Tag: Policy/Politics

Proposal for a THCB Healthcare Reform Effort

Nov 10, 2008• 22

By Deron Schriver

THCB regular reader Deron Schriver wants THCB readers to suggest plans to reform the health care system. Here’s his appeal:

I enjoy many of the discussions on THCB. Intelligent people from all vantage points of the health care system congregate to engage in conversations about the most important issues out there. What if there was a way to translate those discussions into treatment plans for the ailments of our health care system?

Meaningful, sustainable reform can only come from a collection of people from the various stakeholder positions (physicians, patients, insurance companies, employers, etc.) who see what’s working and what isn’t on a daily basis. Politicians do not have the exposure to the system that is needed to prescribe effective solutions. However, they are in a good position to assist in the implementation of well-designed solutions.

We need to approach reform much like a physician approaches an ill patient. That involves obtaining some history, examining the system, and then prescribing a treatment plan. It would require a progress note, similar to what a physician uses, in order to document our work. After all, “if it wasn’t documented, it wasn’t done”. All problems considered should be discussed by all stakeholders until solutions are developed that 1) are thorough, 2) treat the problem and not the symptoms, and 3) are not zero sum. We need to follow the system all the way from the time the patient enrolls in an insurance plan, to the time she is treated by her physician, to the time the claim is paid (or not paid).

Despite Democratic control, major health reform still unlikely

Nov 8, 2008• 19

Laszewski_2 By Robert Laszewski

With 258 House and 57 Senate Democrats, it’s almost certain that major health
reform will be passed, right?

Actually, that was the number of Democrats Bill Clinton started off with in 1993 and we know what happened to health care reform in that Congress.

With similar Democratic majorities, I do not expect a major health care reform bill like the one President-Elect Barack Obama called for during the campaign–in 2009 or 2010.

Is much more than we think really possible?

Nov 7, 2008• 1

By Matthew Holt

On THCB today Maggie Mahar basically tells the health reform crowd to be patient. But two members of the unreconstructed left in other venues don’t agree. In the NY Times Paul Krugman says that deficit spending is OK, and correctly points out that Obama has a real mandate to fix the underlying problems of middle America (and yes that would include health care). And yes polling data shows that on balance America is as liberal now as it was in the 1960s. 35 years of blind-ish belief in conservatism is more or less over.

And if you want to see the optimist’s view on what Obama might do, Jonathan Cohn has a long article in The New Republic called Surgical Prep explaining why now is the time for health care reform and how the brass knuckles approach is being put together to get it done.

I’m not sure I’m there but let’s not underestimate how big a political win this was.

Social Solidarity is Key to Meaningful Health Reform

Nov 7, 2008• 5

By MAGGIE MAHAR

On HealthBeat, I have talked about social solidarity as the key to meaningful health care reform.

In his victory speech, President-elect Obama sounded that theme repeatedly, reminding his audience that he had been elected “by young and old, rich and poor, Democrat and Republican, black, white, Hispanic, Asian, Native American, gay, straight, disabled and not disabled—Americans who sent a message to the world that we have never been just a collection of individuals…”

In the recent past, some progressives have warned that liberals made a mistake when they reached out to minorities, new immigrants, and gays, “ignoring” the mainstream middle class. But in fact, “mainstream” America is no longer one recognizable culture. It is fast becoming a “magnificent mosaic,” the phrase Mario Cuomo used when he ran to become mayor of New York City in 1977.

Barack Obama won, not because he managed to win over the white middle-class, or the white working class, but because he managed to put together a coalition from so many groups—including white voters. Many thanks to Ezra Klein for breaking down the vote: 31.82 percent of voters who chose Obama were white, just as 31.57 percent of the voters who stood for John Kerry in 2004 were white. But Obama won. What was the difference?Continue reading…

The next president’s health agenda

Nov 6, 2008• 4

By Merrill Goozner

Note: This post first appeared at Goozner’s blog, Gooznews.

Picture_4 A year ago, health care held a solid lead in the polls as the number
one concern of the American people. But by the time the Iowa caucuses
closed, and Barack Obama surged to his unexpected win, it had been
supplanted by the economy, a changing reality I noted in this New Year’s Day post.

As my daughter and I stood in a crowd of well over 100,000 people
last night in Manassas, Virginia, and heard the Democratic nominee give
his stump speech for the last time, I was struck by how little of it
was devoted to any issue beyond the core economy. His mom’s struggle
with paying her bills as she lay dying of cancer and the need to put
health into our sick care system got a line; but so did the war in Iraq
and going after bin Laden. As in 1992 when the last Democrat got
elected for the first time, it’s the economy, stupid.

But unlike some pundits who say the health care issue will be put on
the backburner for the first half of the next president first term, I
do not believe the nation will have that luxury. Curbing the growth of
health care spending will reassert itself as an issue next year because
it is key to restoring this nation to economic competitiveness.
American businesses are at a competitive disadvantage when they must
pay twice what companies in other countries pay (whether premiums or
taxes) to provide their workers health coverage.

The morning after reality for the next president is that the U.S.
spends more on health care than any other nation on earth — 16 percent
of gross domestic product and rising. Yet nearly 50 million Americans
go without health coverage during the year, and in traditional markers
of national well-being — longevity and infant mortality — the U.S.
ranks below many former Communist bloc nations of Eastern Europe.

President Obama: A victory for health care?

Nov 4, 2008• 44

By THCB Staff

Now that the results are in and the United States has officially elected Barack Obama as its next president, what does that mean to you and what will that mean for health care in America?

After nearly two years of campaigns, countless pages of material written about Obama’s health care plan and the possibility of reform, the U.S. has elected a Democrat as president and put Democratic majorities in both the House and Senate.

What do you predict the next four years will bring?

This is your space to reflect, comment and debate. Please share your thoughts, and let’s get a vigorous discussion going.

What I want to happen and what I think will happen

Nov 4, 2008• 9

By Matthew Holt

Election day. At last it’s over. A gazillion dollars, mostly wasted making TV stations richer. Two years of
campaigning resulting up in 3–4 months where rushed decision making will create a future that we all have to live with.

It looks pretty clear that Obama will win, with an increase in Congressional control for the Democrats. Although we Dems are used to losing when it never seemed possible…

So what do I want to happen? Certain things need to be done straight away.

1) Guantanamo Bay must be closed & torture renounced.

2) Rampant spying on Americans, national security letters & government abuse of power must be ended.

3) We need a declared route out of Iraq, immediately. (And a truth commission to deal with the lying sacks of **** who got us in there to reward themselves and their now much richer friends wouldn’t be a bad idea).

4) America must rejoin the international community, including
abiding by the principals of Kyoto, the International Criminal Court
& the UN Human declaration of human rights.

5) The drug war should be ended and a rational system of regulation introduced (OK I know I’m dreaming on this one).

6) A Manhattan-type project should be set up to really push the development of alternative energy. (I have some hope this will happen)

7) Complete house cleaning in the Federal departments and agencies
like Justice, EPA, FDA and many more, which have been over-run by
politicization and an attack on science. And a re-adoption of a serious
role for government.

8) A really broad effort to fix the discriminatory, unfair American health care system

But what do I think will happen?

Less than that I’m afraid. But let’s stick to health care reform
which (other than the drug war) of all the above is the least likely to
happen.

The conventional wisdom is still probably correct.

Baseball and Health Care: Only One Is a Spectator Sport

Nov 4, 2008• 3

By Joshua Seidman Siedman

It’s fascinating when two of my passions collide in the opinion pages of the New York Times like they did over the last week. On Friday, October 24, some seriously strange bedfellows came together to write about, “How to Take American Health Care from Worst to First.” Strange enough that Newt Gingrich and John Kerry joined together, but
the lead author was Billy Beane, often thought to be the pioneer in the
trend toward data-driven major league baseball general managers.

I’ve been studying the health care system for nearly two decades,
but I’ve been studying sabermetrics (complex baseball statistics) since
a decade before that. So you’d think that their argument would resonate
with me and, to some extent, it does.

Their thesis is rational in many ways. Much of what is done in
health care has no evidence basis, and we end up spending a lot of
money on things that are unnecessary or even detrimental (or, at the
least, things for which we just don’t know). By developing a better
evidence base and encouraging more use of it, we could improve quality
and lower cost.

Politics 2.0 is a Victory for Health 2.0

Nov 3, 2008• 1

By Michael L. Millenson

I was sitting here getting ready to blog on how Politics 2.0 will affect Web 2.0, when I got an email from the coordinator of a health care-related virtual community established by the Obama presidential campaign. It directed me to a humorous video featuring a group of singing (OK, lip-syncing) Obama staffers bringing a bipartisan message of hope to political junkies facing the looming end of this seemingly endless campaign. Les Misbarack is great fun — although I wouldn’t plan on ditching my Capitol Steps tickets just yet.

This morning, two pillars of the mainstream media (MSM) both examined the role the Internet has played in the presidential campaign. The Wall Street Journal gives us conventional political analysis along the lines of how-the-results-of-this-war-will-affect-the-next-one. The New York Times, by contrast, zeroes in on Campaigns in a Web 2.0 World and begins to discuss the thornier issues of who will generate content, who will control content and how content will be disseminated by online and offline media.

Interestingly, while the Times piece has a photo of Obama Girl, and alludes to her popular “I Got a Crush…on Obama” video in the caption, the article itself makes no mention of user-generated content. You have to go to the online site, Politico.com, to find the “10 most viral videos of the campaign” in order to discover that the Obama Girl video pulled in more than 10 million views.

Is Joe the Plumber responsible for our health care mess?

Nov 2, 2008• 10

By Sarah Arnquist

The financial collapse in the United States and the long, deep recession the nation will likely endure may be the calamitous event needed to finally tip the country toward adopting a universal health insurance, according to Uwe Reinhardt.

The Princeton health economics professor told students at Johns Hopkins School of Public Health last week that thanks to the Wall Street CEOs health care reform may be a possibility. They finally proved the free market can’t succeed without some government regulation and helped drive the U.S. and world into the greatest financial disaster since the Great Depression.

“I think people will realize that government has a role,” Reinhardt said. “Government is of you, it’s your creation. How can you hate your government like that? If you read the paper sometimes you’d think the government came from Mars and is occupying you.”

Then, Reinhardt expressed his deep-rooted anger at Joe the Plumber, and other “rugged individualists” who profess a hatred for government. They say no one has the right to tell them to buy insurance, but when they’re sick, they declare the “right” to lifesaving medical care.

“You chip in when you’re healthy so when you’re sick you get care,” Reinhardt. “If you don’t want to pay insurance than you should absolve me from the moral responsibility to provide care.”