Well, the House health reform bill -- known to Republicans as the Government Takeover -- finally passed after one of Congress's longer, less enlightening debates. Two stalwarts of the single-payer movement split their votes; John Conyers voted for it; Dennis Kucinich against. Kucinich was right.
Conservative rhetoric notwithstanding, the House bill is not a "government takeover." I wish it were. Instead, it enshrines and subsidizes the "takeover" by the investor-owned insurance industry that occurred after the failure of the Clinton reform effort in 1994. To be sure, the bill has a few good provisions (expansion of Medicaid, for example), but they are marginal. It also provides for some regulation of the industry (no denial of coverage because of pre-existing conditions, for example), but since it doesn't regulate premiums, the industry can respond to any regulation that threatens its profits by simply raising its rates. The bill also does very little to curb the perverse incentives that lead doctors to over-treat the well-insured. And quite apart from its content, the bill is so complicated and convoluted that it would take a staggering apparatus to administer it and try to enforce its regulations.
What does the insurance industry get out of it? Tens of millions of new customers, courtesy of the mandate and taxpayer subsidies. And not just any kind of customer, but the youngest, healthiest customers -- those least likely to use their insurance. The bill permits insurers to charge twice as much for older people as for younger ones. So older under-65's will be more likely to go without insurance, even if they have to pay fines. That's OK with the industry, since these would be among their sickest customers. (Shouldn't age be considered a pre-existing condition?)
Insurers also won't have to cover those younger people most likely to get sick, because they will tend to use the public option (which is not an "option" at all, but a program projected to cover only 6 million uninsured Americans). So instead of the public option providing competition for the insurance industry, as originally envisioned, it's been turned into a dumping ground for a small number of people whom private insurers would rather not have to cover anyway.
If a similar bill emerges from the Senate and the reconciliation process, and is ultimately passed, what will happen?
First, health costs will continue to skyrocket, even faster than they are now, as taxpayer dollars are pumped into the private sector. The response of payers -- government and employers -- will be to shrink benefits and increase deductibles and co-payments. Yes, more people will have insurance, but it will cover less and less, and be more expensive to use.
But, you say, the Congressional Budget Office has said the House bill will be a little better than budget-neutral over ten years. That may be, although the assumptions are arguable. Note, though, that the CBO is not concerned with total health costs, only with costs to the government. And it is particularly concerned with Medicare, the biggest contributor to federal deficits. The House bill would take money out of Medicare, and divert it to the private sector and, to some extent, to Medicaid. The remaining costs of the legislation would be paid for by taxes on the wealthy. But although the bill might pay for itself, it does nothing to solve the problem of runaway inflation in the system as a whole. It's a shell game in which money is moved from one part of our fragmented system to another.
Here is my program for real reform:
Recommendation #1: Drop the Medicare eligibility age from 65 to 55. This should be an expansion of traditional Medicare, not a new program. Gradually, over several years, drop the age decade by decade, until everyone is covered by Medicare. Costs: Obviously, this would increase Medicare costs, but it would help decrease costs to the health system as a whole, because Medicare is so much more efficient (overhead of about 3% vs. 20% for private insurance). And it's a better program, because it ensures that everyone has access to a uniform package of benefits.
Recommendation #2: Increase Medicare fees for primary care doctors and reduce them for procedure-oriented specialists. Specialists such as cardiologists and gastroenterologists are now excessively rewarded for doing tests and procedures, many of which, in the opinion of experts, are not medically indicated. Not surprisingly, we have too many specialists, and they perform too many tests and procedures. Costs: This would greatly reduce costs to Medicare, and the reform would almost certainly be adopted throughout the wider health system.
Recommendation #3: Medicare should monitor doctors' practice patterns for evidence of excess, and gradually reduce fees of doctors who habitually order significantly more tests and procedures than the average for the specialty. Costs: Again, this would greatly reduce costs, and probably be widely adopted.
Recommendation #4: Provide generous subsidies to medical students entering primary care, with higher subsidies for those who practice in underserved areas of the country for at least two years. Costs: This initial, rather modest investment in ending our shortage of primary care doctors would have long-term benefits, in terms of both costs and quality of care.
Recommendation #5: Repeal the provision of the Medicare drug benefit that prohibits Medicare from negotiating with drug companies for lower prices. (The House bill calls for this.) That prohibition has been a bonanza for the pharmaceutical industry. For negotiations to be meaningful, there must be a list (formulary) of drugs deemed cost-effective. This is how the Veterans Affairs System obtains some of the lowest drug prices of any insurer in the country. Costs: If Medicare paid the same prices as the Veterans Affairs System, its expenditures on brand-name drugs would be a small fraction of what they are now.
Is the House bill better than nothing? I don't think so. It simply throws more money into a dysfunctional and unsustainable system, with only a few improvements at the edges, and it augments the central role of the investor-owned insurance industry. The danger is that as costs continue to rise and coverage becomes less comprehensive, people will conclude that we've tried health reform and it didn't work. But the real problem will be that we didn't really try it. I would rather see us do nothing now, and have a better chance of trying again later and then doing it right.
Mehmet Oz, M.D.: Real Health Care Reform: What's Next?
Health care reform is not just about who pays. It must also address what we are paying for. And we have to start paying for health rather than treating sickness.
House passes health care reform bill - CNN.com
House health care bill has nowhere to go in Senate - Yahoo! News
Health care bill could slow in Senate
TONIGHT i heard Dr ANGELL on PBS Bill Moyers and decided to research this Dr. Angell.
So here I am reading what she posted on HUFF post on Nov 8, 2009.
WELL my friends..........in September 2009 in a TWON HALL meeting on Health care organized by OFA I got up and said that if the BILL contains a MAndate it is a GIFT to the Health insurance companies..........and that I propose instead B L U Medicare for all
B basic
L limited
U universal....................KILL the H.C BILL if there is no STRONG PUBLIC OPTION
the problem is in the Industry hold on all solutions that don't count their profits..
As long as the people keep supporting this extortion America calls a health care system the longer those on Wall St will continue to exploit it..
We as a people must act in a way that deems this Industry un-American and stop supporting the system,, until the Government has to come in and Bail these companies out because of a loss of customer base,,,,,,,,,,,,,we can fix this,, but it's going to take more than just voting...
First off you don't cover long-term-care. Long term care is what almost everyone ends up needing and Medicare does not cover at all. If you want to rely on Medicaid for this good luck. Do you think a nursing home is going to take 100% of it's fee from someone paying cash or 50% of it's fee by someone on Medicaid. Simple answer to that.
Also, she mentions specialists doing a bunch of "unnecessary" procedures as deemed by the medical community. Those "unnecessary" procedures are necessary to prevent lawsuits. It's an unfortunate fact in todays world that if you don't do every single test possible and you miss something you WILL be sued for millions. Particulary in cardiology where something missed can = death. Gone are the days of easy diagnosis and simple testing. It's all or nothing in this world now and that is a fact. You should know that.
Health care for all, or Afghanistan (WHY are we there?) YOU CHOOSE.
We will not be a democracy again until campaign finance reform is enacted that restores sanity to our law-making out of the hands of the corporate interests!
If there is one issue young voters should latch on to, it is IT. Removing corporate interests from the coffers of our elected officials. We should enact free TV and radio and newspaper coverage for elections, AT ALL LEVELS. No more breakfasts and cocktail parties for candidates, financed by the vested interests.
In Europe, and other parts of the world, the election campaigns last 3-4 weeks. Media time is free. The people (except in Italy where the prime minister, Berlusconi, owns 95% of the newspapers, radio and TV) usually get their first choice. There are anomalies, but on the whole, elections (as long as electronic voting is not in the equation) are fair and accepted. Those are my two-and -a-half cents.
Germany recently banned electronic voting
http://www.inteldaily.com/news/173/ARTICLE/12343/2009-10-23.html
Members of congress try doing something right for a change! go out into the world and find out how the other nations are making it work for them. And 'Yes" you will have to stop and take the profit out of the healthcare industry, and out of the pockets of the CEOs who just can't help themselves from being the "Greedy" little snakes " that they are. Try dropping the 1900 worthless bill down to 100 pages.
At least a dialogue and maybe slight incremental change towards more sensible debates without so many lobbyists and false propaganda from the Far Right.
Aetna Ronald A. Williams: $23,045,834 Cigna H. Edward Hanway: $25,839,777 Coventry Dale B. Wolf : $14,869,823 Health Net Jay M. Gellert: $3,686,230 Humana Michael McCallister: $10,312,557 U.Health Grp Stephen J. Hemsley: $13,164,529 WellPoint Angela Braly (2007): $9,094,271 L. Glasscock (2006): $23,886,169 Ins. Co. & CEO With 2008 Total CEO Compensation THIS IS OBSCENE Aetna, Ronald A. Williams: $24,300,112 Cigna, H. Edward Hanway: $12,236,740 Coventry, Dale Wolf: $9,047,469 Health Net, Jay Gellert: $4,425,355 Humana, Michael McCallister: $4,764,309 U. Health Group, Stephen J. Hemsley: $3,241,042 Wellpoint, Angela Braly: $9,844,212. THAT IS ONE ENTITLEMENT THAT WE COULD DO WITHOUT.
France has shown us what is possible. It would involve changing many things to get from here to there. Two changes are within the realm of possibility. We could adopt the Indana approach to medical malpractice with its compensation fund paid into by physicians and panel of physicians which oversees malpractice cases and which should be a model for the nation. The Left would fight this. If we were to nationalize the health care insurance companies, the Right would invoke the Slippery Slope Fallacy and say that Communism is not far behind. If we could get past the rhetoric of the Left and Right, we could get somewhere
At this rate, the only way to improve anything in our country is going to have to involve beating all the rich people to death so they can't bribe their way out of it!
*grumble*
Aetna Ronald A. Williams: $23,045,834 Cigna H. Edward Hanway: $25,839,777 Coventry Dale B. Wolf : $14,869,823 Health Net Jay M. Gellert: $3,686,230 Humana Michael McCallister: $10,312,557 U.Health Grp Stephen J. Hemsley: $13,164,529 WellPoint Angela Braly (2007): $9,094,271 L. Glasscock (2006): $23,886,169 .. THIS IS OBSCENE: . THIS IS ONE ENTITLEMENT THAT WE COULD DO WITHOUT.
Restoring the rich paying their fair share of taxes is the ONLY way to save our democracy. Democracy means OF THE PEOPLE, BY THE PEOPLE, FOR THE PEOPLE. Not rule by the rich, or the corporations, for their SOLE BENEFIT.
Democrats better "get it" real soon.
any REAL Health insurance reform needs the follwing, or it will be the death of the democratic party, IMO.
1) cost controls of premiums by either
A) a non-profit insurance option open to EVERYONE
B) Simple cost controls on ALL insurance premiums.
2) an EMPLOYER Mandate to cover at least 50% of the cost of ALL employees' premiums.
3) a limit on total out of pocket cost per household for healthcare expenses each year, based on a % of total income per houshold.
all of the above WILL create health insurance reform thats helps the Middle/working class in our nation.
there IS a populist movement building ( I would argue has been coming for over 25 years now), the Bank bailouts and this "great recession" we are in has sped it up, IMO.
The democratic party ignores this movement at it's own peril , I really beleive.
time for the democrats to get BACK to the roots of the party and to start doing things that actually HELPS the Middle/Working class.....or they just might be swept away by the coming wave.
When a politician is really MEANS to deliver health care reform they'll come out with a plan like this. Until you see that you can rest assured that you're being lied to by anyone who tries to sell you some other plan.