The common wisdom the past week has been that whatever challenges health care faces, the president will at least get something because he has a Democratic House and Senate and they’re not going to let their guy die. He’ll get this or that, maybe not a new nationalized system but some things, and he’ll be able to declare some degree of victory.
And this makes sense. But after the news conference, I found myself wondering if he’d get anything.
I think the plan is being slowed and may well be stopped not by ideology, or even by philosophy in a strict sense, but by simple American common sense. I suspect voters, the past few weeks, have been giving themselves an internal Q-and-A that goes something like this:
Will whatever health care bill is produced by Congress increase the deficit? “Of course.” Will it mean tax increases? “Of course.” Will it mean new fees or fines? “Probably.” Can I afford it right now? “No, I’m already getting clobbered.” Will it make the marketplace freer and better? “Probably not.” Is our health-care system in crisis? “Yeah, it has been for years.” Is it the most pressing crisis right now? “No, the economy is.” Will a health-care bill improve the economy? “I doubt it.”
The White House misread the national mood. The problem isn’t that they didn’t “bend the curve,” or didn’t sell it right. The problem is that the national mood has changed since the president was elected. Back then the mood was “change is for the good.” But that altered as the full implications of the financial crash seeped in.
So Peggy, who has a gold-plated health insurance policy and is certainly able to afford health care without insurance, pffers her ideological common sense. I would suggest that a married couple with two children earning about 20000/yearly and facing life with a 13000 yearly family policy has a very different understanding of common sense. But then, how would Peggy know?
Nice attack Dan. But what are the facts? What will this thing do?
There is an old saying: “Anything the government can do for me I can do better.†The Obama, Pelosi, Boxer government run health plan is absolutely the wrong way to go. The market will be freer and offer better value in health service, if we leave it alone. It’s the best in the world now and if it weren’t why do Brits, Canadians, and others with national health care deprive themselves to come here?
My late wife and I were on medicare and medicaid. She almost died six months earlier (and maybe not at all) had medicaid not denied her a drug recommended by her doctor, because it wasn’t on the “List†of approved drugs.
Things that can be done:
1. Have insurance companies offer common policies – covering exactly the same things so that consumers can compare and competition can apply.
2. Allow small businesses to join groups that increase their number so the risk can be spread and the cost can be lessened. A hundred 20 employee small business will then be able to get the same price of a small school system.
3. Require doctors to post their prices for all routine procedures. This combined with medical saving accounts would have people shopping for the best price.
4. TORT reform
So far I haven’t used too many tax dollars
P.S. – A family of four earning 20K does not have a $13,000 policy because the children are already covered under SCHIP.
What frightens me about government health care is the Veterans Administration, which the govt has operated for the benefit of veterans for decades. I have heard many horror stories about the inferior care and insistence on following protocol at all costs. It is infierior health care. People die needlessly because of it. I dont’ want that for myself or my family.
HR 3200, the House bill now under consideration, has many elements of the FOCA (Freedom of Choice Act) bill – including federal law preempting state law, so that state mandates on parental notification, etc. would become invalid. This in addition to the once every five years mandated counselling to the elderly on end of life issues has me very worried about any federal health insurance policy.
In 1966, the year Medicare law was enacted, the cost was $3 billion and estimated to be $12 billion by 1990. Actual cost in 1990 for Medicare was $107 billion. In 2007, Medicare spent $468 billion on prescription drugs, hospital care and physician services.
The Medicare account is now projected to spend more than it gets in revenues in 2017.
Now, can someone explain to me why the government should in any way be trusted with their cost projections?
D Hamilton:
Tax healthcare plans that have a low deductable, till it is cheaper to have a high one, turning “healthcare” plans back into insurance. Encouraging people to pay out-of-pocket will increase competition rather than stifle it. Subsidize the poor if you must, but limit it to the poor..If you possess a 50″ widescreen TV, a computer, and a late model car you are not poor.
Modify tort law so that a physician doesn’t have to risk his livelihood and well being on a twist of fate every time he does a procedure.
Please Read Krauthammer’s editorial that is in Sunday’s (July 26th) Augusta chronicle. It is one of the best analysis of where the issue now stands. Krauthammer points out that even if Obama’s plan is cost neutral the cost is still to high since present health care costs are unsustainable, hence the need for health care reform!
I’m surprised that more people aren’t outraged by the fact that the health care “reform” proposals specifically exempt the President, and Congress from participating in them. Instead, taxpayers will continue to pay for the best medical coverage money can buy for them.
Tort reform is big. Much medical care is defensive and the doctor knows it is not needed. Frivolous litigation is easily dealt with in the courts. I defended doctors in my past life. The system needs to recognize and provide for the times when harm is done by the system and there are long term costs as a result. There has to be some provision for these serious cases.
What Dan Crawford says makes a lot of sense? First, those who can afford health care can have absolutely no say in reforms of the American health care system- their input is tainted by their wealth. Secondly, those who struggle to afford health care should get to decide how it works. Thus we come easily to the Obama solution: let’s have the Noonan’s of the world pay for the the health care of both parties, fair isn’t it?
10, I agree. The President and Congress should be prohibited from opting out.
Dallasite, I have a few members of my congregation who are quite happy with the VA. They get good care, and it is more reliable than the alternative: nothing.
Tort reform wouldn’t make bills go down very much. What would make bills go down is changing the incentive structure: results rather than services.
Costs are going to increase immensely if nothing changes. Someone will have to pay; and people will continue to get mediocre care. But here questions are fairly transparent:
Will whatever health care bill is produced by Congress increase the deficit? “Of course.†– that assumes that there are NO savings by eliminating the corporate bureaucracy that tries to refuse claims.
Will it mean tax increases? “Of course.†Yep: a business will no longer spend $13,000 on insurance, but pay $7,000 in taxes for a public program.
Will it mean new fees or fines? “Probably.†Is this a problem? we pay fees for drivers licenses and parking tickets. It’s whinging.
Can I afford it right now? “No, I’m already getting clobbered.†And sicker. Is this the person making more than $250,000 and up to his eyes in debt? Or is it the person making $40,000? Because that person wouldn’t have to pay very much, depending on the system.
Will it make the marketplace freer and better? “Probably not.†If this is common sense, it’s an example of how common sense is often faulty. Kenneth Arrow showed decisively that health care breaks traditional free-market rules. If anything, there is evidence that a universal health care makes economies strong, and helps businesses.
Is our health-care system in crisis? “Yeah, it has been for years.†So…. we should just…. let things go?
Is it the most pressing crisis right now? “No, the economy is.†Will a health-care bill improve the economy? “I doubt it.â€
Spending on health care will create lots of jobs – and not just jobs for insurance industry bureaucrats, but actual health care jobs.
how about Congress put themselves on the same plan they are proposing? then maybe I’ll buy into the idea that it might work, and not result in the figurative equivalent of putting the old onto ice floes in the Arctic Ocean.
John (#14) -The cost of practicing liability defensive health care is, from some of my reading, 20% of the cost of health care. Krauthammer, who was a physcian before a diving accident render him a quadraplegic really does under stand what is going on. I suggest you read his column!
Driving is a priviledge, what power gives the government the right to force me to buy health care? Please explain where the federal government has that power? Please also explain how the government will poay for this!
This is being presented as yet another “urgent crisis” which demands “immediate action.” I would far, far rather see proposals which have been thoroughly worked through in committee hearings in a bill which everyone has read and considered carefully. Now, in the middle of a major recession, is absolutely not the time to embark on a massive new spending program whose unintended consequences will be very large. This is recklessness.
heh – David, perhaps you are one of those few people who will always be healthy. God bless you if this is the case.
The economics are fairly plain. When everyone contributes, we are able to address the normal vicissitudes in our lives with lower expenses.
If you could live on an island without anybody else, go ahead.
John, nice try, I don’t mind contributing and do (most conservatives give more of their own treasure than do liberals) but you have not adressed the issue of constitutional authority and the cost. Look at the promises of other government run programs the stated cost and see how the projections have worked out!
John, as usual you are taking the collectivist point of view. But the last part of Noonan’s article, to me, is the most important. It shows the ultimate in collectivism – socialism – commune ‘ism living: You are too fat and you’re going to have a heart attack, so why should we pay for that, when you can solve that problem by going on a diet or by eating more healthy foods. (Our PB is on record as saying we Americans are harming the ozone layer more than anyone else because – now believe this, it is true – because we eat too much beef, which causes raising too many cows, which causes too much bovine abdominal gas to rise to the ozone level – yes she has said that! Environmentalism will become a part of healthcare – already has.) Smokers will be persecuted (already are). Anything that could cause healthcare costs, which can conceivably be avoided will become subject to government intervention and control/ thus, enviromental issues will be tied in with healthcare so that all of our lives can be controlled more fully by government. And – fetuses that tests show are flawed will be routinely required to be aborted because why should the public in general have to pay for such expensive healthcare for that fetus after birth, when it can be aborted right now and all that money saved? Elderly people – forget it. Soylent Green is coming.
You may say I’m being extreme here, and perhaps I am, but this is the road Mr. Obama’s statements and the “wellness” emphasis (requirement) on healthcare reform has put us on, and we shall continue down it, unless Noonan is correct, that this whole thing in Congress at present is stopped.
So now you say to me, well something has to be done. I say back to you, ok, you have people who don’t have healthcare insurance – they can go to ERs but you don’t like that; you want them to have healthcare insurance so they can be like everybody else (even though everybody else pays for that insurance). OK, come up with a program to give them what medical care they need. But why are you changing my healthcare to do that? Why does my healthcare have to suffer, in order for you (Mr. President) to provide someone else with healthcare? What gives you the right to say to me – in a country where we are free to contract for anything as long as it is not illegal – that YOU ARE GOING TO LET ME KEEP MY HEALTHCARE IF THAT IS WHAT I WANT TO DO, when, in fact, your plan is not to allow me to do that and, in fact, is to fine me if I don’t join a healthcare plan that is “qualified,” in other words, a plan that you want me to be in (which you will assign me to if you don’t like the plan I’m presently in of my own choosing).
As you can see, John, your love of collectivism and my love of individual rights are meeting head on in this debate, and Noonan seems to think the tide is turning in my direction. I sure hope so.
Can someone point me to a government program that is well-run?
Can someone explain to me why people from countries where they have “free” national health programs come to the United States to get medical care here?
The Obamas took over 3 months to choose a dog for themselves. Can someone explain to me why we have to take less time to completely change our medical system here in the USA?
Just askin’.
[blockquote]Can someone explain to me why we have to take less time to completely change our medical system here in the USA?[/blockquote]
The more I find out about this bill, the more it becomes evident that it is about much, much more than “health care”. Why would a federal bureaucracy need to have electronic funds transfer access to every American’s bank accounts to provide “health care”?
Before the election, I worried that Obama might be a closet Marxist. This attempt leaves no doubt. The only way to foist it off on us is to pass it before we can read it. Fortunately, enough congress critters seem to have read enough of it to realize that their careers are likely over if they vote for it.
These people have a list
The Wall Street Journal isn’t very complimentary either
August is the silly season, when the critters come home and you can buttonhole them at a cookout. Might be a good plan this year.
Hi Billy,
I would be careful with the use of the term “collectivist.” A more accurate term is “social insurance.”
I’m a bit confused about your comments about smoking and obesity. Your comment about soylent green is amusing, but it seems a bit conspiratorial. I don’t think keeping things the same will prevent some animosity toward the old and frail. What is true is that the last 7 weeks of most people’s lives are the most expensive for the system. What does this mean? We don’t know.
The problem with the “market” in health care has to do with issues such as the uncertainty of being healthy; the knowledge gap between doctors and patients; the contagiousness of disease. These make the market a bit clumsy. They aren’t simple transactions – if anything, the fee for service tends to drive up prices.
I don’t believe that a public plan would mean that you would lose your insurance. It would probably mean that, if you owned a business, you’d rather your employees take the public plan at a lower cost than give them an expensive plan. There are all sorts of models out there, but in the end, insurance companies and doctors will have to realize that making money off sick people (or healthy people) ends up making a mess.
You’re a smart guy, Billy. You know there’s a big difference between the Netherlands and Albania. One is a capitalist country with a national health care system. The other was “collectivist.” To assert that modern European democracies are… “collectivist” strains the historical meaning of the word, and places them in the same box as the Soviet Union. I mean, do you really think that Canada is a Marxist country?
If anything, I’m for universal health care because I think it will be a boon to businesses. Health care costs will be more evenly distributed, and businesses won’t have to manage the numerous insurance bureaucracies who make killing from denying people coverage.
John,
There are ways to do what you are talking about without involving the Federal government so deeply in it. To fine people for not having health insurance and put them in a plan is government intrusion at a level unheard of in this country, and you know it. Of course I’m not saying Canada is Marxist, but it does have a socialist medical system that doesn’t work and that has seen its quality plummet since the system was forced on Canadians. “Social insurance” are two nice words for our government forcing people to go into collectives to insured by healthcare policies that the government decides are appropriate.
A better way is to use the system in place – private enterprise system – and to provide tax incentives to get insurers to help set up and agree to cooperatives of different kinds of businesses or locales or whatever kinds of groupings can be organized to spread the risk among all persons, and lower costs so that the working poor can afford it and so employers can again begin to provide it to their employees as a benefit of employment. (The poor will always be with us and need Medicaid, which we are and will always have to pay for with our taxes.) Tax incentives worked to help baby boomers begin saving for their retirements in the mid-90s and created a huge boom in the economy. It can do the same thing here – only the wrong people are in power (as they were before the mid-90s when tax incentives were finally unleashed and began to work).
As far a medical care costs are concerned, Medicare has effectively held down actual costs to the consumer for most care, even for those paid for by private group coverage. The present system needs some help, but it does not need the tremendous invasion our present Fed government is trying to install.
“Of course I’m not saying Canada is Marxist, but it does have a socialist medical system that doesn’t work and that has seen its quality plummet since the system was forced on Canadians.”
Billy, this is the sort of argument that requires backup. For example: what is the lifespan or quality of life of most Canadians; how much on average do people pay per person; what is the percentage of people who try to get care elsewhere? What is Canada’s infant mortality? I’m completely willing to reconsider the Canadian system if you can give me what your criteria are and argue why they are crucial criteria. Why, for example, is setting an appointment a couple months ahead of time worse than having no health insurance at all?
Second, do doctors have power in canada? Or bureaucrats? In our country, its bureaucrats who see patients as customers.
We already have a private enterprise system in place, which creates an incentive system where hospitals, doctors and insurance companies work against one another. Think about this: how does a patient, who is sick, quantify his health? It’s not exactly like buying a car.
I do admit, I don’t share the instinctive anti-government attitude. For many years, serving the USA was considered patriotic. The government was truly by the people and for the people. Somewhere along the way, we’ve decided that the Government of the USA is against the people. What sort of people do we elect to govern, if we presume that government is evil?
A few commentators have said that if you hate government, get elected and then mismanage it. Then everyone can say how terrible government is.
There was a time when being an elected leader was also a way of serving the country: with the belief that one’s institutions should be managed well and truly for the people – not just lobbyists or businesses. It is sad when we’ve decided government is incompetent.
The Pygmalion Effect applies also when we discuss such institutions.