Yesterday we celebrated the 40th anniversary of the moon landing. What else? Oh, right. More pundits and politicians told us that meaningful health reform was impossible. In 1961 the president of the United States set the goal of landing astronauts on the moon and returning them home safely within 10 years.
We did it in eight years -- and while we were at it we created Medicare and implemented the Civil Rights Act. Just how tiny have we become in the last forty years?
The moon landing changed the way we thought about ourselves. It gave us pride, and a belief in our own abilities. It became a folk saying, common in everyday conversation and television commercials: "If they can land a man on the moon (it was always a man in these sayings; we've come a long way), why can't they make a cup of coffee I like without caffeine?" Forty years later, you can even get a decent cup of decaffeinated coffee at Starbucks or the Coffee Bean.
If the president were to set a goal like President Kennedy's today, we would probably see Republican senators saying that the GOP should "slow him down" because it would "break him." And Republicans who thought it might be good for the country to meet such a goal would be confronted by pundits like Bill Kristol, who said this of health reform: "(T)here will be a temptation ... to try to appear constructive, or at least responsible ... Resist the temptation. This is no time to pull punches. Go for the kill." Meanwhile Blue Dog Democrats might be afraid that a bold stand on the issue could hurt them with swing voters.
And yet polls show that the public wants meaningful health reform with a robust public option. To paraphrase that line from Sunset Boulevard, the American people are still big. It's politics that got small.
It's true that the recent Washington Post/ABC Poll shows weakened support for deficit spending to stimulate the economy (the question is phrased somewhat differently in the recent poll, which could skew the results, but the decline is dramatic). Hence the new, poll-driven concern about ensuring that health reform doesn't "raise the cost curve." The first response on the Democratic side has been to propose the partial taxation of employer-provided health benefits (a proposal which may not make as much sense as it seems to make).
There's a bolder, smarter, better way to lower costs and improve health outcomes: Why not create a new national mission, on the scale of the mission to the Moon? Here's the outline for such a mission: To learn what medical techniques work best, for which people, so that we can have the most effective medicine in the world within ten years. That means we'll need to study, identify, and reduce the use of unneeded and harmful medical procedures, starting now.
One good place to start is with the McKinsey study on excessive use of costly services in the US (although we should make more comprehensive studies of this problem a national priority). McKinsey estimates that we spend $480 billion more per year than other industrialized nations on medical services, after adjusting for population and other factors. That figure isn't justified by either our level of health or the results we get from our care. We've been hearing a lot about the reputed $1 trillion cost of reform over a ten year period, but even a 25% dent in this excess spending would give us reform that saves money. Why not make it a goal to use our nation's imagination and ingenuity to make those savings a reality?
Some will say this is a form of rationing. That's not true. It's not 'rationing' to let people know that the painful and invasive operation they're about to undergo isn't necessary, and may even make them worse. You're not 'denying' them something. You're protecting them.
The nation that launched a manned moon mission in eight years can fix this problem -- but only if we stop tinkering with the small stuff and start looking at the big picture.
In other moon-related news this week, the Indian state of Haryana announced that it would provide free travel insurance for a million religious pilgrims. Fear of ill fortune brought by this week's eclipse might made travelers reluctant to come to the state for their ritual bath in the waters of Brahmsarovar, the pond of Lord Brahma. That could deprive Haryana of much-needed tourist revenue at a critical time.
The lesson of Haryana's "eclipse coverage" is this: Insurance is too often a reflection of what we fear, rather than what we can prevent. Americans should make it a national goal to learn the difference in the next ten years, and then manage their care accordingly. If we can land a man on the moon - and make a decent cup of decaf - surely we can do that.
RJ Eskow blogs when he can at:
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Coverage for EVERYONE who applies
Structured premium payments of not more than 100 per individual, 300 per family
Deductibles capped at $2000 and based on income (means testing every year like the va)
No mandates forcing people to purchase insurance (this is a windfall for private carriers)
No triggers (this is also a windfall to private carriers)
No subsidies to private insurance carriers
No taxes on employer provided benefits
If someone has private insurance and wants the public option, they can drop private with no problem and be covered immediately under public.
No mandates on employers to buy into the public option to cover employees. Has to be free choice.
Everyone with coverage gets treated for new or pre-existing conditions.
Fairly negotiated reimbursement to private pracitce, specialty doctors and hospitals
Fairly negotiated prices for medications, even on name brand stuff which has no generic equivalent.
AND IT HAS TO BE EFFECTIVE IMMEDIATELY. Within 1 month of the above bill passing, Americans must be able to start buying in and using it.
See my next post on funding
20 million under insured
Subtract 10 million poor/indigent/mentally ill, etc, who are uninsured and will have to get free care = 37 mill un-insured who can pay.
18.5 million can pay $50/mo = 925,000,000
18.5 mill can pay $100 = $1,850,000,000
20 mill under insured will switch and can pay $100 = 2,000,000,000
That is a grand total of $4,775,000,000
That is FOUR BILLION, SEVEN HUNDRED SEVENTY FIVE MILLION DOLLARS IN PREMIUM PAYMENTS PER MONTH. FIFTY SEVEN BILLION THREE HUNDRED THIRTY MILLION PER YEAR IN PREMIUMS FOR ONE SET OF PEOPLE.
That does'nt count the millions who'll switch from private companies if they can pay $100 or 200 per month and have their entire family covered even with pre-existing conditions. Repeal bush tax cuts asap another 700 billion.
After thinking about it more, institute a 1 penny federal sales tax on EVERY item. I can hear the opponents shouting about making the poor poorer, but my statement is 1 cent on each item NOT on every dollar or hundred dollars. From candy bars tto big screen tv's to your house. 1 cent on everything. If your grocery bill was $100. for 53 items, your bill would be $100.53. That's not putting people in the poorhouse especially when we've been dealing with price increases. Also, if you're saving 300-500 per month on insurance, you have that money to spend and put back in the economy, save, or invest
That about says it all. Great nations do great things. We on the other hand might be genuinely too stupid to survive.
The second debate is about getting heath care to the uninsured and the underinsured. This debate is only among Democrats, who either believe we should have government provided health care or provide THE INSURANCE for health care. If you are trying to provide insurance, instead of health care, you only talk about costs. When you talk about providing health care, instead of insurance, you are talking about morality. It is immoral to withhold health care.
The debates are on two separate tracks, and can never come together.
We were determined to put a man on the moon not because we were interested in the lofty goal of exploring space, but because the Soviets were leading (with Sputnik) and we wanted to beat the enemy. Until we see that the new threat to the US is an unhealthy population, there won’t be the same drive and determination to solve the health crisis. If we agree that health care is an imperative, we would devote our energies to finding a way to pay for it, the way we found a way to get to the moon.
I agree there are two debates on separate tracks, but I think they CAN come together.
hugely complex solution, which is making US hugely nervous, as we much
prefer simpler problems & solutions, which is a great angle for the Repos
to work with. especially connected to a notion that this is *maybe* too big a
deal to hand off to an 'inexperienced' President. Which DECIDEDLY works
to the advantage of Big Healthcare, Big Insurance, Big Pharma, Big Whatever,
who much prefer things as they are. Maybe, MAYBE, the thing is to focus on the
minimum requirements: coverage for all, with the public option & no pre-existing
conditions exclusions, and leave it at that.
'Getting to the moon' was actually a much more straightforward problem. If we
could do one, it doesn't mean we can do the other.
http://www.google.com/hostednews/ap/article/ALeqM5hiiWnivT__38YVG-emF9zy6xVW_AD99ICP600
Yet we are supposed to urgently pass it without having a chance to examine it despite the bill's complete lack of urgency. It couldn't be because there's all sorts of bad stuff in it that the Obama and the healthcare lobbyists have put in it (wich Obama wont say which lobbyists he's meeting with at the WH just like Dick Cheney Energy Task Force) and just want to pull the wool over our eyes. Since there's no urgency in the bill, there should be plenty of time to review it and see who Obama is meeting with about the bill to be sure that we aren't getting a bill that reforms healthcare the way the healthcare lobbyists want it reformed rather than what's good for people in the US.
First, I would like to start off saying I am a member of your white house network.
I work as a problem solver. That’s what I do. I recently wrote a solution for adding the private option AND lower the cost at the same time. I received a call asking if they (your Obama website) could print it on the web site. I gave an exuberant yes.
Now, this was my ideal on fixing health care. Like I said, I passed the ideal out on line and most people like it including the people who run the Obama site.
First, all who qualify for Medicaid and Medicare would have to use those options and only use the public option if turned down.
Second, exclude all people making over 250,000.00. They can afford any private insurance they want.
Third, only small businesses and non-profit companies can offer the option for their employees. But, anyone can go for the public option no matter the employer or employment status.
This should significantly lower the cost of the public option, cover those not covered and give private companies the competition needed.
Let's at least get something done.