breathing.
    At The Present Time With All Of The Visible Taxes And The Taxes That Are Hidden In Every Item That Is Purchased We Are Taxed At If Not More Than 50% Of Our Income’s An Additional $1000.00 Per Month $12,000.00 For A Federal Health Care Product That Once Implemented Will Only Cover 60% Of Medical Expenses After An Already High Deductable This Will Place A Large Burden On Any If Not All United States Citizen’s.
    WE CITIZENS OF THE UNITED STATE RESPECTFULLY REQUEST TO OPT OUT OF THE CURRENT HEALTH CARE BILL
    PLEASE COPY AND EMAIL TO ALL OF YOUR CONTACTS AND ON SUNDAY WHO EVER HAS A COPY FORWARD IT TO THE HOUSE,SENATE, AND THE WHITEHOUSE

  12. I agree with Messrs. Klepper’s and Kibbe’s assessment. Not having any first-hand experience with the legislative process, I marvel at the absurdity of it from the outside. But I agree with all those with knowledge on topic who make similar arguments for passage and rapid passage – as in this weekend of the bill by the House.
    Further delay by Democrats – of course forget about the idiot Republican members of Congress – is inexcusable. The President, the White House staff and the so-called “leadership”, an inaccurate moniker for the Speaker, et. al. but the one generally used, should use every possible threat and so on on every Democrat in the House to force passage of the bill on Sunday. Let’s hope it happens.

  13. Margalit,
    As you point out, its hard to directly correlate the lobbying contributions with votes. The interests carefully cater to both sides of the aisle, although they tend to focus on members with more seniority and clout. But the real impact of the money is in the shaping of the bills, which determines what provisions are actually included. This bill is dramatically flawed as much for what it omits as what it includes, and that’s key. Once bills have taken form, then the discussion can be more strictly ideological.
    Matthew puts his finger on it when he says “the political process is inadequate and has become fundamentally flawed, and therefore unable to reach a successful solution.” This goes not only for health care, but for all our major issues.
    Lobbying contributions are a straight exchange of money for influence over policy. Remove that transaction, and the result would likely be very different, and certainly more in the public interest.

  14. Question for the experts:
    Just saw this voting tally chart in WaPo. It sort of threw a wrench in my thinking. It seems that there is really no correlation between health industry campaign contributions and position on health reform.
    http://www.washingtonpost.com/wp-srv/special/politics/votes/house/finalhealthcare/
    Seems clear party lines to me and nothing more.
    How does this square with the contention that these Congress folks are motivated by corruption? Am I missing something?
    P.S. Brian, I am glad you found your peace too… and David also… 🙂

  15. David & Brian–
    I respect both of you, and so am very, very happy to hear that you accept what is, without doubt, a very flawed bill, for the very best of reasons: because it will expand accesss and fairness.
    And I agree with you that President Obama is trying to deal with extraordinarily difficult problems
    thoughtfully and in good faith.
    I would add that this it not the end of the reform process, just the beginnning. And I believe that, going forward, reform will incorporate many of your best ideas for improving employer-based insurance and making healthcare IT affordable.
    In the future, I’m hopeful that all of us can unite to
    talk about how to make reform better.

  16. The way I see it – this bill will spread financial duress over a wider base – bringing down a larger portion of the population to a level where they are unable to pay premiums. Those of us who are barely able to meet our premiums now will be overburdened when health insurance premiums rise to cover the additional costs of insuring the uninsurable. Insurance, by definition, is the betting that the premiums charges will beat the probable costs incurred to cover your health. Who do you think will be paying the cost for those pre-existing conditions? You and me. Insurance companies are still free to set their premiums, they will just not be free to pick their market – we will all pay and those of us barely scraping by now will join the ranks of the currently uninsured – unable to afford the premiums – only now it will be illegal to be that broke. What will happen when we all need to go to jail for failure to pay the increased health insurance premiums??? I am all for helping the other guy but I need to take care of my own family first – this legislation may make it impossible for me to do that.

  17. I’m a little surprised to see this. Happy but surprised. Brian and David seems to be where I got to a few months back–this bill is better than the alternative (i.e. nothing). But when I stated that in this post https://thehealthcareblog.com/the_health_care_blog/2009/10/time-to-put-aside-the-intellectual-disputes-for-now.html
    David responded in a way that made me think that then at least he thought nothing was better than what we were getting. To be fair he never said that exactly, and today’s piece is not a ringing endorsement–here’s his response from October. Of course on the substance of what should be done in system reform–we’re all agreed!
    Matt: Nice try, my friend. However, I think your position on this is like accepting filtered cigarettes as “progress” because smoking them is somehow “better” than smoking the unfiltered brand. And, because we can’t get the cigarette companies to admit that nicotine is a terrible addiction, and that smoking cigarettes kills people, we should accept this half-measure as better than none at all. But a lie is still a lie, even if sweetened a bit.
    As Brian Klepper stated in his response to one of Maggie’s comments: “Back to the core arguments of our article, the current proposals do little if anything to correct the 3 most important structural underpinnings of the current crisis: fee-for-service reimbursement, transparency, and specialist-dominated care. The proposals all but ignore everything that progressive health care practitioners have learned over the last 25 years about how to best manage the care process. The most straightforward and logical reasons for the disconnect between what many of us interested in reform for many years and the current process is that change in the public interest would drive significant dollars away from the special interest.”
    What I think this argument about is the adequacy of the political process to address the significant, dangerous, and mounting problems that face the public and the republic. Brian, Alain, Robert, and I represent those who think the political process is inadequate and has become fundamentally flawed, and therefore unable to reach a successful solution

  18. Vote no. There is no legitimacy in this bill. There is no savings. There is no care to be bought with the coverage that you will not have. Bring cash in advance, just like the dentists.

  19. REALITY
    “[Obama is] attempting to deal with many difficult problems thoughtfully and in good faith within an extremely toxic political environment.”
    1. He has no authentic management experience.
    2. Classic lawyer — dithers.
    3. “toxic” — i.e., anti-Communists who REFUSE to bow down to him and lick his ACORN boots. Of course, such people are called Nazi in-breds by the Harvard crowd.
    START OVER — OBAMA HAS FAILED BY SPENDING TOO MUCH

  20. He may be a good friend, but he is certianly not a good health plan broker. I believe(one of)you made up this story. This post is dispicable. Not having higher quality standards is what got this piece of crap this far. I guess we can lump you two in with Clayton Williams…”As long as it’s inevitable, you might as well lie back and enjoy it.” I will fight this rape and rapist with all I have. Thanks for listening. LD

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