And it's confusing. And people's eyes glaze over when you talk about it.
But listen up. The next five or six months will have a huge impact on the health care you receive in your lifetime. So, boring or not -- time to pay attention.
There are several messages you will hear about health reform and most of them are inaccurate and downright lies. Here are a few things you will hear.
1. Anything the Democrats do will be a government takeover of health care.
It's hard to know where to start with this one. Oh my. Well, Jon Stewart stopped Newt Gingrich with his question about the military. If you trust the government to run the military, why wouldn't you trust them to run health care? But that isn't even the point. No Democratic proposal suggests that government run health care. There is something called the "public plan" that Obama proposed. This plan would be something like what Congressional representatives have or what people over 65 have with Medicare. The idea is that people should have a choice. They can choose a private plan and they can keep their current insurance if they like it that much. Or, they can choose some type of publicly financed or administered plan. What scares the opposition so much about this? Clearly, the deep and enduring distrust of private insurance in this country could bubble up and more people could choose the public plan than the private plans. But that choice would be yours. And if the private plans are so good, why can't they compete? Especially if all the plans in some kind of exchange are required to play by the same rules, which is the latest proposal.
2. The Democrats want socialized medicine. Does anyone in the U.S. really know what socialism is? No. People here only know that it is something to be feared. The socialism argument is totally irrelevant to what is being discussed in Washington and what is likely to be in the final plan. Both Senator Baucus, who is leading the reform effort in the Senate, and President Obama, have said that we cannot start from scratch in the U.S. If we could, we might have a system more like Germany or France or Switzerland. But we are not like them. So we will not have a single payer approach or a socialized approach to health care. We will have a uniquely American approach, which -- sorry single payer folks -- includes private employers and private health insurance plans. As Baucus and Obama and others have said, over and over, "If you like what you have you can keep it." The dirty little secret is that almost no one much likes what they have. And that fact scares the health care industry a lot.
3. The government will tell your doctor what to do. . This claim comes from the very distorted debate during the Stimulus Funding debate, when Rush Limbaugh and the right wing attacked the Administration for wanting to fund "comparative effectiveness research". This is an eye glazer of maximum proportions. Suffice it to say, if we knew more about what worked in medicine, we could all make better decisions. Why wouldn't we want to know that? More importantly -- why don't we know that now? We don't know what works because no private company is going to voluntarily do the research that shows its product is potentially inferior to another product. Only the government can fund that type of research. The result is that up to now, what we get when we go to the doctor is not always science. It's the best guess of the doctor based on their experience, which may or may not be scientifically proven. If you have treated 100 patients for a disease, it doesn't necessarily tell you what might have worked had you treated 1000, or had you compared your 100 patients with another doctor's 100 patients. So the fact is -- helping doctors and patients know more about what works -- is not the same as having the government tell your doctor what to do.
4. We can't afford health reform. In fact, we can't afford NOT to have health reform. The cost of health reform, of covering every American, is about the same as the cost of the Iraq war. And for all of you who have no insurance, or high deductibles, or a family member who can't get insurance, this ought to make you good and mad. We cannot afford NOT to have health reform. Even the Republicans pretty much agree with that.
5. We cannot tax employers or employees to pay for health reform.. Ezra Klein of the Washington Post makes this point well in a recent blog.
This is why people are bored by health care policy. This, right here. The fact that the central concept in health care reform relies on the differential tax treatment of health care benefits when provided by your employer. Even italicizing that sentence doesn't make it more interesting.
Klein goes on to point out a number of reasons how the lost revenue from the employer/employee tax exclusion could finance health reform. He notes that the tax exclusion is regressive. The rich get the same tax break as the poorer worker. The exclusion hides the real cost of health care from the individual consumer. And the exclusion subsidizes employers big time. There will be plenty of hysterical charges about this tax exclusion issue. However, it is important to point out that it is somewhat unlikely that the Democrats will support taking away the tax break from individual employees. It is more likely they will propose to cap the exclusion that the employer gets. So before your blood pressure goes up, wait and see what it might actually mean for you and your paycheck. It might not be as bad as the opposition will paint it. (And by the way -- John McCain proposed an even more drastic change to the tax issue in his campaign. If Republicans criticize the Democrats for taking it on, they will have to face their own positions on the subject.)
There are many more charges that will be made about health reform. And even if it is boring or confusing, it is truly important to be educated and informed about the real facts. No one wants to take away your choice of doctor. No one intends to tell your doctor what to do with your treatment. No one suggests a government takeover of health care. Boring or not, it's time to think about it.
