Health Care

Like the financial crisis, this topic overwhelms me. I really don’t know where to turn for a simple, reliable and relatively fast presentation on the issue. I hope others will post good links or write posts that help me understand the issue.

Here’s a Fresh Air interview–“The Politics, Power Players of Healthcare Reform”–that I found helpful. The interviewee is a Joel Cohn, a senior editor from The New Republic, so you know where his bias is. However, I thought the interview gave a good idea of some important issues in the debate. I’ll try to break down some of them:

  • There is controversy over a public component of the current proposal. Basically, Congress is considering creating a system similar to the medicare/medicaid to provide health coverage. Cohn likes the idea of a public health care provision because it can provide competition which will lead to better prices and services.Many of the key players–pharmaceutical companies, hospitals, doctors,– oppose this because they fear that the government can pay less than the real cost of these services–which will pay doctors too little or drive companies out of business. Congress is considering provisions to address this–like requiring a minimum that the government must pay for these services, as well as other provisions.
  • One of the big objectives besides giving health coverage to all or most citizens is to provide insurance that will be portable and not deny coverage or charge high prices for people with expensive medical conditions.
  • A big issue is paying for this reform. Cohn points out that the estimated 10 trillion dollars is spread out over ten years–a 100 billion per year–which is not really a huge increase. There are several ways that Congress is considering to pay this. (I can’t remember what they were.)

24 Responses to “Health Care”

  1. Reid

    Here’s a short synopsis of what’s in the health care reforms bills so far: Health Care: a Simple Explanation from You gotta be a little suspicious of a “simple explanation” of health care, but if you’re only going to read one thing, this might be a pretty good one.

    Politifact also has a truth-o-meter of the statements about health care from the President and opponents. There are several levels of the rating, but my favorite is the “pants on fire” level.

  2. Reid

    An NYT article on the public option. Basically, the article argues that is is not crucial for meaningful reform.

  3. Reid

    Atlantic’s idiots guide to health care and a cheat sheet on health care bills from the Washington Post.

  4. Reid

    Here’s an NPR story on a bipartisan health care bill that is not getting attention, even though it covers everyone and pays for itself.

    The main problem is that it would end employer provided insurance. Employers would be required to give what they pay for insurance to employees in the form of a raise and everyone would be required to buy insurance from a regulated market. Government tax credits would be provided and those who cannot afford insurance would be subsidized by the government.

    I’m not sure if the proposal would bend the spending curve for the long term, however.

  5. Reid

    Partisan Health Reform Won’t Work, an article by Jonathan Rauch, that highlights the dangers of passing a healt reform bill strictly on Democratic votes. Rauch explains why Democrats shouldn’t be tempted into thinking that a partisan bill won’t adversely affect the Democratic party.

    This should be required for Democrats, especially those on the far Left. I hope the President is aware of this.

  6. Reid

    This Washington Post interview with Lindsay Graham on the health care issue proves to me that there is at least one Republican willing to work with Democrats on health care. It also shows why I like him.

    Graham talks about his support for the Wyden-Bennet bill (which I mentioned above), which seems to be the only true bipartisan health care bill. I hope more people can get on board with it. Here’s an editorial written by Wyden and Bennet about the bill. It was nice to see Sen. Inouye as a sponsor of the bill.

    This Slate article by Timothy Noah briefly goes into some of the problems of the Wyden-Bennett bill. I agree that the political feasibility is the biggest problem. The bill seems to be a radical change to the way we do things that most people would be too fearful and not support it.

  7. Reid

    This is one of the better discussions about the issue of rationing in health care, namely why it will happen no matter what system we choose and the reason for that. Therefore, whenever a politician criticizes a bill because it rations care, you should take that with a huge grain of salt.

  8. Reid

    Accidents of History is brief explanation on how we got employer based health care insurance in the U.S.

  9. Reid

    I’ve been listening to/watching some of the health care summmit on C-Span. Some initial thoughts:

    • Hearing everyone, Republicans and Democrats, all talk about the seriousness of reforming health care–how it is pushing the country over a cliff–and knowing that there is a good chance Congress will fail to pass any meaningful reform both exasperates and disgusts me. What this says to me is members of Congress are either putting their party ahead of the country or their own political career; that those things are more important than “the country going over the cliff.” If the problem is that dire, then they would find some solution–and there are solutions, but they’re not without pain. Still, the point is that feasible solutions exist; this is not some intractable problem.
    • I think the President was fairly good as a moderator, except I have mixed feelings about the way he would question Republican responses and not challenge (at least from what I’ve heard) any responses from Democrats. To me, a good moderator doesn’t take sides, and while I don’t think the President was completely unfair, his performance wasn’t neutral either.
  10. Reid

    I found this Atlantic piece today pretty discouraging. Basically, my impression isn’t that the degree to which the health care law would reduce health care costs is a lot less than initially anticipated.

  11. Reid

    Universal Health Care: Is it Constitutional? is an Atlantic piece written by Garrett Epps. The article looks at whether the government can require citizens to purchase health care insurance. Mitchell, I’d be interested in hearing your take on this. Do you support this requirement?

  12. Reid

    “A Bulleproof Case for Ending Employer Insurance Subsidy” by Derek Thompson at Atlantic is a primer on a the reason health care insurance offered by employers are not taxed and reasons they should be.

    Taxing employers for the health care insurance they offer doesn’t sound appealing on the surface. For one thing, it probably would stop some employers from providing health care insurance to employees (which is the reason Thompson say a insurance-exchange for people to purchase insurance would also need to be created).

    But there would be benefits. Employees would likely see increases in wages, since employers would likely divert the money they spent on providing insurance to wages. The short article also mentions other benefits.

  13. Reid

    Obama vs. Ryan on Medicare is a good synopsis on the differences between the Democrats and Republicans in terms of reducing health care.

  14. Reid
  15. Reid

    It seems clear that Obamacare is now strictly a political issue. While I find the Republicans attempts to prevent Obamacare highly distasteful (even sickening), I want to step back a little and offer some comments that make their actions not as unreasonable as it seems. Let me do that by commenting on something from Atlantic’s Wire:

    Perhaps his best line came near the end of the speech, suggesting that he would win the fight. “Once it’s working really well, I guarantee you: They will not call it Obamacare.” He argued that Republicans want the policy to fail because of the politics, not because of the policy.

    (The Predident:) The Republicans’ biggest fear at this point is not that Affordable Care Act will fail. What they’re worried about is it’s going to succeed. Think about it. If it was as bad as they said it was going to be, they could just go ahead and let it happen and, man, everybody would hate it so much and then vote to repeal it and that would be the end of it. So what is it that they’re so scared about? They have made such a big political issue out of this, trying to scare everybody with lies about death panels and killing granny, right? I mean, Armageddon. So if it actually works, they’ll look pretty bad.

    Right. But let me answer why they’re really scared, even if they didn’t slander the program. The success of Obamacare will be devastating to the Republicans politically. Think of the way FDR’s programs succeeded and how that seemed to lead to Democratic dominance over the next forty years or so. Is it reasonable to expect Republicans to just lay down and accept that possible outcome? No, it isn’t.

    In my view, the President and Democrats needed (need) to find a way that they can take credit politically–not definitively, but at least make a compelling argument for this. Here’s an example of what I’m thinking: allow the Republicans to modify the bill–not in substantive ways. This will allow the Republicans to make a claim that the bill is now acceptable, if not ideal. It also will provide the opportunity for them to call the bill another name–a name that allows them to take credit for it. Democrats can argue that it’s still Obamacare, and the Republicans can disagree and call it something else. But you see what just happened? This provides a way for the Republicans to claim credit and mitigate Democratic dominance for the forseeable future. Now, this won’t work to prevent Democratic dominance, but my line of thinking. Something has to do be done so that the proposal isn’t so potentially devastating to the Republicans politically.

    Now, Democrats can say they had their chance to give their input and find ways to take credit, but they chose to oppose the bill outright. The Republicans can counter with a list of reasons the Democrats thwarted them from doing that, but all of this doesn’t matter at this point. The Republican strategy and rhetoric has, up to this time, been all in on opposing Obamacare, so they almost have to do everything to cause the program to fail.

    I’m arguing that we need clever statesmanship–from either side–to find a way out–something that won’t make Obamacare so politically devastating to the Republican party.

  16. Reid

    Cool graphic of ACA Impact on Number of Uninsured Americans

  17. Mitchell

    Putting the best spin possible on things, I don’t think anyone denies that the ACA got more people insured. The issue from the right is that this is not the best way to do it, from both ideological points of view and practical points of view.

    Their massive problem is that they haven’t come up with any semblance of a decent alternative that doesn’t cost Americans their lives. I’m slowly coming around to the side that says on this issue, the conservative perspective cannot work within the framework of our healthcare system, because when it comes to human lives, the most important thing is the practicality.

    It’s the main reason I’ve been in favor of Barack Obama’s initiative despite my conservative leanings. If we agree that all men are endowed by their creator with certain inalienable rights, and that among these are life, liberty, and the pursuit of happiness, it’s on the government to make sure the gaps are filled, and the gap has been an abyss.

  18. Reid

    the conservative perspective cannot work within the framework of our healthcare system, because when it comes to human lives, the most important thing is the practicality.

    Just to be clear, by “practicality,” you’re referring to the fact that a conservative health care proposal would lead to too many deaths.

    …it’s on the government to make sure the gaps are filled, and the gap has been an abyss.

    Not to be contentious, especially since I basically agree with the sentiment (more or less), but you would agree this is basically a liberal position, not a conservative one, right? And that’s perfectly fine–I realize that there are some liberal positions that you embrace.

    For what it’s worth, my attitude is that the private sector, maybe up of the market and individuals and non-government groups should basically try to address the main challenges we face in our country. When this doesn’t happen or when these things fail, particularly in critical issues (and health care would be one), then I think the government should step in–in spite of the flaws and problems that accompany government intervention.

    (By the way, I just put up the clip mainly because I thought it was an interesting way to show the effect of the ACA on health care coverage.)

  19. Mitchell

    Just to be clear, by “practicality,” you’re referring to the fact that a conservative health care proposal would lead to too many deaths.

    I used it two ways in my post, but in this instance that’s what I mean. I don’t think there’s any denying it.

    Not to be contentious, especially since I basically agree with the sentiment (more or less), but you would agree this is basically a liberal position, not a conservative one, right?

    Oh, I’m aware.

  20. Reid

    The Best Health Care Money Can’t Buy is a really long piece about a 70 year old, retired MIT professors experience breaking his back, going through the health care system, including a Veteran’s Affairs hospital.

    I wouldn’t necessarily recommend reading this, but what I got out of it was the difficulties and horrors with aging, especially if you experience a serious injury. There was an article a few years ago about the author not wanting to be revived or put on machines after 75 years of age. I can see why he felt that way after reading this article.

  21. Reid

    What is Cost Saving Reductions (CSR)?

  22. Reid

  23. Reid

    Trump’s Executive Order Undermines Obamacare

    From WaPo: This Executive Order is Trump’s Most Significant Step Yet to Undermine Obamacare

    AP’s take on Trump’s actions today.

  24. Reid

    From Greg Sargent of WaPo: Trump is Thrashing Around in a Straightjacket of GOP Lies

    . It’s a lie that funding the CSRs would “bail out” the insurers. These payments reimburse insurers for subsidizing out-of-pocket costs for lower-income customers, which the Affordable Care Act requires of them. It’s also a lie that the Trump/GOP repeal-and-replace plans that Sanders referenced would provide more relief than the allegedly failing ACA does; they would leave millions more uninsured. The lie about CSRs constituting insurance-company “bailouts” sugarcoats the actual reason Republicans oppose them, which is that they don’t want to spend as much as the ACA does to cover poor people. This position also necessitates the second lie — that the GOP replacements would help more people, despite the fact that their massive spending cuts would leave millions stranded.

    If the Republicans had a plan that could more cheaply and effectively cover the same (or more) amount of low income (high cost) individuals, then I could understand their opposition to the Murray-Alexander proposal.

    But, so far, my impression is such a plan doesn’t exist, and my impression is that the issue for most Republicans is that they just don’t want to spend what it takes to insure lower income individuals. In other words this is about shrinking government and cutting taxes, not about finding ways to provide good health care for all Americans.


    Editors from the National Review give a brief explanation as to why they oppose the Murray-Alexander proposal.

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