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Andrew Rubin

Andrew Rubin

Posted: March 2, 2010 11:09 AM

Health Care Reform: Is Less More Or Is It Just Plain Less?

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This past week, the Republicans and Democrats participated in a discussion lead by President Obama with the goal of finding common ground on health care reform. Did the American public really expect our elected officials would come together in a bipartisan way to help solve our national health care crisis? It did provide a forum for the President to finally show leadership on reform. Still, it would have been nice to see our elected officials working together. The news reports from the summit clearly show how far apart the Democrats and Republicans are on a single approach to reform.

Under the Democrat plan, which right now is being lead by President Obama in what is essentially the bill compiled by the Senate Finance Committee, the entire health care system would be overhauled. Congress would make the following changes to the insurance industry:

  1. Legislate the elimination of preexisting conditions so that everyone can get health insurance regardless of their health status;
  2. Create state based insurance exchanges where individuals and small businesses can come together to purchase insurance in a more open and competitive marketplace;
  3. Create standard benefit packages so that everyone in this country can have baseline protections and coverage levels and understand what is included and what is clearly not covered in their plan;
  4. Require everyone in the country to carry health insurance or pay a penalty. This is a key component to insurance reform since without expanding the pool of insured people with more healthy people, we could not expect the insurance industry to survive. It is also important to point out that a national insurance plan is not needed to establish universal coverage. Given the complexities of our health care system, we can accomplish meaningful reform without a government run plan. Any reform should attempt to fix what does not work and preserve what does.

The Democrat plan would also raise money to provide subsidies for those who cannot afford health insurance by increasing the Medicare tax 9% on individuals making over $200,000 and families making over $250,000. No one likes higher taxes but it must be accepted that to pay for all of our current obligations including job growth, the fight against terrorism, and the rebuilding of our national infrastructure, the country is going to have to raise new funds. That means taxes. Harsh, but true. The contrary opinion is to shrink government further and not expand social programs (like health care reform), but that leaves a system that will continue to leave millions of Americans with no access to health care services and health care insurance. Further, as has been shown over the past decades, costs continue to rise for everyone. Doing nothing is something our nation cannot afford.

Finally, the White House reform package includes provisions to start looking at the costs of our current system. It is false to say the Democrat plan does nothing reign in costs -- it does. The problem is our current system is exceptionally expensive, extremely complicated, and highly integrated. When you touch and/or fix one element, you impact another. This is the fundamental reason why health care reform requires a broad overhaul. It would be impossible to do this incrementally. The negative television ads on health care reform play to this very issue. Because health care is so complicated and interconnected, trying to explain it to the masses becomes very confusing. So the Democrats (mistakenly) said very little and allowed the Republicans to capture the agenda by playing into the lack of information on cost controls. All this being said, as a society, it will be critical under any reform bill for the American people to understand the implications of any cost control provisions. Whether emanating from the Republican or Democratic Party, cost controls are needed to slow the growth in health care spending. That does not mean rationing. It means making intelligent and informed decisions on the delivery of health care services.

On the other side of the debate is the Republican Plan. It is actually much easier to write about because it is much smaller in scope. The Republicans support 4 major principles:

  1. Malpractice Reform. The goal of malpractice reform is to drive down high malpractice insurance rates for physicians and hospitals. Further, this would encourage providers to stop practicing defensive medicine and the corresponding ordering of unnecessary and expensive tests.
  2. Allow individuals and business to buy insurance across state lines to create a more competitive health care insurance marketplace by increasing competition. This could potentially drive down costs of health care insurance for everyone.
  3. Provide individual states the tools and money to come up with innovative and cost saving initiatives to lower health care spending.
  4. Allow groups of people to pool together to buy health insurance much like large corporations do today.

The Republicans do have ideas and each one contributes to health care reform. However, there is a fundamental difference and question (or problem). Under the Democrats plan, an estimated 30 million Americans would have access to better health care and health care insurance. Under the Republican plan, that number is 3 million. So the question for all of us to decide is: who is right? We also need to consider what the country can afford and is insuring 3 millions more Americans really health care reform or just a talking point for the next election?

Under the Republican proposal, 27 million Americans remain vulnerable to the current system. Additionally, this plan requires less government intervention and financial outlay. But it also leaves the most vulnerable people in the same situation they are in today. So how does a civilized society, of such great wealth, leave so many behind? Do not forget the estimated 25 million Americans who are under insured and are one bad illness or injury away from realizing their current insurance does not provide them with the protections they thought they had and need. In fact, recent studies show when people do not have access affordable health care, they skip their preventative care and end up sicker and costing the health care system more money. A more fundamental question is to ask the role of government in protecting its citizens. One needs to look no further than the Toyota brake recall to look at the roll of government. Not all Americans drive Toyotas but all Americans need health care. Both parties were able to come together in a bi-partisan and collaborative fashion to review the Toyota recall, should this country expect any less on health care reform?

It is not that the Republicans are right and the Democrats are wrong or reverse. It really is as simple as answering the question: what does society believe we should do to provide high quality and affordable health care for all citizens? There is an answer to the question.

 
This past week, the Republicans and Democrats participated in a discussion lead by President Obama with the goal of finding common ground on health care reform. Did the American public really expect ...
This past week, the Republicans and Democrats participated in a discussion lead by President Obama with the goal of finding common ground on health care reform. Did the American public really expect ...
 
 
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05:09 PM on 03/02/2010
I'd like to ask the insurance company execs. If they're in such agreement with the necessity of health care and health insurance reform, Why have they spend over 450 million dollars in lobbying fees to help defeat the program this year? More and more, a value added tax sounds appealing to pay for this problem and let the insurance companies insure your car, house,boat, and life. Get them out of the equation!
04:33 PM on 03/02/2010
Do A Real Public Option Don't Pretend.

All 300 million people in the US could begin receiving Free Public Option health care this year and it would save $1trillion dollars every year from the $2.6trillion spent last year.

National sales taxes instead of insurance could pay for free Public Option healthcare for everyone who wants to use it no restrictions, no insurance, no copay’s, free period.

Of course not everyone in the US would choose to use public care but the cost savings illustration is dramatic.

Offering Free Public or user purchased Private care could serve everyone.

If everyone who receives government funded health care from any source anywhere in the US whether it be Medicare, Medicaid, all states, cities, school systems, police, fire, prison guards, all government employees from the President, legislators, and the lowest pay scale workers would receive their care and medications free from the Public Option it would cut government health costs in half.

Only a Free Public Option which eliminates insurance companies and uses sales taxes to pay for care, and eliminates the for profit private care providers by using government hospitals, can produce these drastic cost savings.

Veterans Government Health Care is producing better health outcomes for Vets than civilian patients are receiving anywhere else in the country, at any price, including Mayo, Cleveland Clinic, Medicare, anywhere and VA’s costs are a fraction of private care’s.

http://www.washingtonmonthly.com/features/2005/0501.longman.html
12:52 PM on 03/02/2010
The health care system desperately needed a make-over 15 years ago. So why are we just now getting around to addressing this problem now. I believe it is because Fox News artificially creates the stage for which issues are "NOW IMPORTANT" to the American people.

Bill O'Reilly's motto, "You are about to enter into the no-spin zone" is a "crock-pot" of brewing manure. Fox News is a type of "Don King" - in the business of promoting a political issue while sucking his viewer dry of common sense. Most of these issues have been around for a very long time... so why does FOX News spin them into "SUDDEN IMPORTANCE". The answer is simple, special interest groups with conservative right-winged agendas want their agenda promoted in a way that is well articulated and sells... So the likes of Bill O'Reilly, Glen Beck, and Hannity are brought in to knock down President Obama's every move.

Now that the health care issue is "front & center" in minds of most Americans (Thanks To Fox) every newspaper now has to take a stance on this issue.