I’ve been avoiding posting on health reform of late, mostly because I’m so dismayed by what’s happened, and what’s happening.
The Republican Congress passed and then-President Bush signed into law Medicare Part D which added about $8 trillion to our national debt.
Now the Democrats want to one-up the GOP by passing what would be a massive entitlement expansion, with no meaningful cost containment. They want us to believe we can expand coverage now and fix the cost issue later.
No, we can’t, and no, we won’t. It is far more difficult to get people to give things up they already have than to convince them they can’t afford those things in the first place.
The health care reform debate has provided all the evidence we need to see how hard it is to get physicians, or insurance companies, or unions, or voters, or employers, or state regulators, or pharma, or device companies to agree to give back business/rights/revenue/coverage they have today.
Bob Laszewski said it well in his post today –
“adding 30 million more people to an unsustainable system expecting it will create an even bigger crisis and thereby force real reform is tantamount to reboarding the Titanic in the hopes it will sink faster. It is also hard to see how doing such a thing is the politically courageous thing to do.
Just where is the moral imperative in ramming a trillion dollar entitlement expansion through knowing full well it will make our long-term deficit nightmare even worse–for those now uninsured and for everyone else?
The Democratic health care bill makes little if any systemic changes to the health care system–certainly not at the level we need.”
Neither party is acting in the best interest of the nation, or of their own constituents for that matter. And anyone who believes we can pass it now and fix it later is living in a fantasy world.
One example proves the point. The bill presently under consideration doesn’t address the ongoing issue of Medicare physician compensation, a failure that precisely illustrates the problem of passing it now and fixing it later. Medicare physician compensation legislation was passed a decade ago, with hard and tough limits on physician reimbursement. Yet every year Congress votes to overturn the cuts, with the result that we now have a $300 billion deficit in the program.
What does this mean for you?
Not only is sausage making ugly to watch, it produces inedible results.
Good post. One factual quibble: Part D was not passed via reconciliation. Cloture was secured (70-29) and the bill ultimately passed with 54 votes.
What exactly do you propose we do to cut costs and expand coverage? The democrats plan of far from perfect but it’s definitely a step in the right direction. And it does reduce the deficit, especially in the second decade. You can argue that future congresses will water down the savings but you could argue that about any sort of cost saving plan. Personally, I think we need universal coverage under a single payer and we’ll get there eventually. But I can understand taking this intermediate step. I don’t buy the argument that we should just give up on reform and maintain the status quo until some sort of perfect health reform comes along.
It is disappointing to read/hear how much the Health Insurance industry is taking the brunt of the hate. It is not perfect, and I am not a fan of the pre-existing med. condition rule, or sudden drops due to x, y or z reasons. However, when I hear about hospitals and clinics raising their prices, I think we need to look at what is driving these increases and see how we can reduce the amount they charge. The clinic billed me $404.00 for 3, small tissue samples (for biopsies) and another $432.00 for tests on the samples; I would like to know how that price was determined. Are there ways to reduce the charges? Health insurance companies do not tell clinics what to charge for a particular service. Perhaps if provider prices were lower, the discounts could be less and premiums would climb down the cost ladder…
Chris – thanks for the comment.
I’ve been advocating adoption of the Wyden-Bennett Healthy Americans Act (with specific modifications discussed in this blog) since Sen Wyden released it a couple years ago. I remain convinced it is the best solution.
Note that the President’s plan does NOT address the elephant in the room – physician reimbursement under Medicare. It is difficult to take any plan seriously that does not address this issue.
Chris – thanks for the comment.
I’ve been advocating adoption of the Wyden-Bennett Healthy Americans Act (with specific modifications discussed in this blog) since Sen Wyden released it a couple years ago. I remain convinced it is the best solution.
Note that the President’s plan does NOT address the elephant in the room – physician reimbursement under Medicare. It is difficult to take any plan seriously that does not address this issue.
What I find frustrating is that while Congress debates coverage for all (mandated through legislation no-one fully understands!), there is scant acknowledgement of the other elephant in the room.
Healthcare fraud costs the industry $60,000,000,000 per year (http://www.usdoj.gov/usao/fls) . The National Health Care Anti-Fraud Association (NHCAA) conservatively places the cost of fraud in healthcare at 3-5% of annual expenditures. Using the 3% figure, fraud costs the industry $100,000,000 per day ($36,500,000,000 per year). The FBI uses a 10% figure.
A more sensible solution to healthcare reform is an incremental approach to the myriad issues in need of solutions. Start with the identification of cost drivers. Design and implement reasonable solutions with targets. There are many opportunities to rein in costs: waste, fraud & abuse, defensive medicine, unhealthy behaviors leading to chronic conditions, etc.
When government refuses/fails to manage costs within the current system, how can we possibly expect them to be fiscally responsible after they’ve legislated coverage for all?
Joe,
I’ll jump in with some thoughts, per your dismay with our political leader’s handling of healthcare.
First, I strongly believe that the ‘problem’ of our health care system is not due to doctors, insurers or pharmaceutical companies, but rather to the ‘for profit’ nature of healthcare in general. Healthcare has made a lot of money for all companies and industries involved. But…isn’t that what’s supposed to happen with ‘for-profit’ models? Am I missing something here?
We can analyze all of this (figuratively) all of the opinions, ‘thots’, studies, etc. and with all the finger-pointing, to fix this will come down to several basic tenants.
1. It will take at least 15 or more years to unravel what has taken 40+ years to entrench. Between all the interrelationships, contracts, employee levels, public shareholder ownership and methods of insuring (risk-pooling), only dishonest or disillusioned individuals like our political leaders would even think to imagine that we could create any real type of traction in solving this within just a few years.
2. It will take sacrifice in profits and salary. Not just the CEOs, but those in management, sales, customer service, etc. Everyone will need to share in the sacrifice financially, if we are to bring down costs across the board. Do people want to do this readily or even with legal mandate? Not likely.
3. Increase taxes. Government chooses to run a sizable portion of our healthcare, its going to need more money.
Joe, not saying that this can’t be done, but I wish that someone would just step up and tell it like it is. Unraveling a for profit system that involves trillions of dollars, shareholders and massive levels of employment cannot be done through manipulation of emotions.
Oh yes, it takes a bit of pragmatism too. We could sure use and FDR or Eisenhower at this point.
Thanks
Steve