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Tag: Policy/Politics

I was largely in favor of Swiss-style health care…

until I found out that the people who the NY Times says are really in favor of it are Bill O’Reilly and Regina Herzlinger…

Actually I’m kidding. I knew Regi says she likes it, and Maggie Mahar ripped her position—(Herzlinger’s position being that she espouses a version of the Swiss system for the US)—to shreds a while back. But would Herzlinger really want to live in a world where there was no easy money to be made trading in the stock of health insurers who are defrauding state governments? But I’ve got to say that Herzlinger and O’Reilly make a interesting couple.…pass the falafel.

Morons like us

I still read the articles every day that Google and the rest of my searches spit into my inbox. But as the sausage gets made I despair for the country. Not so long ago the NY Times met the Rush Limbaugh fan who decries the government takeover of health care, even though his wife ran up $68,000 in care while she had breast cancer and no insurance. Somehow because his local hospital let him off the charges, he thinks that the system was OK, and drove for an hour to shout at a Democrat who wanted to change it! (Of course the taxpayer absorbed the costs).

Yesterday NPR reported about the Sacramento man who loves his current health insurance. He’s had six or seven surgeries in the past five years—in other words he would be completely uninsurable if he lost his job (post-COBRA). He even sort of understands that.

“I mean you hear horror stories about people who have insurance and then all the sudden get denied coverage down the line because they may have had a pre-existing condition,” Koenig says. He, too, worries that he’s one step away from being dropped from his plan or losing his job and not being able to afford coverage…..And that’s why Koenig is on board with parts of the big push to change the health care system.

And like about half of other Americans, he’s actually been uninsured.

In the early nineties he was laid off and went without insurance for several months. He says it was an uncertain time and he sympathizes with the millions of Americans who don’t have coverage — or could be dropped at any time

So what does he think?

he says the focus should be on regulating the insurance industry and not a government take-over, which he believes President Obama is pushing for.

Let’s quickly review here.

Obama/Baucus/HR3200 all basically keep employer-based insurance as is with a bit of expansion, keep Medicaid as is with some expansion to suck up a few of the uninsured poor, and change the regulations in the insurance market to prevent (some of) the problems the Sacramento man understands. Oh, and they sort of put in place a backstop public plan (well HR 3200 does anyway) which people could buy into if there wasn’t a private plan they liked.

So does this sound like “regulating the insurance industry” or is it “a government take-over”.

I hesitate to remind the Sacramento man that a government takeover means the communists collectivizing your farm and stealing your pigs, and shipping you off to Siberia. What Obama/Baucus/HR3200 is proposing is minor reform of the insurance market.

And yet, somehow that message cannot get itself into the thick skulls of people who those reforms would actually help.

Will Victory on Health Care Reform Mean Defeat for the Democrats?

Being a futurist is not really about making predictions, but people ask for them anyway.

So here is one: The way things are trending right now, Obama and the Democrats will succeed in getting a reform bill – and it will cost them the Congress in 2010 and possibly the presidency in 2012. Why? Because it will be ineffective at bringing most voters any tangible benefits soon, and ineffective especially at bringing down the cost of health care.

Obama (along with everyone else) repeatedly talks about “affordable” health care. What the bill is most likely to bring is health insurance reform. This is very important, and will bring tangible benefits especially for those who must go without insurance now because they have “pre-existing conditions.” But there is nothing in the bills that are most likely to pass that will really bring down the costs of health care any time soon. Yet the bills demand that the health plans cover many more people, and the providers treat them, while putting in place no mechanisms that would forcefully and quickly control costs – so costs are likely to go up even faster than before.

Continue reading…

Yet another reason to abolish the Senate

Ezra Klein, feeling a little soft, interviews Kent Conrad—he of the co-op feed stores for health care idea.

My take on the interview is that I seriously believe Conrad's entire knowledge of health care comes from his time being lectured on the vagaries of Medicare reimbursement by a local rural hospital lobbyist, his one visit to a co-op seed store where he found the farmers chatting happily, and his reading the cliff notes (prepared by his staff) of TR Reid's good but not too sophisticated book focusing on the Beveridge v Bismarck distinction—which is high school civics lesson stuff.

Yet he gets to meet 61 times with the Gang of six that was really going to get it all right before time ran out, and he gets to make policy!

And you wonder why the Senate should be abolished.

A little ain’t enough, or is it?

I've been so buried in the run up to Health 2.0 that I haven’t had a chance to add to the deluge of electrons about the bills in Congress, Obama’s speech, the several hundred amendments to Baucus’ bill in mark-up, etc, etc. And my colleagues on THCB and elsewhere are taking good care of you in the details.

But I thought that I’d quickly respond to today’s WaPo article in which Erza Klein connects two themes that matter, while leaving out two that matter more. The first of the two he identifies is that most Americans don’t see the cost of health care. If we made them all write a check for $13,000 a year, and they’d seen that number go from $8,000 a decade ago and realized that it will be $25,000 in another decade, then the cost problem would be much more real. It would also get associated with the access problem as people realize that as the cost goes up, they (and their employer) can afford less. At the moment those problems are disconnected.

The ignorance here remains palpable. An HR exec I know did an exit
interview last week with an employee who was astonished to find out
that now he was on his own he could buy family health insurance in
California for under $500 a month which was less than his contribution
to the company plan. The concepts of risk pooling, risk selection,
varying benefit levels et al were clearly foreign to him. And of course
had his family had a pre-existing condition that policy might have cost $3,000 a month or more.

Continue reading…

Health Care Outlook Not Improving

Sen. Max Baucus (D-Mon) released his much-anticipated healthcare proposal Wednesday morning.

Sen. Max Baucus (D-Mon) released his much-anticipated healthcare proposal Wednesday.

By ROBERT LASZEWSKI

The next big test for a health care bill in 2009 (notice that I did not call it health care reform) will come in Senate Finance. The final vote in that committee will tell us a lot about whether the Democrats have any chance for 60 votes in the full Senate. So far, it does not look good.

I have the greatest respect for Senators Baucus and Grassley and their good faith efforts to find a bipartisan health care solution. But I also think their efforts were fatally flawed from the beginning.Continue reading…

Interview: TR Reid on healthcare reform around the world

TR Reid is a former foreign correspondent with the Washington Post. He spent two years (partly funded by the Kaiser Family Foundation) looking at health care systems across the world and has been featured heavily in many media venues lately asking the simple question, if everywhere else can cover everyone at half the cost, how do they do it?  I had a great and not too long interview with him last week.

His book is called The Healing of America: A Global Quest for Better, Cheaper, and Fairer Health Care and here's an interview he did as part of Frontline's Sick Around The World.

Funnily enough I'm posting this from Barcelona, Spain where hopefully I won't have to use the healthcare system unless I get carried away with the late night Sangria…

Expect to hear a whole lot about this…

Seniors care about death panels (apparently) but they usually really care about drug prices and costs. Part of the political rationale for the Republicans passing Medicare drug coverage in 2003 was to deny the Democrats the ability to bundle seniors’ desire for drug coverage with a universal coverage bill. So far the Republicans have to say the least muddied the waters as to whether universal coverage is a good thing for Medicare recipients—or at least the ones that don’t care about their kids or grand-kids.

But there’s one minor trick. The deal with big Pharma that’s part of HR 3200 cuts the donut hole in half. That’s real money for seniors.

And when the cuts to Medicare Advantage become apparent, that donut hole is going to affect many more seniors who now are getting good benefits from Medicare Advantage and are pretty unaware about what’s about to happen to those benefits, according to this recent Silverlink/Suffolk University poll. (Hint, many Advantage plans will get much less generous).

In that case, knowing that there is something in the bill that helps them might change some seniors’ minds. Right now the Silverlink/Suffolk poll does not make happy reading for the Administration:

The survey also polled Medicare recipients on healthcare reform. Despite high levels of satisfaction and relatively strong amounts of optimism, nearly half of Medicare recipients polled (48%) say they do not believe the Obama administration is looking out for their best interests when it comes to healthcare reform. The remaining are split, with 28% believing the administration is looking out for them and 24% unsure.

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