Bending Over Backwards to Be Wrong on Health Care
I guess it was predictable in this day of "balanced" reporting, where each side gets equal treatment regardless of the lunacy of its arguments, that Health Affairs would feature articles from competing economists about the faults in the health care proposals of Senator McCain and Senator Obama. That approach feeds into the mainstream press' balanced cynicism, as in the lead of the Associated Press article, "John McCain's health care plan won't lower the ranks of the uninsured. Barack Obama's fails to curb the soaring cost of health care..." I would have hoped instead that Health Affairs, which is after all a publication of Project Hope, would have also invited articles about why each plan would work, instead of featuring articles about each plan's shortcomings.
Fortunately, the problems with the McCain plan are so huge that they've been getting more attention than the charges made against the Obama plan by three conservative economists, one of whom is an advisor to the McCain campaign (The Obama Plan: More Regulation, Unsustainable Spending, Joseph Antos, Gail Wilensky, Hanns Kuttner, Health Affairs, September 16, 2008). In a nutshell, the McCain plan would mean even higher cost and worse coverage - as if that were imaginable, given the state of the health insurance system now. What's been getting less attention is that the conservative criticism of the Obama plan is based on the same fundamental misunderstanding of health economics that is at the heart of our health care problem and would be accelerated by the McCain plan.
The core of the conservative criticism of Obama's plan is that because the United States has health insurance with "first-dollar coverage" people don't care about what health care services costs and use too much. The authors say that, "Subsidized third party payments have helped drive up health care spending..." In other words, if instead of people having health insurance, we paid for health care costs out of pocket - with insurance for catastrophic costs - then we'd solve the health care cost problem.
There are so many things wrong with this analysis that I'm not sure where to begin. But I'll start with just one observation: If this assumption were true, then the United States would spend much, much less than any other country in the developed world instead of spending much, much more. In every other country, the government fully or heavily subsidizes the cost of health coverage and provides little or no financial barriers to care ("first dollar coverage"). The United States places huge and growing financial obstacles to care - big deductibles and co-payments for many of the insured and no insurance for 46 million - and our spending per person is in the stratosphere.
What the conservative economists who trashed the Obama plan can't see behind their ideological blinders is that health economics are different. Charging people more doesn't make them smarter consumers, it makes them sicker and ultimately more expensive to care for. When people delay care because they can't afford it, the result is that they too often end up needing more expensive treatment for much more serious illness that could have been prevented or treated early on.
Interestingly, big business now increasingly understands this. For a while, larger employers flirted with the conservative dogma of higher deductibles and co-payments in order to discourage their employees from using too much care. But now an increasing number of large employers are offering first dollar health coverage for preventive and primary care and for other care that is recommended as being necessary. They want their employees to get in the system early and avoid costly illness later on.
Another mistake that conservatives make, and one that the private health insurance industry encourages, is confusing the cost of health insurance with the cost of care. In the Health Affairs article, the conservative economists argue that because Obama pegs coverage to a decent health insurance plan, rather than a skimpy one, his plan is not fiscally sustainable. But the skimpy plan comes with skimpy benefits and higher out-of-pocket costs - like co-pays and deductibles and expenses that just aren't covered. So the insurance plan has a lower price tag, but that doesn't mean all around lower cost. With a skimpy, less expensive plan, a family pays less for health insurance but more for actual health care when the need arises. This is the crux of McCain's plan too.
While the Health Affairs editors may be bending over backwards to look balanced - and falling off their perches in the process - the American public understands the choice between government guaranteeing access to affordable - coverage with good benefits from a choice of regulated private or public health insurance - and being forced into an unregulated, private health insurance market. Health Care for America Now's campaign in 2008 is very simple. We are asking America, with a focus on the next Congress, to decide between those two courses and working at the grassroots level to make certain that quality, affordable health care for all is the first order of business for the next President and Congress.
(also posted on the NOW! blog)
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It's not only health care it's a whole host of issues wherein the plan is to ensure the rich continue to keep the middle class in their current state of despair and hopelessness. Anyone who thought that the republicans would easily give up their enormous share of the pie don't really understand greed and wealth.Col
Continued failed economic policies
Unequal pay for women forever with the help of your Idol Palin (a woman)
Support of teen pregnancy instead of proper sex education and the use of protection
Not alerting your young kids about pedophiles.
Reversal of Roe vs Wade
Your kids dying in Iran, Georgia and the Ukraine next year...dra
Min wage at $7 for 20 yrs while you sleep in the park after loosing your home
A possible nuclear confrontation with Russia
Against the former Secs of State who endorsed Obama's foreign policy yesterday
Now think hard before you vote!!!
I'm sure that when people with employer based health care are paying taxes on their health care I will feel so much better about not having health care that I'll just never get sick!?
I use Kaiser Permanente
Kaiser does a good job of PREVENTIVE medicine..
I have a history of heart problems, brathing problems, etc. BUT I've managed to lose 25% of my weight, KEEP IT OFF and am healthier, happier than ever... Kaiser didn't exclude me from any type of preventive medicine and actually wants me to come in for tests... just to make sure...
I believe ALL AMERICANS.
What say you?!
I actually agree that both are flawed. Simple solution is: single payer health care.
Costs are managed ( admin costs reduced to approx 1%, health care dollars per person reduced to 50% of current levels for equivalent care *used Canada as the comparative example* ).
Care is afforded to all US citizens and legal residents without question.
Tada?
Your health care system will be woefully flawed until insurance companies are removed from the equation. End of story.
Universal health care is the only way. But millions of dollars are spent every year trying to scare americans and make them believe that universal health care is a flawed ideal. You're told horror stories of not being able to pick your own doctor, having to pay more so others can benefit, and dying on some waiting list. They manage to convince you that all the skilled doctors will flee. LIES LIES LIES!! Every wealthy country in the world (and some very poor ones, too) has universal health care; yet the U.S. does not. Do you ever really ask yourselves "Why?".
An educated, healthy, and confident nation is harder to govern.
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