Freedom, Choice, and Health Care Reform

Perusing the 2001 introduction to Karl Polanyi's classic tome The Great Transformation, Joseph Stiglitz helpfully reminded me that "today, there is no respectable intellectual support for the proposition that markets, by themselves, lead to efficient, let alone equitable, outcomes." Stiglitz was, of course, referring primarily to contemporary economists, rather than conservative bloggers. Yet the willingness of certain reform naysayers to peddle the notion that our current health care system provides more choice and more freedom -- more efficiency -- than the Affordable Health Choices Act casts doubt on Stiglitz's assertion.

Earlier this week at The Foundry, the blog of the conservative Heritage Foundation, Rory Cooper took a crack at defending the health care status quo. His main message was that reform in general, and the House's tri-committee bill currently being marked up in committee hearings in particular, would "force" millions of Americans into health insurance that they presumably did not want.

Cooper cites a Lewin Group study from April that found that a public option would enroll about 119 million Americans. He writes:

Currently, there are roughly 160 million Americans who have private health insurance. So this figure represents more than two out of three privately insured Americans. Are you going to be the lucky one out of three?

In emphasizing the number of Americans who will be "forced" to give up their private health insurance, Cooper completely conflates the "public option" with the Health Insurance Exchange. The public option is a government-run insurance plan that would be cheaper than private plans because of government pricing power and other presumed efficiencies in administrative costs.

The Health Insurance Exchange, on the other hand, is essentially a mechanism to improve regulation and oversight of the health insurance industry: the insurance remains private, but the government sets minimum coverage standards, prohibits denial of coverage in most cases, and limits cost-sharing for preventive procedures. In addition, consumers can more easily compare the benefits and payments associated with each plan.

Indeed, instead of doing archival research of studies published in the spring, Cooper might have looked at this week's CBO analysis of the actual Affordable Health Choices Act, which asserts that "total enrollment in the public plan would equal about 11 million or 12 million..." This is a far cry from a government monopoly of the health care system and a farther cry from Cooper's harangue that the Act will "slowly kill private insurance..."

The rub here, for Cooper and other supporters of the unrestrained market, is that the health reform bill actually increases consumer choice by creating more quality health care options. The Health Insurance Exchange is a means of regulating private insurance, not destroying it: it maintains a market for insurance, while affirming Stiglitz's confidence in modern-day economists' good sense.

Follow Harry Moroz on Twitter: www.twitter.com/hmoroz

Comments

[porsche996]

So now, we're starting to see what the house of representatives is going to offer we the people. And it flat out sucks. For starters, the public option doesn't go into effect until 2013. That's right. It's like one of those balloon mortgages... If you believe that it will actually happen. Frankly, if the bill, as currently written, is signed by Obama, he won't deserve to be re-elected and Sarah Palin or Mitt Romney or whatever right wing extremist replaces him will surely stop the public option from going into effect.

[imaparrot]

Medicare has a 3 percent administrative overhead. That's too high. It cost too much.

[Chaimirija]

11-12 million people who probably would not be able to find a provider because the public option plan only reimburses 5% above Medicare. And the reason it would be only 1--12 million people is because the bill prohibits those with insurance from switching. There is no choice.

And everyone would still be required by law to purchase insurance or face a penalty. I guess those who will not be insured will be those who don't file tax returns, or who decide to pay the 2.5% penalty versus the "affordable" policy required of them by the gov

[socalgal38]

3
•HR 676 IH
1 SEC. 2. DEFINITIONS AND TERMS.
2 In this Act:
3 (1) USNHC PROGRAM; PROGRAM.—The terms
4 ‘‘USNHC Program’’ and ‘‘Program’’ mean the pro5
gram of benefits provided under this Act and, unless
6 the context otherwise requires, the Secretary with
7 respect to functions relating to carrying out such
8 program.
9 (2) NATIONAL BOARD OF UNIVERSAL QUALITY
10 AND ACCESS.—The term ‘‘National Board of Uni11
versal Quality and Access’’ means such Board estab12
lished under section 305.
13 (3) REGIONAL OFFICE.—The term ‘‘regional of14
fice’’ means a regional office established under sec15
tion 303.
16 (4) SECRETARY.—The term ‘‘Secretary’’ means
17 the Secretary of Health and Human Services.
18 (5) DIRECTOR.—The term ‘‘Director’’ means,
19 in relation to the Program, the Director appointed
20 under section 301.

[socalgal38]

TITLE II—FINANCES
Subtitle A—Budgeting and Payments
Sec. 201. Budgeting process.
Sec. 202. Payment of providers and health care clinicians.
Sec. 203. Payment for long-term care.
Sec. 204. Mental health services.
Sec. 205. Payment for prescription medications, medical supplies, and medically
necessary assistive equipment.
Sec. 206. Consultation in establishing reimbursement levels.
Subtitle B—Funding
Sec. 211. Overview: funding the USNHC Program.
Sec. 212. Appropriations for existing programs.
TITLE III—ADMINISTRATION
Sec. 301. Public administration; appointment of Director.
Sec. 302. Office of Quality Control.
Sec. 303. Regional and State administration; employment of displaced clerical
workers.
Sec. 304. Confidential Electronic Patient Record System.
Sec. 305. National Board of Universal Quality and Access.
TITLE IV—ADDITIONAL PROVISIONS
Sec. 401. Treatment of VA and IHS health programs.
Sec. 402. Public health and prevention.
Sec. 403. Reduction in health disparities.
TITLE V—EFFECTIVE DATE
Sec. 501. Effective date.

[socalgal38]

2
•HR 676 IH
1 SECTION 1. SHORT TITLE; TABLE OF CONTENTS.
2 (a) SHORT TITLE.—This Act may be cited as the
3 ‘‘United States National Health Care Act or the Ex4
panded and Improved Medicare for All Act’’.
5 (b) TABLE OF CONTENTS.—The table of contents of
6 this Act is as follows:
Sec. 1. Short title; table of contents.
Sec. 2. Definitions and terms.
TITLE I—ELIGIBILITY AND BENEFITS
Sec. 101. Eligibility and registration.
Sec. 102. Benefits and portability.
Sec. 103. Qualification of participating providers.
Sec. 104. Prohibition against duplicating coverage.

[socalgal38]

http://www.pnhp.org/nhibill/nhi_bill_final.pdf this bill would be simplier to set up, would cost practically nothing to start up. It would be an overhaul that would not have to start from zero. It would cover ALL Americans, it was the original plan that Mr. Obama talked about before he ran for office, before he received 18.8 million campaign donations from the health care industries. Let's face it, 20,000 people are dying without affordable healthcare in this country. Waiting 4 yrs to empliment a health care reform will mean that 80,000 Americans will have died waiting for medical care. Doesn't our representatives get it, the lobbists are bribing them with blood money? This is worse than the mobs of organized crime.

It makes more sense to have two options funded by our tax dollars than having VA, Medicare, Medicad, single payer for the Federal government, and the American Native health care systems. The only health care that I think should be saved is the VA and all the others should be converted to Single payer system. The money funding the other 4 would go into the single payer system would save over 1 trillion dollars. Problem solved!

[WinterParkMom]

47 million un insured
20 million under insured
fast food companies and insurance companies making profits hand over fist. Bushes tax cuts for the rich still in effect

Subtract 10 million poor/indigent/mentally ill, etc, who are uninsured and will have to get free care = 37 mill un-insured who can pay.
18.5 million can pay $50/mo = 925,000,000
18.5 mill can pay $100 = $1,850,000,000
20 mill under insured will switch and can pay $100 = 2,000,000,000
That is a grand total of $47,750,000,000
That is FOUR BILLION, SEVEN HUNDRED SEVENTY FIVE MILLION DOLLARS IN PREMIUM PAYMENTS PER MONTH. FIFTY SEVEN BILLION THREE HUNDRED THIRTY MILLION PER YEAR IN PREMIUMS FOR ONE SET OF PEOPLE.
That does'nt count the millions who'll switch from private companies if they can pay $100 or 200 per month and have their entire family covered even with pre-existing conditions. Repeal the bush tax cuts asap.
After thinking about it more, we should have a 1 penny federal sales tax on EVERY purchase. I can hear the opponents shouting about making the poor poorer, but my statement is 1 cent on each purchase NOT on every dollar or hundred dollars. From candy bars to fruit to big screen tv's to your house. 1 cent on everything. If your grocery bill was $100. for 53 items, your bill would be $100.53. That's not putting people in the poorhouse especially when we've already been dealing with price increases