This is not real health care reform

December 17, 2009 | By | 4 Replies More

Howard Dean on what pretends to be “health care reform”:

Real reform would significantly lower costs, improve the delivery of health care and give all Americans a meaningful choice of coverage. The current Senate bill accomplishes none of these. Real health-care reform is supposed to eliminate discrimination based on preexisting conditions. But the legislation allows insurance companies to charge older Americans up to three times as much as younger Americans, pricing them out of coverage. The bill was supposed to give Americans choices about what kind of system they wanted to enroll in. Instead, it fines Americans if they do not sign up with an insurance company, which may take up to 30 percent of your premium dollars and spend it on CEO salaries — in the range of $20 million a year — and on return on equity for the company’s shareholders. Few Americans will see any benefit until 2014, by which time premiums are likely to have doubled. In short, the winners in this bill are insurance companies; the American taxpayer is about to be fleeced with a bailout in a situation that dwarfs even what happened at AIG.

I entirely agree with Dean.  I would like to tear up the current proposals and start over. I’d do it in two steps. First, quickly pass a bill with all of the low-hanging fruit, to get them out of the way: for example, requiring portability and prohibiting rejection of new customers based on pre-existing conditions. Only then, proceed with the brunt of the program. Let the expensive part of the program live or die on its own merits. Undistracted by the low-hanging fruit, we can better evaluate how much the new program would cost and what the tax-payers would get for their money.

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Category: Health Care Reform

About the Author ()

Erich Vieth is an attorney focusing on consumer law litigation and appellate practice. He is also a working musician and a writer, having founded Dangerous Intersection in 2006. Erich lives in the Shaw Neighborhood of St. Louis, Missouri, where he lives half-time with his two extraordinary daughters.

Comments (4)

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  1. Erich Vieth says:

    Comment by "Braden" at Yglesias's blog:

    This is no Child Left Behind for health care. When a policy is both bad on its merits (doesn’t do nearly enough to reduce the cost of health insurance) and bad politics (requires citizens to purchase a substandard product with little or no competition and no government-provided alternative) it will become a horrific piece of zombie legislation that will stand in the way of any attempt to reform the system in the future.

    http://yglesias.thinkprogress.org/archives/2009/1

  2. Tom Degan says:

    I don't know what kind of health care reform will come out of this session, but I strongly suspect it won't be much. There is, however a silver lining behind this very dark cloud. I am reminded of the Civil Rights Act of 1957. Don't be embarrassed if you've never heard of it, there really isn't a hell of a lot to remember about it; a mere pittance, really – a scrap of leftovers tossed out to "American Negros" (in the parlance of the age) in order to appease them. But it made the passing of the Civil Rights Act of 1964 – the one we remember – all-the-more easier seven years later.

    We'll live to fight another day.

    http://www.tomdegan.blogspot.com

    Tom Degan

  3. Erich Vieth says:

    It looks like I'm going to get my way on Health Care Reform. It appears that the White House is going to focus on all those desperately needed reforms on which everyone agrees.

    Only then should we go to Phase II, which needs to stand on its own merits, if it stands at all. Real health care reform, like it or not, needs to be financial sustainable. It needs to involve serious cost containment. It shouldn't require citizens to buy policies from private insurers that are lying in wait to screw them, because there is no option. To be financially sustainable and politically sustainable, it might be that the coverage offered to the poor might be less expansive (akin the the Oregon state plan) than the expensive coverage for which many middle class voter work long hours in order to make the premium payments. It should (in my opinion) involve a single payer that could essentially be an expansion of Medicare. It should developed in a transparent process that does not invite private health insurers or their lobbyists to the table. It should give real relief to many of the people who cannot afford insurance, at a cost that is clearly explained to voters. It should repeal the antitrust exemption for health care insurance.

    I would LOVE to say that we should have a gold-plated private health insurance policy for every single American, but I don't see how that is affordable, certainly without massive cost-containment, and I suspect that the quality of health care will reform will suffer with substantial cost-containment. Having said that, I am certain that much of the "treatment" we are offering is utterly wasteful. There is no better evidence for this than the chart that recently appeared recently in National Geographic. Countries that spend far less per capital have equal or great expected life spans than Americans. Meaningful health care reform will invoke all of these cost-containments that seem to work well enough for most other countries.

    Here's another reality check. Obama's plan was toxic for at least half of Americans because it makes our long-evolved cheater-detector alarms go crazy. Family A has two hard-working adults that deny themselves many things in order to buy expensive health care for themselves and their children. Family B consists of two parents who have screwed around all their lives, never worked hard in school or since, and and not working hard enough to support their children. They sit around most of every day and watch television. They make so little that they are in line to get essentially free health care coverage under the plan that Obama has now apparently abandoned. And for good reason. It was this palpable sense of unfairness that drove many conservatives to hate this plan. That is why I think that the only politically palatable approach is some basic (nationally affordable) coverage (similar to the Oregon plan) for everyone. Anyone needing antibiotics, a cast for a broken leg, or the removal of operable brain tumors should get the treatment, no questions asked. If you want more than that, you're free to supplement the basic government plan with your own private coverage for such things as liver transplants for alcoholics and high cost drugs of that have only a 30% change of extending your life by 15 months. Hate it if you will, but this is the only kind of health care reform that I can imagine to A) help many of those who are desperate, B) not break the budget, and C) not piss off those who work extra hard for what they have.

  4. Erich Vieth says:

    Frank Rich explains how Obama's vagueness killed him on health care reform:

    "[T]he master communicator in the White House has still not delivered a coherent message on his signature policy. He not only refused to signal his health care imperatives early on but even now he, like Congressional Democrats, has failed to explain clearly why and how reform relates to economic recovery — or, for that matter, what he wants the final bill to contain. Sure, a president needs political wiggle room as legislative sausage is made, but Scott Brown could and did drive his truck through the wide, wobbly parameters set by Obama. Ask yourself this: All these months later, do you yet know what the health care plan means for your family’s bottom line, your taxes, your insurance? It’s this nebulousness, magnified by endless Senate versus House squabbling, that has allowed reform to be caricatured by its foes as an impenetrable Rube Goldberg monstrosity, a parody of deficit-ridden big government."

    http://www.nytimes.com/2010/01/24/opinion/24Rich….?

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