Health Care Reform's Odds

Interesting quote by the NFIB. I was expecting more on Daschle and Baucus included with Ted Keneedy and his Hillary in the mix. Were you constrained by space, JC, or didn't you the confluence of politicos seemingly committed to doing something about the process?

The odds against "systemic reform" are short, those against successful reform are long. It's already clear there will be something systemic done. It's also clear that the elimination of the for-profit gatekeepers is not on the table.
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The continued harping on the mandate question indicates a failure to understand the difference between politics and policy.
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In fact....
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I've never typed this out because I've always thought it is obvious. But.
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When a campaign releases a policy paper or specifies a plan to be implemented, they aren't actually planning to implement the thing they are talking about. What they are trying to do is signal to voters the direction they would take reform. When positions are very similar between two candidates', excessive focus gets placed on differences that are irrelevant, because the general shape of the policy actually implemented won't actually turn on that detail.
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The question of a "mandate" for acquiring care is an example. The plan proposed by the Democrats will be as comprehensive as they can make it. If the way to get the votes is to impose a mandate of some kind,they will. If not, not. Obama won't "lose" if there is a mandate. Clinton won't "win" if there isn't.
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What Obama was saying with his just slightly less comprehensive form of health care coverage was that he was more willing to compromise than Clinton. I happen to believe this was actually directed at the Village.
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Presumably the insurance companies has done some polling and focus grouping and have discovered that they are so unpopular that it won't be enough to spend money in Washington.

Jayackroyd,

I think the health insurers are expecting change. I think they know that from the outcomes of the elections. The really big players like Wellpoint only have limited leverage, as they have to write policies virtually within all 50 states and are regulated by state Departments of Insurance.
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Since that is not likely to change most of this reform will be through tax legislation and additional revision to ERISA and HIPPA.
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So they're lobbying would have to occur not only in congress but in all states where they write policies. (insert snark) They can only deny so many claims to pay for those lobbyists.

I profoundly hope health care reform is coming, and that we find a way to make disease prevention a large part of our plan. In Vermont we do have staggering health care costs, but all children are covered. It makes for a more civil and just society.

[...] Excerpt from:  Health Care Reform’s Odds [...]

Kathy I think we can feel relatively confident that health care is going to happen this time because it is a critical component to reviving the economy.

Yeah Andy. that's what I'm saying. It's reached a critical mass. Everybody hates the system, and everything that is wrong with it is due to the insurance companies' role. So they have to get out in front.

Everybody hates the system, and everything that is wrong with it is due to the insurance companies' role.
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Literally everything?
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Malpractice abuse, such as this example. The article doesn't mention the worst issues either, such as malpractice insurance rates going through the roof, driving doctors out of the business.
http://www.boston.com/news/local/massachusetts/articles/2008/11/18/doctors_fear_of_lawsuits_tied_to_added_costs_of_14b/
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Doctor shortages, such as this example. Mostly caused by the complete mess that is the medical education system (frankly, the entire educational system, from K to whatever), as well as, obviously, health care. You also have immigrant "brain waste" thanks to our insane immigration laws, such as the second example. How do you promise everyone a doctor when there aren't enough of them?
http://www.usatoday.com/news/health/2008-02-26-doctor-shortage_N.htm
http://www.latimes.com/news/local/la-me-immigwork11-2008nov11,0,3236612.story
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The burden of illegal immigrants, unfortunately, such as this example. Not the biggest problem but still an elephant in the room as it's affecting Medicaid and the taxpayer.
http://www.latimes.com/news/local/immigration/la-me-dialysis29-2008oct29,0,2740041.story
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Big Pharma. Not talking about the outrageous costs. Talking about actual "planned obsolescence" in medication, designed to be less effective in order to promote more of its use. Also talking about side-effects and the corrupt FDA: guy spends a fortune on FDA-approved asthma medication, gets cancer from the mega-steroids used in the medication, spends another fortune on cancer treatments.
http://www.worstpills.org/
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It goes on and on. I personally think insurance is by far the worst evil, but everything related to health care is a mess in this country and I doubt there is a single bill that can be the magic bullet.

Everybody hates the system, and everything that is wrong with it is due to the insurance companies' role.
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Literally everything?
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Malpractice abuse, such as this example. The article doesn't mention the worst issues either, such as malpractice insurance rates going through the roof, driving doctors out of the business.
http://www.boston.com/news/local/m@ssachusetts/articles/2008/11/18/doctors_fear_of_lawsuits_tied_to_added_costs_of_14b/
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Doctor shortages, such as this example. Mostly caused by the complete mess that is the medical education system (frankly, the entire educational system, from K to whatever), as well as, obviously, health care. You also have immigrant "brain waste" thanks to our insane immigration laws, such as the second example. How do you promise everyone a doctor when there aren't enough of them?
http://www.usatoday.com/news/health/2008-02-26-doctor-shortage_N.htm
http://www.latimes.com/news/local/la-me-immigwork11-2008nov11,0,3236612.story
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The burden of illegal immigrants, unfortunately, such as this example. Not the biggest problem but still an elephant in the room as it's affecting Medicaid and the taxpayer.
http://www.latimes.com/news/local/immigration/la-me-dialysis29-2008oct29,0,2740041.story
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Big Pharma. Not talking about the outrageous costs. Talking about actual "planned obsolescence" in medication, designed to be less effective in order to promote more of its use. Also talking about side-effects and the corrupt FDA: guy spends a fortune on FDA-approved asthma medication, gets cancer from the mega-steroids used in the medication, spends another fortune on cancer treatments.
http://www.worstpills.org/
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It goes on and on. I personally think insurance is by far the worst evil, but everything related to health care is a mess in this country and I doubt there is a single bill that can be the magic bullet.

There might be a hefty double post a-comin', for some reason, the mods got the first one. If it happens, my bad.

I remember a few weeks ago way down in a thread when KT bemoaned the fact that we can't seem to have a serious discussion of health care reform in the country. I suggested that was because the media entertains all of the scorched earth rhetoric -"it's socialism!," and false stories - "everyone in Canada hates their system", that the right inevitably throws out.
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I have no doubt that such rhetoric will be injected into the media again in an attempt to poison the debate. Ramesh Ponnuru said as much early this year, in an honest accounting of the weak political position Republicans found themselves in. He stated unequivocally that they could not let the Dems pass health care reform because that would demonstrate that government can provide meaningful benefits to people which would ruin their core message (No, I can't find the article, tried.)
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I know the national mood makes passage of reform more likely now. But will the msm allow the usual RW tripe to poison substantive debate without challenge?

Yes. VM. everything.
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Malpractice abuse is a BS issue, and easily handled.
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Patent abuse and big Pharma is handled easily by good dispensing policies and a revision to patent law. But without any revision to patent law, the way copays work drive up costs, needlessly. The idea that doctors should only dispense on patent medications is dealt with by government agencies managing studies of effective practices.
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Illegal immigrants are best handled by 1) enforcing American labor laws and 2) covering people who are here legally. Illegal immigration is only an issue because employers violate the law. Enforce the law. Punish employers. Problem solved.
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Dr shortages are easily fixed as well. My brother the doctor spent his first few years in practice in a doctor shortage area as a condition for a loan reduction. This is not hard to do.
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The problems in the American medical care system are entirely tied to the existence of profit-making gatekeepers.

Healthcare reform is a guarantee this time.. as it will be tied to the economy. Massive unemployment, companies straining under the weight of retiree health insurance plans, and the need to change health care programs to make labor less expensive makes it all go quick and fast. This is a no brainer.

@jay+wm: Great comments. Excellent posts.
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@wv: I'd be great if you could find that post.
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On a related note: A friend of mine works for the VA in their pharmacy administration unit. An unsung hero if there ever was one. Travels to VA Hospitals in the midwest encouraging the use of generic drugs in cases where patient care is not compromised. Works on the 80/20 rule: 20% of the drugs dispensed by the VA account for 80% of the costs. Any dent he can make into that 20% is a plus for vets and the US taxpayer. From what I've read (no links handy), the VA could be a model for Universal Health Care with minimal overhead.
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Note: Walter Reed is an Army, not a VA, hospital. Oh, and BTW, has McCain ever gotten around to straightening out Walter Reed?

Jayack –

Spot on regarding malpractice. Just track malpractice premiums relative to the stock market, and it becomes clear the premiums go up when the insurance company isn't making enough on unrelated investments.

Our old family doc made dire pronouncements about the coming of Medicare. A few years in, he called it the best thing ever to happen to his practice. His son the doctor and his grandson the doctor seem not to have been deterred by government involvement in the health care system.

Flown,
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Further evidence is to just look at the number of lawsuits being filed...a riduculously low number. Suits don't get filed when people aren't going to the doctor because they lost their job and have no insurance.
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The health care industry is just another GM situation. Seriously. Mismanaged.

I hope we get universal health care. I'm a single-payer fan--I'd love to give businesses a break by taking it off their hands...

Great photo for the article, by the way...the man's got game!