Health Care Reform: The Road Ahead

Here are my 5 big questions:
1. Why aren't the odious and despicable Ben Nelson and Max Baucus in jail for the bribes they take from the death for profit industry?
Actually, that is only one question.

"For now, it appears that lawmakers will ultimately go for a watered-down version of a public plan — one, for instance, that would have to operate like a private insurance company, sustaining itself with the premiums it brings in and paying doctors and hospitals higher reimbursements than Medicare does."
.
That's actually an interesting idea. Operating like a private insurance company but without shareholders who expect dividends or insanely over compensated CEOs like Bill McGuire.

Here's my response to the five big questions:
.
1. Will there be a big, new government system?
.
I certainly hope so!
.
2. How can a nation already deeply in debt afford health-care reform too?
.
Well, we can start by not comparing apples and oranges. It is unfair to measure what the government now spends on health care to what the government would spend under a universal health care system. We should be measuring what the nation as a whole would spend under the present system compared to a reform system.
.
For example, if I currently spend $10k/year on health insurance and under a hypothetical single-payer system I would pay $0 and the government would have to raise my taxes by $5k to cover the expense of running the system...well, it is pretty obvious that we have a political problem (raising taxes) and not an economic problem.
.
3. Can we really cover everyone?
.
Can we? Of course. Will we? Doubtful.
.
4. What will be covered?
.
I admit this is a fair question. But it is a question that you have to ask regardless of whether you are covered under a private insurance policy or a government-administered program.
.
Do Cigna or Aetna cover preventive care? How about mental-health care? Abortion services?
.
5. How will we bring down costs?
.
Costs to whom? To the taxpayer? To the patient? Their costs would largely be brought down under a single-payer system by eliminating the unnecessary insurance bureaucracy.
.
Health care providers will have a financial incentive to bring their own costs down because they would not be able to bill whatever they feel like and pass their costs on the patient. Every dollar doctors and hospitals saved would be profit directly into their pockets...or they can be inefficient and go out of business.

"Not unlike Calpers.". Very Socratic of you KT. I had to Google them.
.
There is some appeal to the idea but I need to read a lot more. At least it's something else on the table. I kind of appreciate this style of throwing out different ideas and see what is preferable/practicable/achievable.

pafro asks a good question.
.
Here's another: Why couldn't KT include a single quote from someone in support of single-payer (unlike Baucus and Nelson)? Just because there are corrupt politicians who have chosen to take the best reforms off the table before talks have even started doesn't mean that the press has to accept the narrowing of the debate.
.
Here's another: Why couldn't KT identify who she is relying on to assess the costs of health care?
.
The problem with American health care, those who have studied the system will tell you, is not that we get too little care but that we use too much.
.
Really? Does that mean that NOBODY is claiming that Americans get too little care? Or that anybody who claims that Americans get too little care hasn't "studied the problem"? Or that Americans do get too little health care, but that just isn't "the problem"? Enquiring minds want to know.
.
By some estimates, as much as 30 cents of every health-care dollar is spent on medical treatment that is unnecessary, ineffective, duplicative or even harmful.
.
What estimates? Made by who? If "some estimates" say that, presumably "some other estimates" say something else. Why weren't those other estimates provided.

It never ceases to amaze me that the "big government spenders" actually believe that health care can be compared to the local electric company. That a "single payer" will miraculously eliminate waste, inefficiency, corruption and fraud.
.
Sorry to say folks, but until they invent a machine you can walk into, that will diagnos and fix all of your health problems ala Star Trek, then and only then will "Universal Health Insurance" work.
.
I will ask a 6th question. If the current private system is so broken, how will creating a public program make it run more efficiently and less costly? If you cannot acheive that slight miracle, this country or any other country in the world will never be able to sustain the program over time. Just simply saying an electronic medical record is the end all of all health care costs is ludicris. Believe me, if McDonalds thought that they could open up healthcare clinics across the nation in conjunction with their fast food operations, it would have already been done by now.
.
Very good article Karen, at least you are now pointing out the barriers to universal health care that will need to be fixed before you can simply start out come January 1st, 2010 with a Government backed program of any kind.

KT: Congratulations. You have convinced the "Obama is the Anti-Christ" demographic.
.
Rusty:
.
That a "single payer" will miraculously eliminate waste, inefficiency, corruption and fraud.
.
It isn't magic. It's called economics. It's called market power. It is the same miraculous way that Walmart can buy Chinese-made products cheaper than you can. You want to individually negotiate the cost of an MRI or heart surgery or an insulin pump? Knock yourself out. Personally, I would rather leverage the purchasing power of the entire nation to negotiate lower prices.
.
If the current private system is so broken, how will creating a public program make it run more efficiently and less costly?
.
See above.
.
BTW, if single-payer wasn't more efficient, you wouldn't hear the insurance industry squealing like stuck pigs over the thought of competing with the government.

KT:
.
Thanks so very much for engaging with your readers; it is always very much appreciated.

KT: True. But there is no different Congress to get.

Is Karen's article worth reading? -- I couldn't get past her completely uncritical Baucus quotation. Setting up a corrupt insurance company factotum like Baucus as a credible source for comment on the health care reform tells me that what I'm expected to read will be full of the same kind of beltway BS we find in the rest of the media. (Here's a clue Karen -- Baucus has no interest in meaningful reform; he's there to protect the profits of the insurance, pharmaceutical, and for-profit health care conglomerates. Quoting Baucus about "meaningful" health care reform is like quoting bin Laden on "meaningful" progress on West Bank issues...)

Why doesn't anyone ever ask crooks like Baucus whether their experience with the Senate Health Care plan mirrors the crap we put up with? things like denial of service or having to have pre-approval for everything or having to go to another state like I did (WY to CO) on my last dental plan (had to wait ~6 mo. for an appointment too!). I read a story from an ex-Congressional staffer about how when they worked on the Hill there was never any denials of service or any of that garbage, but after they left and kept COBRA they got the shenanigans we normally face.
Here is the trigger I think we should use: Every month we don't have meaningful health reform, another Congressman goes to jail. We start with the ones who have taken the most bribes from the death by spreadsheet industry and we work our way down.

KT: Thanks for the citations and links. I will try to take a closer look at a more opportune moment.
.
I understand that single-payer is a non-starter. Of course I get that. Baucus has made it clear and I haven't seen any pushback against his position from the rest of the Democrats.
.
But that isn't the point. Why aren't the American people entitled to know that many people (including those who have "studied the problem") believe a single-payer system would be the most effective at keeping costs down and providing the most, if not total, coverage? Why aren't the American people entitled to know why they aren't getting it?
.
Especially if the reason that we are not getting the best policies is that our politicians have been corrupted through legalized bribery to protect the profits of insurance companies at the expense of the taxpayers. Or are we expected to believe that the reason Baucus has taken single-payer off the table is because he has already performed a comprehensive economic analysis and concluded that it would be so mistaken that it can be dismissed out of hand?
.
It seems like you could slip in a sentence or two on all this.

sqrl: as i note in the story, the lewin group has estimated that if a medicare-like plan were available to everyone, more than 130 million would go for it. would suggest that if you want one, you should get a different congress.
.
I would remind you that it wasn't too long ago that you were buffaloed into believing that Baucus was in favor of some sort of Medicare-for-all plan (as opposed to merely reducing the eligibility age by a couple of years).
.
The fact is that many Americans don't know that they STILL have to replace large segments of Congress if they want meaningful reform because the media continues to treat players like Baucus like good-faith actors. Furthermore, one questions whether it is even possible to change Congress given that the insurance industry appears willing to corrupt politicians on a bipartisan basis.

Paul Lukasiak:
.
Baucus as a credible source for comment on the health care reform
.
Baucus is a credible source for comment on the health care reform process.
.
For some reason (probably having to do with Time's Editorial Guidelines), Karen can't come on out and report anything about Baucus other than what she knows (as an insider and a professional covering his schedule and pronouncements) in terms of what the Senator is most likely to do, not whether what Baucus is likely to do will help or hurt most Americans.
.
When she writes about Baucus' supreme confidence in the odds that Congress will pass its most sweeping piece of social legislation since the New Deal, she can't actually provide any real definition of the phrase "most sweeping", since telling the reader whether it means "will be a comprehensive solution to the problems facing a majority of Americans" or "like Pol Pot, only worse" wouldn't be sufficiently (according to her editors) restricted to a description of the process.
.
When Max Baucus declares "Meaningful, comprehensive health-care legislation passes this year. That's a given," Karen has to write it down, since the operative phrase in that sentence is only "passes this year", and not "Meaningful".
.
The actual meaning of what will probably happen to Americans living with their sh*tty, overpriced, bankrupting-Medicare, bankrupting-Americans, death-by-spreadsheet, reason-there's-no-raise-for-you, held-over-your-head-by-employers, screwed-if-you're-unemployed, screwed-if-you're-self-employed, screwed-if-you're-already-sick, screwed-if-you're-underinsured-but-don't-know-it-yet private health insurance system is implicitly beyond the scope of this type of reporting.
.
This is political reporting, which can only analyze how things are going to be in the context of an accepted consensus on how things already are, and not how things should be if we really lived in a democracy, which is how we get a piece of reporting like

The insurance industry now says it is willing to make concessions it never would have considered before — like agreeing to set prices on policies without regard to an individual's health history — in exchange for the access to the vast new market that would come with universal coverage.

, without even an eyebrow raised at the notion that the insurance industry has any say in anything at all when it comes to the people's business and elected officials weighing some private firms' interests against the public interest.
.
The sanity or morality of the circumstances in which the will of executives in a few large companies is being considered in a discussion of the health and well-being of the American people by their government simply isn't within the purview of political reporting, at least as far as the editorial staff at Time Magazine (and the rest of these soon-to-be-out-of-business publications) sees it. According to these soon-to-be-out-of-work professionals, reporting of that sort would be the job of activists, not journalists.
.
It is the task of journalists to report on systemic corruption only if it meets certain thresholds (William Jefferson, Tom Delay), which precludes reporting that there's a link between Senators like Baucus accepting tens of thousands of dollars from insurance firms like AIG and Blue Cross/Blue Shield, and the interests of the insurance industry being considered as if those corporations were somehow constituents with needs to be soberly evaluated by policy makers on a par with the interests of American voters who will bankrupt their families as they inevitably get sick, tragically suffer and needlessly die.

KT: I did read the article. It isn't that I thought that it was "wrong". It's just that I thought it missed the mark in key areas.
.
I concede that you address cost savings of a hypothetical Medicare-like public-insurance plan. But single-payer? Aside from the "Don't talk crazy now!" quote from Dodd, it is completely unaddressed (And, yes, it won't happen. Too bad.)
.
You write: "A public plan of this magnitude could be a powerful force to contain costs. But it could also destroy the private insurance industry, while doctors and hospitals say its lower fees would drive them out of business."
.
Um. Destroying the private insurance industry is a feature not a bug. And it shouldn't be lumped in with speculative doomsday-imagery of doctors and hospitals going out of business.

Um. Destroying the private insurance industry is a feature not a bug. And it shouldn't be lumped in with speculative doomsday-imagery of doctors and hospitals going out of business.
-
Gotta agree with sqr1 on this KT. If the health insurance industry dies (and it won't, there are private health insurers in every single country with a single-payer system) why is this such a horrific negative? You do sort of just leave that hanging there like it should be a huge issue we should be concerned with since the health insurance industry seems to have zero investment in making sure Americans don't die.