The latest Obama healthcare plan
The comments on the last two posts about Sarah Palin are starting to get nasty and personal (as opposed to just nasty), so I thought I'd try and shift the discussion to something less controversial. Like, say, healthcare reform.
The Times editorial board on Monday urged Democrats to add more meaningful cost controls to their healthcare reform bill before trying to punch it through Congress. President Obama, meanwhile, has called for Republicans and Democrats to meet with him for an on-camera exchange of ideas about the legislation. Hmm. Now that's going to be productive.
My guess is that he wants the public to see a real debate over how to improve the system, and they haven't gotten (and can't get) that by watching the floor debates on C-SPAN. That's what happened on a variety of issues when Obama spoke at the GOP retreat last month -- no meeting of the minds but a good exchange of arguments.
Republicans have already indicated that they won't consider an individual mandate to buy insurance (an idea some Republicans used to promote -- and some still do). Because of the adverse selection problem, dropping the individual mandate would rule out trying to stop insurers from cherry-picking customers, which knocks a fairly large hole in that part of the reform. The Republicans' counterproposals for making insurance available to more people would yield barely a 5% increase in the number of insured over the coming decade, according to the CBO.
The Dems have already included in the bill a version of several other major GOP ideas, including some of their tax breaks, risk pooling and the sale of insurance across state lines. So what's left? There's plenty of room in the Dems' bill to use market forces to restrain the growth of medical and insurance costs, so it would be good to see more action there. But I seriously doubt that Obama has any interest in abandoning a comprehensive bill in favor of the more incremental changes favored by the Republicans. Instead, the event seems designed to lay the groundwork for getting the existing Democratic healthcare legislation moving again.
Photo: President Obama and House Minority Leader John Boehner (R-Ohio) at the Republicans' retreat in January. Credit: AP Photo / Charles Dharapak
-- Jon Healey
Wait a minute. I thought President Obama said he got the message and that the priorities of his administration this year was going to be: jobs, jobs, jobs. He just can't seem to get it, no matter how many times he's told. Nov 2, 2010.
Posted by: andrew nelson | February 08, 2010 at 05:52 PM
So now he's calling for a bipartisan effort...Where was he over a year ago? Why didn't he do it right the first time around? Oh, I guess because he realized that being an elitist and trying to push an overbloated and expensive health bill through Congress was a bad idea and obviously didn't sit well with the real people. Now he's got a whole lot of people angry at him - and you know what? I still don't think he gets it.
Posted by: Barbara | February 08, 2010 at 10:59 PM
We're completely enslaved by the healthcare industry as a result of enshrining the medical profession. Supply falls far short of the demand, allowing the medical supplies manufacturers and insurance companies charge way more than the price in other markets (outside of the US). The ultimate solution to the problem is having more healthcare providers, but the price of medical schools is prohibitive and the licensing is way too complicated. The government should make medical school affordable and simplify licensing in order to reduce costs.
As for universal coverage, just force the insurers to enroll everybody, without considerations for the pre-existing conditions. In order to avoid the unpopular mandate, allow the insurers to charge the adverse selection fee, as high as they like, to those who go for more than a few months without coverage, with a grace period allowing everyone to buy coverage right after the law goes into effect.
Posted by: LiberalReason | February 09, 2010 at 10:23 AM
@LiberalReason -- Interesting idea, but unless you made the "adverse selection fee" equal to the dollar amount of premiums avoided, wouldn't you still be giving people an incentive not to carry insurance? And without an effective incentive for individuals to buy policies, wouldn't insurers be left with the sickest policy holders, driving up rates?
Say I'm 24 and healthy. I could self-insure to cover the price of routine doctor and dental visits for way less than the price of an individual policy, so that's what I do. Then, 20 years, later, I notice a spot on my arm that looks like skin cancer, so I sign up for insurance. Unless my "adverse selection fee" was north of $50,000, I will have come out *way* ahead. I can't imagine regulators allowing fees that high, can you?
The best suggestion I've heard for how to combat adverse selection without a mandate is to let insurers exclude coverage for pre-existing conditions, as they do today for many individual policies. But that's "best" just in terms of effectiveness; in terms of policy, allowing insurers to continue denying coverage for pre-existing conditions would be to give up on one of the central goals of the reform effort.
Posted by: Jon Healey | February 09, 2010 at 10:36 AM
@LiberalReason -- Well, very reasoned. I don't know if it's liberal, tbh. But you're hitting on something. The Medical Profession is a protected Monopoly, and I'm pretty sure there's an alloted quota that is set by the AMA for doctors licensed per year. Breaking the monopolies in health care (state run insurance monopolies, too) would be the right thing to do in congress, and tort reform. I think the arguments we've seen so far, from both sides, is just the result of competing oligarchies fighting over the seats at the table. I would much rather forgoe mandatory insurance coverage, and in conjunction with that, quite requiring hospitals to provide care for the uninsured. If charities want to run hospitals, fine. But there's a point in everyone's life where they need to grow up and take responsibility for themselves and the lives they have spawned.
Posted by: andrew nelson | February 09, 2010 at 11:11 AM
@Jon - I was thinking that if you go for years without insurance you deserve a huge fee, and it shouldn't be regulated at all other than to set a mandatory grace period of a few months between lapse of the previous coverage and buying a new one. Public education campaigns should take care of that. I'm pretty sure it won't be a year before people will realize that they're better off with insurance, even if they're perfectly healthy. Because they'll start seeing these cases of "adverse selection fees" reported in the news. Eventually the fee will go down as more people buy insurance. It won't need to be equal to the total of the lapsed coverage, just scary enough to make you buy one. If there is enough market competition, eventually insurers will even offer periodic amnesties, subject to pre-existing conditions, of course.
Posted by: LiberalReason | February 09, 2010 at 01:01 PM
Obama has proven to be an important president, strike that, he's impotent.
Posted by: whamo | February 09, 2010 at 01:21 PM
The healthcare industry is all about making money; it's not about keeping people healthy. My kidney doctors don't know hardly anything about the low protein diet I follow to keep myself off dialysis (which costs $40 to $50K a year); I had to research it myself. When I talked to my kidney doctor about it he scoffed at it, but was surprised when my tests showed improvement. Most heart failure patients could be helped, if not cured, by using "Cardio Plus" and "Catalyn B" supplements, but no way, do they write prescriptions for it. All they know is how to push drugs or perform expensive tests and operations.
Posted by: whamo | February 09, 2010 at 01:28 PM
Obama gets it, all right, he's just playing a shell game. Before, no Reps allowed in the closed-door healthcare discussions led by Pelosi and Reed. Now that the American people have spoken on the matter (check the polls Pelosi), Obama wants to include the Reps. But it looks like a trap to me. When the Reps balk at Obama's "new" healthcare plan, then he can turn around and point the finger and say, "See, I, I, I, I, I told you so. They are the No Party." Axelrod even threatened to "expose" and get nasty with the Reps who oppose the plan. So on the one hand you need the Reps and on the other you threaten them. Stupid bunch of people in that cabinet.
Posted by: el chapulin | February 09, 2010 at 02:08 PM
We just got a notice from our health care insurance, Anthem Blue Cross, telling us that our policy will again go up by some almost 30% percent this year. In less than five years they have more than doubled our insurance premiums. The premium is as high as some people's rent payment or enough to be paying for two new car payments, which we won't be buying anytime soon anymore. On top of the high premium, the deductible is very high and many things are turned down for coverage. Overall we are very unhappy with the situation we are in as I'm sure a lot of people are too. But what I find very difficult to understand is how, or why "there are" so many other "happy" people with the current system and cost that we now have that they don't want any changes made. To me it seems that the republicans just want a business ass usual approach of letting big industries taking from us as much as they want, the insurance and big oil companies for example.
By the way I can't imaging how having such a huge health care expense paid by so many people is not detrimental to the overall economy. If we can no longer afford to buy things like a new car or other costly items because of the high premiums, I'm sure many other families find themselves in the same situation and the economy will suffer from it.
Posted by: RM | February 09, 2010 at 04:59 PM
You are right, andrew nelson. Obama said he was going "focus on jobs." Based on what he's doing now, it seems he meant he was going to focus on DESTROYING jobs.
That's why he continues to threaten businesses with the higher taxes and costs that would be generated by his Obamacare and cap and trade SCAMS.
Threatened by the scams and uncertainty, most business are letting workers go, closing down, or considering moving to freer countries.
As we can see, Obama is working hard at destroying jobs. His Obamacare and cap and trade scams work like fuel to keep unemployment growing.
Posted by: AntonioSosa | February 09, 2010 at 06:45 PM
Excuse me, but I need this health care reform. I don't know where you all have been the past year, but in case you weren't paying attention, all the Democrats have done is to negotiate the best packages they could come up with any chance of passage. It represents a start. We need to get started on this, remember?
Why did it get held up by these grinning Republican morons who have nothing to offer? Why does anyone listen to them anymore?
Posted by: Daniel Biehl | February 09, 2010 at 08:41 PM
If we want health care, reform, I think we need radical change. Let me quote a Black Democrat, a GREAT past elected Governor of Virginia, a super delegate to his party, and a Democrat of National Prominence.
His thoughtful OP-Ed was in Politico, which no one here can accuse of being right-wing.: http://www.politico.com/news/stories/0210/32741.html
"I still believe Obama can stand for positive change. But first he must make some hard changes of his own.
The need is becoming more obvious by the day: He must overhaul his own team, replacing the admittedly brilliant advisers who helped elect him with others more capable of helping him govern. Getting elected and getting things done for the people are two different jobs.
The changes must go much deeper. Obama’s West Wing is filled with people who are in their jobs because of their Chicago connections or because they signed on with Obama early during his presidential campaign.
One problem is that they do not have sufficient experience at governing at the executive branch level. The deeper problem is that they are not listening to the people."
Posted by: andrew nelson | February 10, 2010 at 01:51 PM
Bipartisanship. The first thing you must asses and require when entering into a discussion or negotiation is the veracity of valid premises on both sides.
Without valid premises it is a fools errand.
So we ask, how true and valid are the premises that President Obama brings to the table? Well let’s borrow a few clips from a Blogger that has been on the subject:
- HealthCare Reform (Democrats version) “will bring down costs and is necessary to
Reduce deficits”.
- More spending in the form of “stimulus packages” or “Jobs Bills” are the “key for reducing
Unemployment”.
- “Freezing the budget” in selected expenditures that do not amount to more than 17% of the total
Budget and do not start until these departments have already increase spending by 25 to 38%
In the last year.
- ...and more...
Are these premises that 'we can believe' in? Can we enter into an honest negotiation with the carrier of these premises?
Each of these and “more” was taken from:
http://www.robbingamerica.blogspot.com ....
...where they have the complete argument. You decide. Bipartisan?
Posted by: John Galt | February 10, 2010 at 04:51 PM