How to Pass Health Care

Time magazine: "How to Pass Health Care".

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For the kids in the audience who are unfamiliar with Time magazine: "Health Care" is Time magazine's euphemism for socialized medicine. Time magazine is for it, btw.

It's too radical. We need a plan that will appeal to the centrists in the Senate, guys like Evan Bayh and Arlen Specter.

Joe
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Are you sure business would back this? I am not familiar with the Act but from the TNR analysis there looks to be one major point that business might not like (I could be wrong here) but if employers have to terminate their insurance and then subsidize some of the cost of their employees then would they still get to write off the costs? One of the little known secrets is that while employer based health care does kill a lot of their bottom lines many of them also bank on getting those tax breaks to help offset other expenses. Besides that it would probably too easily be framed as socialized medicine by the Party of No. I guess the biggest question is are those same 6 Republicans even still on board with the act.

@textee

As a Canadian, I am amazed to learn that I live in a socialist country. You know Canada, your neighbour up north!

lizzie - textee doesn't do conversations, just drive-by posts.

Joe Klein:
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I'm not really sure I understand why you are a proponent of this plan.
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From Galston's piece:
The strategic question now before the Congress is whether this year's legislation will proceed on a bipartisan or Democrats-only basis. Early battles over the stimulus package and the budget have convinced many Democrats that cooperation with Republicans is impossible--or possible only on terms that amount to surrender of key hopes and core principles.
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Is there something truly perfect about this plan (that it has a real public option, for example), or is it merely that you can say that it's "bipartisan" (because a handful of Republicans currently say that they support it) that gets you so enthused?
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What specifically about the plan, other than that it will save money (almost any reform should reduce the current, insane cost of US heathcare, the question is "by how much and to do what?"), that some Republicans support it (who cares?) and that corporate America "strongly backs" it (again, who cares?) makes sense for the vast majority of people who need health care reform, Joe Klein?
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Why isn't the Obama Administration into it? I don't know, why don't you ask President Baucus? Isn't he in charge of everything? Or is it Presidents Collins and Nelson? Why not ask them?

I don't know too many of the details on this, but how is it too radical? People who oppose government run health care typically cite lack of choice and overwhelming costs. A self-financing system seems like it would take care of both.

Health is a huge issue in the U.S., but it's a bigger issue in developing nations around the world. Especially during harder economic times here, we should not forget our previous commitments to promote health overseas. The U.S. should be doing way more to address the Millennium Development Goals. The plan to end world hunger has been getting seriously ignored.

$30 billion: Annual shortfall to end world hunger.

$550 billion: U.S. Defense budget.

(source: borgenproject.org.)

Cliff - Sorry, I didn't know. Maybe that is the problem with some of the people here, they do not know what they are talking about. Excuse me if there are writing errors, English is my second language.

lizziefrommontreal Says:

"As a Canadian, I am amazed to learn that I live in a socialist country."

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lizziefrommontreal:

Evidently, you have been fortunate enough not to need much medical care in Canada. In the event that you need a CT scan, an MRI, needendarterectomy, cataract surgery, gall bladder surgery, hip replacement, knee replacement or much more, then you will immediately discover that, yes Lizzie, you live in a socialist country. Suggestion in the event that you need such medical care: Head south and don't stop until you have crossed the international border and then proceed immediately to an American medical center. Good luck.

Well goddammit, textee has to go and prove me wrong.
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Congratulations, lizzie, that's the most I've seen him respond to anyone.

well for one thing, it's the issue of subsidizing the poor. it'll be untenable in 4 years. it's a return to the welfare state. Americans are willing to pay higher taxes if it gives THEM better healthcare, not if it helps ensure lower income citizens. That's why social security has been popular all this while, but clinton had to cut back on the welfare state.
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And there's also the fact that there isn't any real change to the system. businesses just get off the hook, which is great because i anticipate a good deal of them will be bankrupt under the current system pretty soon, but i frankly don't see how it expands choices, or reduce costs. and how do have manage to have a standard for all businesses to pay workers to get their own healthcare. But hey, it's a better plan than the current system, and if nothing else, it's preferable to the current system.

Yeah, Lizzie, good luck indeed. At a US medical center they won't be very interested in helping you unless you've brought a big bag of loonies with you. And your pharmaceuticals will cost three times as much as at home.

Americans are willing to pay higher taxes if it gives THEM better healthcare, not if it helps ensure lower income citizens. That's why social security has been popular all this while, but clinton had to cut back on the welfare state.
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Very well said.

oops. quick edit. i meant "how do we manage to have a uniform standard for all businesses to pay workers to get their own healthcare?" And how much do we have to spend annually to enforce it? I mean, we can't even get a hold on the tax code and we're losing billions in loopholes every year. How do we make sure businesses aren't cheating their workers? and just because u give workers more money doesn't mean they'll go get healthcare. in fact, most will not.

There several good reasons why the administration has never seriously considered Wyden-Bennett:

1) The individual policies that employees would be forced to buy would be more expensive than what they pay now because individual policies have higher overhead costs. They will either pay more for coverage or more out of pocket for medical costs.

2) There's no guarantee employees would buy the policies even with a mandate. Many with lower incomes will not. There's still lots of folks in Massachusetts without insurance even with a government subsidy.

3) They would raise the income, and the income taxes, of every employee substantially. And some would be forced into higher brackets by the increase.

4) Employees would be forced to make there own choice as to the best policies. The experience with 401(k) plans shows employees don't want to make those kinds of choices. The average person is ill-equipped to make the right choice of coverage... most will choose what's they think is cheapest... not what's best for them and their family.

5) Employers have health insurance for employees not only because of the tax write-off but also because it helps the productivity of the enterprise. It keeps people working. Under an employee purchase system, employers would lose some of the advantages of a managaing their own healthcare plan.

well they do say they'd make the the increase in income tax deductible, so that's a good point. but yeah, these kinda things only work when you have the perfect market. where everyone is just as well informed about every single plan out there. and i just don't see that happening. and one of teh reasons of a public-private plan is that it allows pooling, which reduces costs. if employers don't pool the costs of their workers, costs will inevitably go up.

TriCare.
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It's government run. It's cheap. It's effective. It's been around fro decades. Why is no one supporting an expansion to the civilian population?

Sean, it be 'cause th' insurance companies, who be stayin' in business an makin' tidy profits by takin' money bu' refusin' t' pay fer actual medical care, be totally opposed, an' th' congress be shiverin' in their boots afearin' th' lobby!
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Aye, matey, we got a right shipshape system 'ere...if ye' be a shareholder in one o' those insurance "providers"...providin' ye don't be a needin' any care yerself...

"Congratulations, lizzie, that's the most I've seen him respond to anyone."
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And he did it to tell a Canadian all about the Canadian health care system. Gobsmackingly cocksure about their misinformation, aren't they?

Totally off-topic, but Joe, but I was just wondering if you'd like to revise your prior takes on the various NSA surveillance programs given this revelation:

http://thinkprogress.org/2009/04/15/nsa-congress-spying/

Just what in the Sam Hill is a "centrally financed, publicly regulated private market?"

Is it a public utility, a quasi-governmental organization or a private, for-profit insurer being regulated by some corruptable agency?

Just how is it in any way superior to a true public plan option? How could inducing, or keeping, profit driven private entities reduce costs? In what way is this different from a guaranteed profit, full employment plan for insurance companies?

It all sounds like a scam to me promulgated by insurers who want nothing more than mandated coverage that they provide, for which they are more than willing to submit to toothless, poorly enforced "regulation."

Color me skeptical.

In fact, the more I think about it, the more this idea really sucks.

TriCare.
It's government run. It's cheap. It's effective. It's been around fro decades. Why is no one supporting an expansion to the civilian population?
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Because its not government run, and its cheap only because it is massively subsidized. Basically, TriCare is run by the for-profit health care industry... its administered in "the north" by HealthNet, in "the south" by Humana, and in "the west" by TriWest Healthcare.

As for the plan itself -- its basically a scam supported by rich white people like Klein, who don;t give a flying **** about whether the plan will actually work.
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Here's a clue - no money will be saved, and costs will rise under this plan. There are no real cost saving measures in the bill, and no incentives to insurers to cut costs. We've seen in Massachusetts the big lie that 'cost savings' can be achieved through private insurance and individual mandates.
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Because the system will be run for profit, the administrative model will continue to be based on denial-of-care; the less care the insurers pay for, the higher their profits, and a massive bureaucracy whose sole purpose is to deny/discourage medical care is economically efficient for these companies. Its far cheaper for insurance companies to pay someone $30,000/year to find ways to deny/delay care than it does to provide full services. (And to demand "pre-authorization" for everything -- then raise questions and force doctors to sit on hold with the insurance company while "questions" are dealt with.)
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Moreover, marketing costs will increase substantially; currently, for profit health insurance markets itself primarily to businesses, under Wyden-Bennett, health insurance will be marketed like car insurance -- involving huge national advertising campaigns. These campaigns will be targetted at younger audiences because the rates will not be able to consider the age of the insured individual.
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But Klein doesn't have the first clue abut health care economics -- so he's happy to support what is essentially a massive giveaway to the insurance industry.