Tag: Policy/Politics

Single-payer folks still determined

Oct 7, 2008• 1

By Shuka Kalantari

John McCain would never endorse it, and Barack Obama’s plan carefully steered away from it, but the proponents of a single-payer national health care plan are as determined, and hopeful, as ever to bring it the U.S. Conyers

Congressman John Conyers of Michigan, who introduced HR 676, the United States National Health Insurance Act, to Congress in 2003, isn’t giving up. Under his plan, a single agency would organize health financing — cutting out the insurance companies as the middle men — but health care delivery itself would be mostly private.

On Sept. 19, single-payer advocates gathered at the 1199/SEIU building in midtown Manhattan to honor Conyers as he received a lifetime achievement award from members of Physicians for a National Health Program (PNHP). He concluded his speech with a quote from Dr. Martin Luther King, Jr., "Of all the forms of inequality, injustice in health care is the most shocking and inhumane."

Conyers spoke to me that evening about how he thinks a national health care plan is inevitable – because every other plan has led the country into dead ends. Click here to listen to the interview.

The single-payer advocates gathered that evening were also celebrating the release of PNHP’s new book, "10 Excellent Reasons for National Health Care."

I spoke with the editors, Mary E. O’Brien, M.D., and Martha Livingston, PHD, about the book and their views on McCain and Obama’s health care plans. Click here to listen to Dr. O’Brien and Dr. Livingston.

Obama’s new ad is clever, but why aren’t they taking the open shot?

Oct 6, 2008• 10

By Matthew Holt

One of the few virtues of getting on a plane and leaving California is that you get to see Presidential political ads on actual TV. Obama has a new ad about health care which explicitly attacks “government run health care” on the left of an arrow and then attacks unregulated insurance companies on the right end. Geddit? Yup it’s 1996 Bill Clinton all over again. The man is a triangulator. Or an arrownator…

(Apologies for the poor quality but it’s the only version I can find online).

Obama’s plan is in the middle of the arrow of course. It’s a little bizarre that he attacks government-run health care — given that his plan involves both extending FEBHP and creating a separate version of Medicare/Medicaid that everyone can buy into. And of course Medicare is the most popular health insurance plan in the nation by a long way. I think the government still runs it.

But I guess that’s just politics. And of course nothing as major as what he’s talking about is going to happen once he gets elected anyway, (as I’ve been saying for more than a year).

But talking about politics, what I cannot get over is how the Obama team has not bothered to connect the McCain plan’s designs to push more people into the individual insurance market to specific actions of health insurers in California. There are still smart intelligent people running major health care lobbying organizations in DC (one of who I had dinner with last week in my professional life) who still have not heard about the retroactive policy cancellations in California despite the fact that all of the big insurers were doing it. And yet McCain’s plan is designed to explicitly put people into a situation where they’re at the mercy of those insurers!

This isn’t hard to explain. Why isn’t the Obama campaign featuring it? Especially as he’s now talking about health care. They are not taking the open shot (or as the English say, they’re missing an open goal!)

Obama vs. McCain on health care

Oct 6, 2008• 10

By Donald Johnson

Sen. Barack Obama’s attack on health insurance reforms proposed by Sen. John McCain shows that Obama’s not for real change in health insurance.

Obama wants more government-sponsored health insurance schemes, like
the VA health care system, Medicare and the unaffordable Medicaid scheme
that’s bankrupting the states and the Feds.

Obama wants to keep employers involved in the insurance markets,
even though they limit consumer choice, increase costs for consumers
and make their workers buy expensive policies they don’t want nor need.

Please, can we now re-structure health care, too?

Oct 5, 2008• 16

By David Kibbe

Kibbe I respectfully disagree with my friends and colleagues who believe that the recent financial crises will make it more difficult to reform health care. In fact, now that we’re socializing large chunks of the financial system, we may find it a lot easier to socialize health service delivery assets, too. You’ll know a federal health system bailout is around the corner when you hear someone say, "The hospital is simply too large to allow it to fail."

Let me explain.

In the past three weeks we’ve all become regulators. Amazing. Almost overnight the federal government, we the taxpayers, have taken ownership of Freddie Mac and Fannie Mae, financial organizations that own about half of the mortgage debt in this country. We’ve nationalized AIG, one of the world’s largest insurance companies, and we are now owners of a large share of several of the country’s biggest commercial and financial banking institutions, with much more government transfers anticipated in the coming weeks and months.

Half-baked Alaska: Palin short on health care explanations in debate

Oct 3, 2008• 12

By Merrill Goozner

Merrill Goozner has been writing about economics and health care for many years. The former
chief economics correspondent for the Chicago Tribune, Merrill writes the blog Gooznews.com, where this post first appeared.

Palin

It must be disconcerting to health care economists to see one of their pet peeves about the inequities of the employer-based insurance system so poorly used by the Republicans, who would repeal it. I’m referring, of course, to the tax deductibility of health insurance premiums.

Gov. Sarah Palin repeated Sen. John McCain’s promise to give every American household a $5,000 check to buy health insurance. They would raise the money to fund the program by repealing the deductibility of employer-based coverage. I can’t recall if she gave one of her trademark winks when she said it, but she certainly gave an enthusiastic nod. Health care will become just like Alaska! The government will be sending you money every year so you can go out and buy your own insurance.

There is an argument that can be made in favor of repealing tax deductibility. Like the home mortgage deduction, the higher your tax bracket, the more valuable the tax deduction. So if your employer buys you a gold-plated health care plan that costs $15,000 and you’re in the highest tax bracket (around 30 percent), you get the equivalent of a $4,500 tax break from the government. But if your employer buys you a plan that only covers hospitalization and serious illnesses for $7,000 a year and you’re in the 10 percent income tax bracket, the tax deduction is only worth $700. Repealing all tax deductibility and distributing the revenue equally to buy individual insurance policies seems simpler and more equitable — both appealing traits.

Obama’s Health Plan Under the Microscope and Through a Fair Lens

Oct 3, 2008• 5

By MAGGIE MAHAR

Each presidential candidate offers a blueprint for health care reform. Neither can expect to see his plan enacted whole—legislators will leave their fingerprints all over any proposal. And, if truth be told, neither plan is perfect. Each proposal is blinkered in its own way; each ignores just how difficult true reform will be. I very much doubt that national health insurance will become a reality in the next year.

That said, I believe that we can take steps toward reform in 2009 if we begin thinking clearly—and honestly—about exactly what it is that we want and what it will cost. To that end, I believe that in-depth analysis of each candidate’s proposal can help underline the core ideological differences between conservatives, libertarians and progressives, and highlight the economic realities that any reform plan will have to face.

Recently, opponents of each plan have offered their critiques in Health Affairs (here and here) and supporters have defended their favorites here and here. Inevitably, many readers found the critiques too partisan. At the same time, they complained that rebuttals from the home team “read more like a stump speech with details glossed over and facts overlooked.”

If you can stay awake, the candidates’ health plans explained

Sep 25, 2008• 2

By Sarah Arnquist

The New England Journal of Medicine and Harvard University teamed up to bring you this compelling, hour-long nail-biter of Gail Wilensky and David Cutler discussing their respective candidates’ health plans.

I wonder if the NEJM has had to buy more bandwith to support the flood of viewers?

In all seriousness, I think it’s great the NEJM is sponsoring this type
of dialogue. It probably won’t reach many people, but it might reach
and influence those who have the potential to influence others — legislative staffers,
journalists, doctors and health care leaders.

There have been calls recently for more serious coverage of the candidates’ health care issues. We need a mix of coverage. This kind of wonky dialogue and the kind that ordinary folks read and watch — yes that 800-word explainer story with a few pithy quotes.

Divying the pain

Sep 24, 2008

By Jim Jaffe

When campaigning politicians talk about reforming America’s health care system, they’re understandably quiet in identifying who will take the pain that will ultimately be allocated between the three basic groups involved –- patients, providers and payers.

If politicians ever get serious about reform, their big challenge will lie in finding a balance that at least two of these groups find tolerable. They’re not serious yet.

A new analysis this week by the Tax Policy Center confirms that, giving neither presidential campaign credit for doing anything to cap costs and sensibly concluding that the bottom line here is that insuring more people requires spending more money (Obama’s plan, it concludes spends more money more efficiently to insure many more people).

So the current spate of ads on the topic may seem a bit puzzling. Here’s how to decode them.

Health care expansion? Forget about it

Sep 23, 2008• 2

By Jeff Goldsmith

Thoughbubble

"Jane has missed the most obvious implication of the implosion: the
bailout will use up the fiscal margin for any subsidized solution to
health reform. There will simply be no extra dollars in the federal
budget for the uninsured for many years. Obama’s health reform plan,
which relied on new taxes, is dead as a doornail unless he is willing
to push the budget deficit into Argentinian territory, or finance it
from savings inside existing health spending or health related tax
subsidies. Even the existing base of health spending will probably have
to be re-examined. Stay tuned for a more detailed analysis."

Health Affairs makes an apPaul(y)ing choice

Sep 22, 2008• 10

By Matthew Holt

Health Affairs ran a couple of partisan analyses last week. Joseph Antos, of AEI, Gail Wilensky, former Bush 41 HCFA administrator, and Hans Kuttner labeled the Obama plan as excessive tax and spend socialized gulag regulation.

In the other analysis, four liberal academic wonks — Thomas Buchmueller, Sherry A. Glied, Anne Royalty, and Katherine Swartz — derided the McCain plan as the counter-productive ravings of a right wing nutjob. OK so they didn’t exactly say that, but you get the message. No surprises here.

The McCain plan is so far out of the mainstream that, when Bush proposed something very similar in 2006, he could not even get it introduced into a Republican-controlled Congress. Obama’s plan is a wishwashy centrist Democrat plan that doesn’t even pretend to get to real universal coverage and ignores the fact that the vast majority of Democrats prefer a straight single-payer plan (and so does he when scratched hard!).

So who does Health Affairs chooses to create a middling compromise between these two?