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Building a House of Health

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President Obama is trying to bring about the largest change in social policy in more than 75 years. To do that, he has to get consensus among 300 million Americans who fall into two basic categories: those worried that change will not go far enough, and those worried they will be worse off when the process is done.

The President tried to allay the fears of those who already have health insurance by assuring them that they could stay where they were. At the same time he promised to create a health insurance system for all 300 million. It would be as though you were living in a house and the president came and said he was going to build a new one that would house everyone on your block, perhaps even you.

The President is trying to build a house of health in which all Americans can live without fear of losing their coverage or being threatened by bankruptcy. In the process of building this house he is promising the American people that it will be a better place to live and will not cost more than it presently does.

Congress has shaped the president's vision into legislation that includes major provisions like a public option, prevention and wellness, increased competition and assistance for small business. Together, the president and the Congress have started to pour the foundation and build the structural supports. Much of the argument that is going on today is over the details of what the house will look like, what will be included, and at what cost.

From the beginning, the President clearly understood that not every detail could be worked out before construction started. This house of health is a work in progress that will be created over the next three years. There are those who feel that if we can't know all the details of the construction then we should not begin to build the house. Their plan is to do nothing until everything is decided in final form. People who feel this way don't want a house of health.

The President has succeeded in convincing the majority of the Congress that the most effective way to provide both access to health care and control the cost of health care is to have everyone living in the same house that is universal coverage. No one can be excluded from the house because of where they lived before (pre-existing condition) and no one can be thrown out of the house because of problems they develop while living in a house. Today in the United States some 50 million people do not have a roof over their head and another equal number have a leaky roof that does not protect them when the storms come. Every other industrialized nation in the world has built a house of health for their people. It is inconceivable that the richest democracy on earth cannot provide a house of health to cover everyone.

When one builds a house there is not unlimited money available, so choices have to be made. None of these decisions are simple or easy, but they will be made over the course of the next three years as we build the house of health. Cost estimates will be made, but anyone who has done home construction knows that unexpected things come up which require decisions.

In 1965 when we built the house of health for senior citizens called Medicare, we could not anticipate all the changes that would occur in health care delivery since then. Congress has changed Medicare many times since it was created to keep up with the times and the needs of older Americans. This compassionate flexibility is at the heart of Medicare's popularity and success. The same process will go on as we build the house of health for the American people.

The President and the Congress are about to lay the foundation so that all Americans can live securely in the house of health, unafraid of the consequences of an illness or injury. This house will protect the American people from the weather they cannot predict. We must begin now.

 
 
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05:38 PM on 10/25/2009
(…continued from previous post…)

Haven’t American politicians studied at all European attitudes towards work? Why the more competent (on average) Europeans produce less than Americans? Have they no concept at all of a citizen’s perpetual calculation of how much more marginal happiness will extra or higher value work bring to them? The naiveté or near-free lunch arguments that American people buy from their politicians these days is amazing.
11:55 PM on 10/24/2009
As someone who has lived in Europe most of his life, I find it baffling that politicians, with supposedly international experience, do not see that the grand tipping point for Americans is approaching soon…That is the point where American capitalism (what sets this country apart from the rest of the world) is diluted to the point where it is no longer sufficient to compensate for the lower competence of Americans compared to citizens of other nations (*). Past this grand tipping point Americans will loose their number 1 spot on the worldwide competitiveness scale and from that point on things will unravel fast for the enviable American standard of living that so many Americans take for granted.

(*) This is not only my own assessment. Every standardized test that at various times has attempted to measure the competence of the average American against other nations, has come to the same conclusion.In other words, Americans cannot afford to turn away from capitalism and expect to maintain their number one position worldwide.
11:52 PM on 10/24/2009
Please, let's complete the analogy Mr. McDermott. You are describing how to turn US healthcare into a Government Housing Project.

The advantage that individualism has given America for the last 100 years has thinned to the point where Americans cannot afford to go down any further on the path to a welfare state. Unfortunately, nobody wants to hear this, but average Americans are not as competent as, say, their European counterparts who can squander large portions of their competence in collectivist schemes and still survive. America will fall much harder.

An America that adopts European policies is an America that drops far below Europe. And the most important factor is that the relationship between competitiveness and prosperity is NOT LINEAR. Loosing the number one competitiveness position that Americans have been accustomed to for almost 100 years, will have catastrophic and irreversible consequences for American prosperity.
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HUFFPOST COMMUNITY MODERATOR
ncmom54
12:28 AM on 10/23/2009
We already have the foundation
re-post:
excerpted from: http://www.pnhp.org/amendment/?key=36225527

"Rep. Anthony Weiner (D-N.Y.) is introducing a substitute amendment to the House leadership’s bill, H.R. 3200, House Speaker Nancy Pelosi has promised a full floor vote on Weiner’s amendment in the weeks or months ahead. The Weiner amendment, unlike the House leadership’s bill, assures universal, comprehensive, and high-quality coverage, free choice of doctor and hospital, and no co-pays or deductibles through a publicly financed system similar to Medicare. Because of the massive savings on private insurance overhead and paperwork, the Weiner amendment would entail no increase in U.S. health spending, in contrast to the House bill’s $1 trillion price tag over 10 years."
10:11 PM on 10/22/2009
The impact of Universal Health Care on Employment would be astounding.
Bringing millions of persons into the Health Care system would create tens of thousands of jobs. Guaranteed income for new graduate doctors, nurses, technicians, cnas, hospitals and support personnel, would have an immediate fiscal impact.
Manufacture of drugs, durable HC goods, medical supplies would increase significantly.
A huge (secure) electronic medical network will be required, providing jobs and when active, will have an immediate impact on effiency of health care delivery and costs.
But the greatest cost saving could be achieved by eliminating profit from the administrative function of health care. Insurance companies are the only non productive (in the actual delivery of service) link in the chain. On the contrary, care is often denied by administrative manipulations to maintain a profit for the insurance company. A car has a value, so does a house with its contents. It is reasonable to have insurance companies insure these fixed costs and make a profit, while maintaining competitiveness. But what value can be given to a person's health. At any time a claim may range from less than a hundred dollars to tens of thousands of dollars. How does an insurance company assure that it will make a profit in the long run? It does this by calculating worst case scenarios and then adding a profit. This is smart business for insurance companies, but it is completely incompatible with low cost health care. Administrative functions must be non profit.
04:51 PM on 10/22/2009
At the end of the day, Representative, you only have the please the voters who want real reform. Because if you create real reform, all the Chicken Littles will realize that they're better off than they were before. Whereas if you fail to do real reform, you get hate from everybody.

What's wrong with having an ecstatic base who loves you, while delivering an invaluable program to millions of people who currently oppose it, and are going to find out that they love it?

Figure it out, Centrists. look at Medicare. Reagan equated it with Stalin; now everyone agrees that it is so self-evidently good that the GOP is using a pretended threat to Medicare to fight the same exact public option for non-seniors. It will be the same way with Medicare for All. The same Teabagger who calls single payer "Nazi" today will panic ten years from now if someone threatens their Medicare for All.
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HUFFPOST SUPER USER
sposton
right to tell what they don't want to hear
04:27 PM on 10/22/2009
Did you know that the "public option" as it is currently written will only go into effect in 2013 and that only those who do not have an insurance will be able to sign up? If you have a crappy insurance policy and wish to switch to a public option you will be unable to do it.

And for this public option we are supposed to be forever grateful that Democrats are fighting for us. ;-) It is almost foreordained that whatever we end up getting will be a giveaway for insurance companies. All this talk about insurance companies losing the battle is just that - talk, a ruse for gullible Americans.
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HUFFPOST PUNDIT
FoonTheElder
Always choosing between the lesser of two evils
03:50 PM on 10/22/2009
What political babble. This health care plan is compromised to the point where it is little more than a big health care corporate welfare program. The only thing that keeps it from being 100% corporate welfare is the public option.

It will do nothing to control the costs of healthcare for Americans. The bill allows the insurance companies three more years to jack up their prices before most of the provisions even go into effect. Americans will not be able to afford health care premiums after this bill is passed any more than they are able to afford them today.
04:47 PM on 10/22/2009
Yes, sheer pabulum.

He talks about every other industrialized nation having a "house of health"--yeah--all those countries have cost-effective socialized medicine or single payer, not the cartelist cr*p the Democrats are kicking around in Baucus' committee.

The representative neglects to point out that some of the changes his illustrious colleagues have made to Medicare include creating Medicare Advantage, a scheme of brazen graft for AHIP, and Part D, a price fixing scheme for pharma.

Why don't Democrats stand up for an improved Medicare for all? Combine SCHIP and Medicaid into Medicare, close the doughnut hole, make only one comprehensive plan, and open it to all Americans. Employers pay in for employees; the self-employed pay in for themselves; those who can't afford to pay in get subsidies. Eventually the funding mechanism can be changed to be paid for through the tax code in a progressive manner, ending the connecting between health insurance and employment. Yes, wiping out private insurance would end a lot of jobs, but was unemployment an argument against cracking down on the mob in the 1930s? At least all the private health insurance workers would have good health insurance.
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HUFFPOST SUPER USER
sposton
right to tell what they don't want to hear
05:25 PM on 10/22/2009
Exactly right!
HUFFPOST PUNDIT
vippy
Carpe Diem!
07:55 AM on 10/23/2009
Exactly. Have you seen the articles of late regarding this. Seems we are getting screwed big time. The corporations won. Now if the corporations win then how can we get a viable healthcare bill, not happening. Obama promised us the same healthcare bill congress has. Like everything else he backtracked. Yes, I voted for him, yes I stomped for him. I would have never voted for another GWB like McCain or Hillary. But seems to me Dennis Kucinich should have been chosen only the media made fun of him and the public, as usual, fell for it.
03:37 PM on 10/22/2009
I wish these congress critters would check the constitution and show me just where they were given the power or authority to "give" or force everyone into a healthcare plan. Which article is it under that congress has the right to start and regulate a socialized medical plan for every citizen and alien?
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HUFFPOST PUNDIT
FoonTheElder
Always choosing between the lesser of two evils
04:33 PM on 10/22/2009
It's right in the section where is says corporations are people and that the ability to spend money on a campaign is free speech.
HUFFPOST PUNDIT
vippy
Carpe Diem!
07:58 AM on 10/23/2009
It is a necessity! You send people off to war and then you don't want to take care of them in case they get injured and weren't lucky enough to get killed. How insane is that? What are they fighting for if their own country only protects the rich and their lifestyle? A soldier should be proud to serve his country and not just empty rhetorics like patriotism or the pledge of allegiance. It has to have
some substance to it, right? We are worth no less than other people in other countries, right?
03:34 PM on 10/22/2009
Representative, McDermott, if Medicare has worked for seniors for 40 years, why can't it work for younger people, who on average are much healthier and much less expensive to insure?

We know this model works. Why not come up with a bill that gets employers to pay into Medicare for their workers and do a CBO analysis, and compare the total cost of the health sector under Medicare for all to the cost of insuring all those people with private insurance?

What are you waiting for?
Why wait to save money while providing Americans the care they need?
Why the kabuki dance?
03:22 PM on 10/22/2009
Sorry, the more we learn, the more it looks like single payer is the only answer, anything else =fail.
Some options = fail faster than others, but all will end in failure unless we get proper health care like those other industrialised countries you mention. What we are being offered is a far cry from that.

As mentioned in another post below, if you build on sand, don't expect much out of your "house"...
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HUFFPOST COMMUNITY MODERATOR
ncmom54
12:24 AM on 10/23/2009
do you think NC would opt-out if given the opportunity?
03:08 PM on 10/22/2009
The problem with building a house of health that includes a built-in role for the useless private health insurance cartel middlemen and includes massive price-fixing guarantees for the pharmaceuticals cartel is that it's like building an ordinary house with big holes in the walls instead of windows. How are you going to pay to heat it? The design is inherently flawed and utterly irrational. It's design by and for the cartels, a house built not for the occupant of the house, but for the profits of the heating oil company.

Why not build the most cost-effective, safe, comfortable house that can be built? One whose design has been proven by forty years of history?

Medicare for all!
03:03 PM on 10/22/2009
What's wrong with HR 676 or Medicare for all? They pay for themselves, by eliminating the $400 billion a year in plutocratic waste and graft caused by the continued existence of the zero-value-added, parasitic, unnecessary private health insurance cartel?

Seems like Medicare worked great for seniors.
Why can't it work even better for younger people, who are healthier and less expensive to care for?
What are you afraid of, Representative?
HUFFPOST PUNDIT
vippy
Carpe Diem!
08:00 AM on 10/23/2009
WHAT IS WRONG WITH THAT IS IT WOULD NOT DO ANYTHING FOR THE PHARMA INDUSTRY!
HUFFPOST SUPER USER
threegoal
02:48 PM on 10/22/2009
We are trying to get something done that should have been done 60 years ago or so. We have to do it on the scaffolding of all that has happened since, including partial solutions such as Medicare, Medicaid, and SCHIP (spelling), and an evolution that made our health care system very expensive and in many ways a place that is pillaged by the greedy.

The very notion that people in this country suffer various combinations of financial and life ruination to illnesses that are not that big a deal in other modern countries is a complete outrage, and we as Americans have to rise up and say that we can be a better country than that. I refuse to accept the soft bigotry of low expectations on how humane and caring a country we can be.
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02:17 PM on 10/22/2009
I am proud to say that this is my representative.