Tear up the health care bill and start over.
I wrote a comment on this same issue last night, but I wanted to make it into a post as well, given the importance.
Marcia Angel, M.D., former editor of the New England Journal of Medicine, is highly critical of the proposed “health care reform.” Although she admits that it accomplishes a few things, it is worse than doing nothing.
It throws more money into a dysfunctional and unsustainable system, with only a few improvements at the edges, and it augments the central role of the investor-owned insurance industry. The danger is that as costs continue to rise and coverage becomes less comprehensive, people will conclude that we’ve tried health reform and it didn’t work. But the real problem will be that we didn’t really try it.
Read the full post at Huffpo for Angel’s clear and understandable ideas for meaningful (and not corrupt) health care reform. I agree with Angel that the current bill is an industry-coddling joke and that it is worse than doing nothing, for the reasons she offers. The House bill has a few pieces of low hanging fruit (e.g., portability), but at great unnecessary expense and waste. We need to tear up this celebrated new bill (celebrated by the Democrats, anyway) and start over. For more on Angell’s ideas for reform, also see her recent appearance on Bill Moyer’s show.
Well, I’m not a lawyer, but I am not unfamiliar with legal lingo in relation to health care, as I’ve had tp manage for several years of paperwork for myself, my wfe and my older son, all of us with chronic medical problems.
I’m currently up to page 361 in the bill and while some parts are vague and concern me, several other parts stand out as addressing many of the past anti-consumer practices by corporate insurers.
Several parts seem to be designed to enable workers to transfer their insurance coverage to a new employer.
Other parts seek to increase competition between insurance providers. One part targets the unethical practice used by some large businesses (e.g. Walmart) that offer unfordable insurance coverage to their workers, then help them sign up for Medicaid.
However, it is not a complete retooling of the health care finance system, but a a busload of band-aids trying to patch the holes in the current system.
One thing that I am for is the establishment of a standardized electronic medical records system with provisions to make it available to all healthcare providers, including single doctor practices and small clinics. Such a system, if designed properly, can provide better health care, prevent fraud, and after the database has built up for a few years, can provide a resource that can be analyzed to identify at-risk groups for preventative treatment, as well as help identify environmentally related health problems.
I remember the Tax Reform act of 1986. The basic idea was to simplify the tax code. The result was turning a book of rules into a bookcase of rules. Few of the old loopholes were plugged and many more were created. The rich still evaded as much as ever, and the poor paid as much as before. More tax accountants were needed for more hours because fewer normal people could figure out the “simplified” rules.
This is just one example that I recall of how well committees do in reforming big systems of rules written by earlier manifestations of the same committee, composed of or influenced by those who don’t really want to change.
Niklaus: The bills will all grab the low-hanging fruit, addressing the abuses of insurers regarding portability and unfair cancellation.
I haven’t read more than 20 pages of the House bill, but I would assume that the obviously necessary and popular portions would be a small sliver of this bill. Most of the language, I suspect, is to shovel huge amounts of tax dollars into the accounts of private insurance companies, except for the crumbs off the table that will go to the relatively few people who will end up with the “public option.” I think that Marcia Angell’s criticism of this approach is spot-on.
From Today’s NYT:
Even as drug makers promise to support Washington’s health care overhaul by shaving $8 billion a year off the nation’s drug costs after the legislation takes effect, the industry has been raising its prices at the fastest rate in years.
http://www.nytimes.com/2009/11/16/business/16drugprices.html?_r=1&hp
Per the NYT, it’s time to tell Big Pharma to shove it:
The drug industry has been ramping up its prices in advance of any health care reforms that might clamp down on its profits. The industry’s rapid price escalation over the past year threatens to make a mockery of its deal with the Senate Finance Committee and the Obama administration to contribute $80 billion over the next decade to help pay for covering tens of millions of uninsured Americans.
http://www.nytimes.com/2009/11/18/opinion/18wed3.html?_r=2&adxnnl=1&ref=opinion&adxnnlx=1258549529-1ih+H0IGRBPKrwkN/u/x3A
This doesn’t surprise me, any more than finding out that my doctors bill the insurance companies more than twice what has been deemed “reasonable and customary” in order to get a fraction of that. In order to cover costs, they need to raise prices, because prices in health care have become pretend money. Once again, those bearing the brunt of it are the people who aren’t part of the problem in the first place - the uninsured. For them, the pretend prices are the actual cost, putting health care even further out of reach.
Well I’m up to page 1000 in the house bill. A lot of the bill addresses specifically the loopholes that have been exploited by large corporations like Wal-mart that have permitted those companies to put most of their employees on public health care or to deny them access to coverage. Some actually includes provisions for making those corporations pay for the coverage under medicaid (and medicaid waver programs) on employees they they dump into the public health care system.
Parts of it also address the outright fraud by insurance companies and various medical suppliers. In the past, the penalties were often far less than the additional profits from the fraudulent activities. The will mean no more $10 aspirins
Niklaus: I admire your determination. There are probably only a few hundred people in the entire country who have read the first 1,000 pages. When you finish, I’ll invite you to read the Senate version too, so that you can do a comparison.
Niklaus: How many hours have you spent just to reach page 1,000?
Ya know, I thought NO ONE actually read those bills. I’ve always wanted to slip in weird, off the wall statements and regs that make no sense into the middle of such a document to see if anyone is actually reading them.
Jay, I agree. A lot of the house bill, particularly where Medicaid reform is concerned, references specific paragraphs in the Medicaid laws. Understanding the full effect of the changes wil require reading those as well.
I’ve often thought it would be fun to get an amendment to repeal or suspend an obscure law of physics, such as the chandrasekhar limit, and see how many people take it seriously.
Kill the senate health care bill. A rising chorus of those who seek meaningful heath care reform propose that we tear up the monstrosity emerging from the Senate.
http://www.huffingtonpost.com/2009/12/15/kill-the-bill-some-progre_n_392436.html
Glenn Greenwald argues today that the bill is pretty much exactly what President Obama wanted all along.
Brynn, thanks for the link to Greenwald’s post. I read it as a stinging indictment of the White House:
From the start, assuaging the health insurance and pharmaceutical industries was a central preoccupation of the White House — hence the deal negotiated in strict secrecy with Pharma to ban bulk price negotiations and drug reimportation, a blatant violation of both Obama’s campaign positions on those issues and his promise to conduct all negotiations out in the open (on C-SPAN). Indeed, Democrats led the way yesterday in killing drug re-importation, which they endlessly claimed to support back when they couldn’t pass it. The administration wants not only to prevent industry money from funding an anti-health-care-reform campaign, but also wants to ensure that the Democratic Party — rather than the GOP — will continue to be the prime recipient of industry largesse . . . What remains is a politically distastrous and highly coercive “mandate” gift to the health insurance industry . . .
http://www.salon.com/opinion/greenwald/2009/12/16/white_house/index.html?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+salon%2Fgreenwald+%28Glenn+Greenwald%29
Labor leaders are fuming at the concessions that Democratic leadership made in the last few days to win the support of the caucus’s most conservative members . . .
http://www.huffingtonpost.com/2009/12/16/labor-holds-emergency-mee_n_394070.html
Democrats lashing out at Obama regarding health care reform. They concur that we have the bill Obama wanted all along and that the bill Obama wanted is not impressive.
http://www.huffingtonpost.com/2009/12/16/democrats-lash-out-at-oba_n_394424.html
Howard Dean explains why we should tear up this bill and start over. http://abcnews.go.com/GMA/HealthCare/howard-dean-health-care-bill-bigger-bailout-insurance/story?id=9349392&
What I find appalling is that the Republican party is working very hard to sabotage healthcare finance reform, not because it is detrimental to big business, and not because they have a better idea, but because the health care finance reforms are a Democrat idea. As part of a strategy to regain Republican control of the government. By causing these reforms to fail the issue can be spun as a failure of the Democrats in general and of Obama in particular.
As for what Obama wanted, well I don’t read minds, (it’s very impolite and can make a person go crazy). I do suspect that the senate bill is closer to what Obama expected as the worst that could be achieved from the bunch of out-of-touch-with reality dolts that we elected to the senate.
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