Tag: Policy/Politics

Perhaps Obama will have to do rather more than he says he will

Oct 31, 2008• 8

By Matthew Holt

I feel like Mrs Miggins in my favorite comedy show, Blackadder. It’s the scene when Blackadder says “The hustings are down, the candidates have spoken and after the madness of a general election, we can return to normal” and Mrs Wiggins says “Has there been an election? I’ve never heard about it?” (Yes that is a much younger version of Dr House playing the Prince Regent).

Anyway I’ve had my head so far up the Health 2.0 rear that until this week I haven’t really paid too much attention to the election. In all honesty (speaking as a Democrat who could never conceive of a Republican win in the current circumstances) I’ve been trundling along expecting an Obama win with the same set of Democrats running Congress but not with the vicious efficacy that Tom Delay & friends showed in getting their bills passed in 2001–2004. So I haven’t been expecting that much change in the healthcare system.

But if you do believe something is going to happen, over at the HuffPo Susan Blumenthal, whom I saw earlier this week, nudges me towards her side by side comparison of the U.S. Presidential Candidates’ Health Care Plans.

On the other hand, and I’ll be writing more about this before the election, if the recession is bad enough—and this morning’s numbers suggest that it could be—what Obama is proposing may be torn up and we might do something much more radical. It sounds crazy, but then again a year ago you wouldn’t have thought that the US taxpayer was going to own the biggest insurance company and most of the banks. After that actually IS socialism according to Lenin’s “owning the commanding heights of the economy” definition, no matter how much Sarah Palin rails against it. And socialism in health care makes rather more sense than socialism in banking, or autos.

So if there are 90 million uninsured and 15% unemployed, perhaps a Federal rescue package for health care is on its way—we just haven’t seen it poke its head out of the water yet. And if it does, it will likely be much more radical than the gentle proposal Obama is starting with, which the conventional wisdom says is a non-starter anyway.

McCain’s health plan likely going down with him

Oct 29, 2008• 7

By Robert Laszewski

John McCain would reform the American health care system by providing big tax incentives for it to transition from being employer-based to one built on a system of individual responsibility. He would do this by eliminating the longtime personal tax exemption on employer-provided health insurance and replacing it with a $2,500 individual, and $5,000 family, tax credit for those who have health insurance.

It’s too bad this idea will likely recede from the national health policy debate whether John McCain wins or loses the presidency. Even if he wins, the Democratic majorities in Congress will be so large there is little chance we will be able to move away from the traditional employer health insurance base in the next few years. All you have to do is look at the way Obama and all of the Democratic candidates for the Senate and House have railed against McCain’s plans to "tax your health benefits" to see how Democrats have willingly painted themselves into a political corner that makes this idea a non-starter in the new Congress.

As I have said before on this blog, I have been largely disappointed in the McCain health plan. He started out with a bold new approach but never closed the loop on so many key elements in his plan. For example, he leaves those with pre-existing conditions to the fate of state-based risk pools–a place no one would ever vote themselves into.

Will a $5,000-tax credit be the silver bullet to solve health care?

Oct 28, 2008• 9

By Shuka Kalantari John_mccain

If Senator John McCain becomes U.S. president he plans to give each American family $5,000 to pay for health insurance premium costs in the individual market. Individuals would get $2,500 for the same use.

How does McCain propose to pay for this? In part, by revoking the tax deductibility of workers’ health benefits and by making cuts to Medicare and Medicaid. Even with these provisions, however, The Tax Policy Center estimates McCain’s plan will run an estimated $1.3 trillion short in funding over the next ten years.

In McCain’s “Health Care Action” television ad, he says, “The problem with health care in America is not the quality of health care, it’s the availability and the affordability. And that has to do with the dramatic increase in the cost of health care.”

Firefighters attack McCain’s health plan

Oct 27, 2008• 6

By Shuka Kalantari

The International Association of Firefighters (IAFF) recently launched a campaign in support of Senator Obama for president — and an attack on Senator McCain’s health care plan.

The commercial features four firefighters. "Our job is to risk our lives to protect you, and your loved ones. We’re proud of that," one of the firefighters say. "Like you, we need our health care for our families," adds another firefighter.

The IAFF, based in Washington D.C., is a labor union representing approximately 292,000 full-time firefighters and paramedics in the United States and Canada. The commercial will air on local cable networks in New Hampshire, parts of North Carolina, Orlando, St. Louis, parts of Ohio and parts of Virginia.

Health care at risk

Oct 25, 2008• 3

By Jacob Hacker

Jacob S. Hacker is Professor of Political Science and Co-Director of
the Center for Health, Economic, and Family Security at U.C. Berkeley.
He is also a Fellow at the New America Foundation in Washington D.C.

Health reform is moving back to the top of the political agenda. Over the last fifteen years, the biggest problems in U.S. health care—the dwindling reach and generosity of private coverage, the rapid escalation of costs, the uneven quality of care—have all grown substantially worse. Now, we may well finally have a true opportunity to address these problems. What are the big issues at stake? What are the options for reform? And what are the prospects for real change after decades of political defeat?

These are the questions taken up in Health At Risk: America’s Ailing Health System–And How to Heal It, a book I recently put together that features the commentary of some of the nation’s leading experts on health care (plus yours truly). The book is premised on a simple notion: All of us are entitled to our own opinions about health care, but not our own facts.

The chapters in the book — on the uninsured, medical bankruptcy, the quality of American medical care, the consumer-directed health care movement, and the political prospects for reform — carefully examine these facts and offer original ideas for reform. The contributors don’t check their opinions at the door. But they all ground their arguments in the evidence, and express those arguments in clear and straightforward language. In short, the authors are experts who have written their contributions so that they are accessible to interested nonexperts—which, ideally, should include all Americans, so important is this discussion to us all.

The toughest job in America

Oct 17, 2008• 14

By Jane Sarasohn-Kahn

Today, the loneliest job in American isn’t being the Maytag repair man. And the hardest job in America isn’t necessarily the Presidency. It’s being a state governor.

Take Pennsylvania (the state I call my home). Governor Ed Rendell sought the position with an explicit goal of expanding health insurance to uninsured Pennsylvanians. After two years in the job, Rendell is facing declining tax revenues, increasing costs. Rendell is already facing a $281 million deficit in this fiscal year, which could increase to over $1 billion. A detailed analysis of this story was published by PR Newswire, "Pennsylvania’s Loss of Employer Health Coverage Outstripping National Average."

The Kaiser Commission on Medicaid and the Uninsured has been studying other state initiatives targeting covering the uninsured. The Commission has found that in California, Illinois and New Mexico, for example, have been unable to broaden health insurance access to citizens without it.

Health Care Reform: The Public Speaks (With Forked Tongue)

Oct 15, 2008• 10

By Michael Millenson

Who says Congress doesn’t accurately reflect the will of the American people? The public has spoken about health care reform, and the message is clear: “Whatever.”

If you’re a politician who believes that soaring promises soothe voters, while the painful tradeoffs involved in voting for an actual proposal can only bring trouble, the latest figures from the11th annual Health Confidence Survey of the respected Employee Benefit Research Institute (EBRI) have got to be good news.

The public is practically demanding inaction! Asked what they would do to fix health care, an overwhelming 87 percent favored health tax credits, similar to the health plan of Republican presidential nominee Sen. John McCain, CQ Health Beat reports. On the other hand, a nearly-equally-overwhelming 83 percent favored letting people buy into the same health care system government employees get, the option trumpeted by Democratic presidential nominee Sen. Barack Obama.

Indeed, one might say the public and the politicians are in sync about the urgent need to pay lip service to the notion of health care reform. So, while a whopping 71 percent of respondents endorsed "major change" or “a complete overhaul “of the health care system, it finished a distant third to the economy and energy costs as a priority. Only about half as many people think health care is as important a crisis as the cost of gasoline (13 percent vs. 24 percent). And should the war in Iraq or some other issue heat up, one can expect health care to continue to finish well back in the pack.

Finally, there was the fine print: About half the respondents said they are “very” or “extremely” satisfied with quality of care. And while hardly anyone had a good opinion about health care costs, the key figure to look at is the personal saliency of their concern. The percentage of Americans reporting an actual increase in their personal health care costs dropped to 55 percent from 63 percent.

We knew the Swedes hated the Bush Adminstration, but…

Oct 13, 2008• 9

By Matthew Holt

…we never suspected that they hated it to this extent.

After giving Al Gore the Peace Prize a couple of years back, today Paul Krugman wins the Nobel Prize for Economics.

They say the prize is for his work on international trade, but it must be partially for his columns in the New York Times since 1999 skewering the Bush Adminsitration on economics, war, healthcare, and just about everything! Congrats, Paul.

Let’s get real about the economy and health care

Oct 13, 2008• 15

By Robert Laszewski

I just got a call from a reporter at one of the major news organizations to talk about the chances for health care reform.

We both commented on the almost surreal environment we are all in. I’m not sure if my friends and neighbors are in denial or just numbed by the recent cascade of events in the financial world. Up on the Hill and in the presidential campaigns it’s business as usual when it comes to extending the Bush tax cuts, spending on alternative energy, or the imperative to do health care reform.

The reality is we are now headed down an unavoidable slope into a recession. The only question is how bad. Today, Dr. Phil told his audience to stop spending money, get their credit card debt paid off, and hold cash–"Cash is king." They are and they will.

Is Health Care a Right?

Oct 8, 2008• 91

By MAGGIE MAHAR

I have to admit I often have found the language of health care “rights” off-putting. Yet the idea of health care as a “right” is usually pitted against the idea of health care as a “privilege.” Given that choice, I’ll circle “right” every time.

Still, when people claim something as a “right,” they often sound shrill and demanding. Then someone comes along to remind us that people who have “rights” also have “responsibilities,” and the next thing you know, we’re off and running in the debate about health care as a “right” vs. health care as a matter of “individual responsibility.”

As regular readers know, I believe that when would-be reformers emphasize “individual responsibilities,” they shift the burden to the poorest and sickest among us. The numbers are irrefutable: low-income people are far more likely than other Americans to become obese, smoke, drink to excess and abuse drugs, in part because a healthy lifestyle is expensive, and in part because the stress of being poor—and “having little control over your life”—leads many to self-medicate. (For evidence and the full argument, see this recent post). This is a major reason why the poor are sicker than the rest of us, and die prematurely of treatable conditions.

Those conservatives and libertarians who put such emphasis on “individual responsibility” are saying, in effect, that low-income families should learn to take care of themselves.Continue reading…