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James Love

James Love

Posted: March 21, 2010 08:43 PM

Health Care Reform Without Cost Control

What's Your Reaction:

Like others, I am watching the House of Representatives debate the health care reform bill. One way to pay for the bill, or at least to ease the burden of watching, would be to tax cliches spoken on the House floor.

The health system in the United States needs lots of reform. What it is getting this week is highly selective. The Congress will make it easier for many persons with prior conditions to obtain insurance, and ensure that plans cover more, and more people are covered. These and many other provisions in the bill are important elements of any reform package.

What is generally missing is anything that will seriously control costs. Indeed, many provisions will predictably drive costs up, as expanded coverage will expand the demand for expensive services and products. When the AMA, the hospitals and PhRMA are lobbying for the bill, it isn't because of humanitarian urges.

This is the big gap, the big failure of nerve, in the health care debate. Americans will continue to pay about double the share of GDP on health care as do most high income countries, without getting better outcomes for patients.

At this point, the Fox News crusade against the bill, the antics of the Tea Party and the Sarah Palin wing of the Republican party, and the ugly campaigning by the Chamber of Commerce have created a political environment where the bill pretty much has to pass, or the Democrats might as well give up trying to govern. They have to deliver something, and this apparently is about all they can do right now. So a lot of people are rooting for a fairly disappointing bill -- expectations being so low these days.

 

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09:29 AM on 03/22/2010
Congressional "liberals" who feigned support of a public option need to step up and take action. They need to co-sponsor (with Republicans) a bill to eliminate the insurance mandate. They need to pursue this unless and until a real public option is passed in a separate bill. Otherwise, they're just corporate shills forcing everyone into a crappy for-profit system with no end in sight.
09:13 AM on 03/22/2010
This is nowhere near universal health care and with no controls on costs the insurance companies will be laughing all the way to the bank. I also want to thank the democrats on behalf of big pharma for making people pay more for their prescription drugs. Thanks for your "reform."
08:11 AM on 03/22/2010
Unfortunately your pessimism is right on.
The House had a pretty good bill. The Senate screwed it over, and unfortunately we are stuck with the Senate version.
Obama sold out universal health care, single payer, and opt in early in the game, Rahm alienated the independents and progressives, under cutting the Senate.
After watching the "process" last night I would say that both houses of the Congress need seriously to grow up.
It was embarrassing to watch last night's proceedings, and the Senate is worse. No wonder the world laughs at us and pokes fun at us. The House and particularly the Senate are embarrassing.
02:56 AM on 03/22/2010
James Love writes:
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What is generally missing is anything that will seriously control costs. ... When the AMA, the hospitals and PhRMA are lobbying for the bill, it isn't because of humanitarian urges.

This is...the big failure...in the health care debate. ...
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It's all by design.

Neoliberal Democratic public policy is all about turning the vulnerable and powerless "least among us" into an income stream for the "haves". Nothing more and nothing less.

These same sold-out mainstream Dems induced countless gullible renters who couldn't afford to buy houses to do so with sub-prime mortgages so their Wall Street friends could run a world-wide scam by securitizing them, forcing most new homeowners into bankruptcy and/or lesser forms of ruined credit, making their already difficult lives even more bleak.

Neoliberals also engineered the mass incarceration of poor African-Americans and Latinos for the benefit of rural white communities where most prisons are located and prison guards reside.

And now they are forcing tens of million folks of modest means who can't afford health insurance to pay every last discretionary nickel of their income to one or another member of the current health care industry oligopoly.

Thus does charlatan and oppressive public policy masquerade as beneficence. Neoliberal Democrats and their faux rightist Republican opponents are the American peoples' adversaries not their friends, much less their savoirs.

Truth and decency are not forever mocked. It's time for a progressive third party.

Eric C. Jacobson
Public Interest Lawyer
Culver City, California
03:19 AM on 03/22/2010
From what I can see most of these actions by Neoliberals is instigated by the very progressives you support.

A socialist by any other label, is still a socialist.
02:31 AM on 03/22/2010
This whole process and all the parties involved are disingenuous. Either party could have taken care of pre-existing conditions without doing anything else, for the last 20 years, but neither party did.

They could have easily controlled costs by tackling the unfunded mandates of the past that have driven us to this. Without testing the constitution, taking $500B from medicare, and taxing the people $500B. It appears cutting costs wasn't on the list of priorities.
http://an-independent-voice.com/2010/03/19/how-did-health-care-become-a-crisis-in-america/

Eliminating unfunded mandates would be to much to ask for, from our current government. It would step on to many special interests toes.
HUFFPOST SUPER USER
masher
software engineer
01:11 AM on 03/22/2010
It passed and now the law of the land is that you all have to buy a corporations product. Congratulations Democrats you did something more radically right wing than the GOP ever dreamed of doing.
12:10 AM on 03/22/2010
Before cheering too loudly, everyone with an interest in the subject should read this recent post concerning the great (Senate) "Health Care Insurance Reform Bill", which just passed the house.

http://www.huffingtonpost.com/jane-hamsher/fact-sheet-the-truth-abou_b_506026.html

The more things change, the more things remain the same...
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HUFFPOST SUPER USER
jcwtts1
Elections have consequences
11:51 PM on 03/21/2010
What the President has shown us is that just when you think it is over, it isn't. Here is what I mean. I wouldn't be shocked if a PO surfaced after the senate finishes reconciliation. No need to hurry the PO wouldn't be in effect for 3 years any way so let's marshal our strength deal with jobs right away and then push through a public option in March 2011. Buck up little camper.

J
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HUFFPOST SUPER USER
NWBrunette
Blessed Girl
02:25 AM on 03/22/2010
Once the recon bill is done, there's a not a Dem in Congress with a neuron left in his or her brain that will touch health care with a ten foot pole for a decade.
02:39 AM on 03/22/2010
You presume it will get done.

Personally, I don't see why the Senate would want to change a bill that required them to buy off senators for records amounts, just to get the votes to pass it.

The Senate and House are totally different animal, created for totally different purposes. Some of you might have forgotten that since the Senators are now elected by the people. Originally the were sent to the Senate by the state legislatures, some think changing that was a mistake for the states. Considering the burdens that have been passed on to the states since that time, I am beginning to agree.
Palito
_/\_/\___/\_________
11:27 PM on 03/21/2010
this battle is not over. this is just the first step. passing a public option or forcing price controls on insurance companies (run like utilities or nationalization) will be the next step if costs keep growing out of control.
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HUFFPOST SUPER USER
NWBrunette
Blessed Girl
02:31 AM on 03/22/2010
Costs WILL keep growing out of control. That's what happens when you have insurance companies with an anti-trust exemption.
10:14 PM on 03/21/2010
Government has no understanding of the costs of health care. This bill merely seeks to control prices. Changing the payment to a doctor from $50 to $40 does not alter even a penny the underlying costs. It only alters the price the provider is paid and puts the squeeze on that provider.

Prices will go up, though, not down, as costs magically expand to capture the magically expanded pool of money.

Good article here: http://goo.gl/8Z6v
10:08 PM on 03/21/2010
You say there is little in this bill to address costs. Since I assume you're more expert than me on this topic, could you explain why the following provisions DO NOT--in YOUR estimation--provide adequate cost control? Have I been sold a "bill of goods?" Are these provisions, which are CURRENTLY IN THIS BILL inadequate?

§§ 51XX-55XX are supposed to establish a "G.I. Bill" to increase the supply of healthcare professionals in the shortest supply (relative to anticipated future demand)--from grants & loan subsidies for medical students who become family practitioners & nurses to the creation/expansion of educational facilities. (See pp 38-43 in linked summary.)

§§ Commencing 56XX are supposed to build new medical infrastructure to meet underserved demand for basic medical services (family medical/dental clinics, pediatric centers, etc.). The USA may currently offer the most "Rolls Royces" of medical services worldwide, but most citizens just want opportunity to buy a "Ford Focus" at a reasonable price. (See pp 43-44 in linked summary.) These provisions are supposed to deal with that.

http://dpc.senate.gov/healthreformbill/healthbill49.pdf

The most chronic problems facing our healthcare system are SUPPLY & DEMAND and their effects on ACCELERATING MEDICAL COSTS. Whether they're addressed through private insurers, Medicare, Medicaid, employer plans, individual plans, the VA, a "public option," etc.--DOESN'T MATTER MUCH. What matters MOST is WHETHER and HOW EFFECTIVELY we confront them. It's OK if this bill's a first step. Continue fighting.
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godipo
10:05 PM on 03/21/2010
As things stand now, the uninsured are paying for the insured. The forgone tax money that the federal government loses, each year, is over $200 billion. If the Republicans are so keen on the existing system because it is not involved with
'big government' they should fight to get rid of pre-tax payment and medical deductions. Let the health care cartel find a way to be affordable and competitive without this huge, giant government subsidy. I don't want to be called a socialist, while I and all the people of this country, who are the government, are paying for the health care that the people who are calling me names support.
09:30 PM on 03/21/2010
I agree that costs will go up but they already are going up. I would imagine that the Government will step in if everyone starts jacking up the prices ridiculously across the board

If the Health Insurance Industry thinks they will be able to raise our rates to whatever they like, they have another thing coming
09:40 PM on 03/21/2010
Yeah, because no deals were made by Obama with said industries to keep single payer from ever happening, and then killed the public option.

There are no cost controls in this bill, and there won't ever be any because they'll never get passed the senate! If they wanted cost controls in it, they would have done it already.
11:39 PM on 03/21/2010
We can add a public option, and single payer can be worked on - this just gets the underlying structure in place for universal health care.

Remember Civil Rights Bill didn't include the right to vote, or ban segregation etc. etc. etc. it took years of additional legislation for us to have what we now know as "Civil Rights."

Now we must work on adding a public option - 70% of Americans wanted the public option. Many states are working on single payer.

Remember, we are the only western industrialized country that allows for-profit insurance. Every other country, including the ones that have private insurance, requires health insurance to be non-profit and are highly regulated.

Until we add the public option and/or non-profit single payer programs, we will never lower the % of GDP spent on health care. This slows the increase in % of GDP down, protects people from the most insidious practices of the insurance industry and sets a structure in place that we can improve on with future legislation.

But we have to keep the Dems in office. If Republicans take over they will destroy everything we've put in place. Just like they destroyed EPA, Food and Drug, deregulated the Banking Industry etc etc etc.

We have a start..... i'm grateful for that - it took over 50 years to get to this point.... ;-)
schatsie
Wall Street is Worse than Vegas
11:11 PM on 03/21/2010
Sure, just like the SEC and the Federal Reserve enforce banking regulations...NOT.....