Health Care Reform Dead

[Jug Pilot]

http://thinkprogress.org/2010/02/24/...er-subsidiary/

Transcript:

WEINER: You guys have chutzpah. The Republican Party is the wholly owned subsidiary of the insurance industry. They say this isn’t going to do enough, but when we propose an alternative to provide competition, they’re against it. They say we want to strengthen state insurance commissioners and they’ll do the job. But when we did that in our national health care bill, they said we’re against it. They said we want to have competition but when we proposed requiring competition they’re against it. They’re a wholly owned subsidiary of the insurance industry. That’s the fact!

LUNGREN: Mr. Speaker I ask that the gentleman’s words be taken down.

WEINER: You really don’t want to go there, Mr. Lungren. [...] Make no mistake about it. Every single Republican I have ever met in my entire life is wholly owned subsidiary of the insurance industry. That is why —

LUNGREN: Mr. Speaker I ask that the gentleman’s words be taken down once more.

WEINER: Look, the point is very simple, there are inequities in the present way we distribute insurance. There are winners and there are losers. The winners are the insurance industry. [...] There is not bipartisanship on this particular issue. The people who sit on this side, at the risk of offending anyone, generally support the idea of standing up for the American people in their battle against big insurance. And the people generally speaking who sit on this side of the chamber and specifically speaking as well in a lot of cases, simply won’t permit that to happen and haven’t for a generation. Well, that is going to end now. [...] Enough of the phonyness. We are gonna solve this problem because for years our Republican friends have been unable to and unwilling to. Deal with it!” (applause)

[Garnet]

Originally Posted by godfry n. glad

Who said health care reform is dead?

Just today, steps were taken...

I guess we'll just have to watch, see if the requisite Justice department is adequately funded and purposed to actually have some positive effect. Expect pressure at the Senate level and full-scale whining at the Executive level ("We had a deeeeeaaal, Barack!")

As I've noted before, don't expect the rest of the insurance and finance lobbys to sit by idly while this goes down. They are going to see this as a "camel's nose".

Camel's nose aside, I don't really understand what that will do. The root problem is the cost of medical care as well as insurance. If the anti-trust law addresses on the cost of medical insurance then it's just a leaky band-aid.

[Garnet]

http://www.reuters.com/article/idUSTRE61O6H420100225

Obama dominated the debate during Thursday's nearly seven hour cross-party summit on healthcare, always in command not only of the room but also of the most intricate policy details, as he personally rebutted every point he disagreed with.

[Garnet]

Perhaps the purpose of the health care summit yesterday was to clearly show the country that no compromise is possible between the two parties.

Health Economists Urge Passage of Reform - Economix Blog - NYTimes.com

We commend the President’s pursuit of bipartisan solutions. Yet the summit made plain that it is now time to move decisively and quickly to enact comprehensive reform. We believe that the only workable process at this point is to use the President’s proposal to finish the job. After long debate, the House and Senate have passed two similar bills that do crucial things to improve U.S. health care.

Health summit shows divergent views - USATODAY.com

Congressional leaders remain pessimistic that a marathon health care policy session with President Obama on Thursday will lead to compromise, which could prompt Democrats to forge ahead alone.

[BrotherMan]

Wait, wait, wait. Just wait. Six hours is a marathon now? What fucking dream land are these people living in?

[Adam]

Stupid slow Congresspeople.

[Garnet]

Whut?

[Adam]

Sorry, I was responding to Brotherman's "Six hours is a marathon now?" Obviously, a marathon should not take that long.

[Garnet]

Ahhhhhhh!

[godfry n. glad]

Originally Posted by Garnet

Camel's nose aside, I don't really understand what that will do. The root problem is the cost of medical care as well as insurance. If the anti-trust law addresses on the cost of medical insurance then it's just a leaky band-aid.

Agreed.

Single-payer is the objective, but those in power will stand in the way of doing that. The reason? They've got a program now where they dictate the prices. They can share information at will and collude as they so wish. Making that less attractive seems to certainly be a means of dislodging some of support for the status quo.

It may only be show, too. Lots of posturing about how Obama is doing something to reduce healthcare costs by "spurring competition". It's only as good as the enforcement that goes with it.

[Caligulette]

"Spurring competition" by forcing people to buy insurance and fining them if they don't. Yeah.

Besides which - why is health care down to profit and competition in the first place? This is the real heart of the matter - why are people living and dying based on the pocketbook and say so of insurance companies? Why are people denied care because they cannot afford it - people who work full time and yet have no coverage, or not enough, or who have reached the "limit" - yet there's no limit placed on how much they are *charged* by the insurance companies!

Come to that - why isn't business lobbying HARD for single-payer nationalized health care? Think of the savings they would have in not having to cover their workers.

[godfry n. glad]

Originally Posted by Caligulette

"Spurring competition" by forcing people to buy insurance and fining them if they don't. Yeah.

Forcing them into anti-trust provisions of federal commercial law does not force anybody to buy anything. It should, if it worked properly, force health insurance companies from collusion and price-rigging.

[Adam]

Originally Posted by Caligulette

"Spurring competition" by forcing people to buy insurance and fining them if they don't. Yeah.

The thing godfry is talking about "spurring competition" is a recent bill to repeal the insurance industry's exemption from anti-trust laws. The mandate (part of a different bill...well...several different bills) isn't intended to spur competition, but to hold costs down in a market where insurers aren't allowed to discriminate.

[Garnet]

Originally Posted by Caligulette

"Spurring competition" by forcing people to buy insurance and fining them if they don't. Yeah.

Besides which - why is health care down to profit and competition in the first place? This is the real heart of the matter - why are people living and dying based on the pocketbook and say so of insurance companies? Why are people denied care because they cannot afford it - people who work full time and yet have no coverage, or not enough, or who have reached the "limit" - yet there's no limit placed on how much they are *charged* by the insurance companies!

Come to that - why isn't business lobbying HARD for single-payer nationalized health care? Think of the savings they would have in not having to cover their workers.

I don't get this either. I don't understand why businesses all over the US aren't lobbying for single payer. Health insurance is a big fucking nightmare for all of them. Why the hell are they sitting on their hands?

[Plant Woman]

Originally Posted by Garnet

I don't get this either. I don't understand why businesses all over the US aren't lobbying for single payer. Health insurance is a big fucking nightmare for all of them. Why the hell are they sitting on their hands?

I don't either, it would certainly save them huge amounts of money.

[Jug Pilot]

It is really strange. Why would they not want something that would make them more money?

[lisarea]

Most employers aren't required to offer health insurance, and a lot of them don't, so there's that.

And among those that do, that's some pretty big leverage they have against their employees. There are a lot of people who are effectively trapped in their jobs because they need their health insurance.

[Garnet]

Well, I'm looking for a different job because of the way my employer slashed my health insurance and basically hung me and everyone else who works in Lansing out to dry. I have heard of stories of people being trapped because of a medical but I think that's far from the norm. What I see happening is that employers are making huge cuts in medical insurance benefits because of escalating costs and the effects of the recession. My own company just had the worst year ever and is about a heartbeat away from being delisted from NASDAQ.

I really can't see that employers who do offer medical insurance would be too terribly upset if that whole bureaucratic nightmare went away.

[yguy]

Originally Posted by Caligulette

Besides which - why is health care down to profit and competition in the first place?

Because people have to be paid to provide it.

This is the real heart of the matter - why are people living and dying based on the pocketbook and say so of insurance companies?

Because people don't want to pay the full cost of the health care they get, so they buy insurance hoping they'll come out ahead.

Why are people denied care because they cannot afford it -

Where is this happening?

Come to that - why isn't business lobbying HARD for single-payer nationalized health care? Think of the savings they would have in not having to cover their workers.

Probably because business owners themselves don't want to partake of gov't run health care, and because any financial relief to their businesses will be offset by increased taxes and the downturn in the economy resulting from increased government control.

[just me]

It is my present opinion that health care reform at the federal level should not occur in the US. It is my opinion that it should occur at the state level. The US is a pretty unique place in that it is a collection of independent states that all agreed to a union under a constitution. Since the union began the federal government has grown and grown in it's power. States have to comply or the taxes they paid to the federal government won't be sent back to maintain roads. It's really pretty silly. I do think a strong federal government is a good thing in some aspects, but I also think it has it's disadvantages too. In terms of health care reform I see it as a real disadvantage.

Nobody really knows what the overall effect of any proposed health care reform will be, but everyone knows the current system is unsustainable as it is increasingly denying coverage to more and more people.

Clearly 'a fix' is needed, but what should that fix be?

It is my opinion that the federal government is simply incompetent to come up with a fix. Senators and Representatives have already more or less gone on record as saying 'if you want my support, buy it'. They want huge pork concessions to their states or they won't support health care reform. Ultimately we the voters need to ID these folks and vote them out of office, but I certainly am not holding my breath.

What I think Obama should do is restore some power to the states and let the states handle health care reform. The states with the senators and reps who don't want reform can have their politicians answer to the voters of that state. The states who do want reform can band together and try a solution. Some solutions might really suck and backfire and others might be really great. Over time what works and does not work will become self evident.

I do not believe the US should adopt Canadian or European solutions, I think we should develop our own solution and it should be *better* than any solution to date. I don't see the federal government as being capable of this, but I do believe if the individual states were empowered to pursue reform at least one of them would stumble upon something brilliant.

[lisarea]

What specific powers do you think the states need to implement health care reform on their own? Because they already have a fair amount of leeway, and they haven't really done anything much with it.

And even if we were to remove whatever barrier stands in the way of states instituting their own healthcare systems, state plans would suffer from having a smaller pool of 'insured' as well, so they'd have that to overcome. Whatever innovations states were to come up with on their own would have to account for the losses incurred by having a significantly smaller risk pool. And, of course, poorer states would have a far greater burden, and frequently have a greater need as well for health care services (think coal mining in West Virginia, for example).

And what are the flaws as you see them of the Canadian and assorted European health care systems that the individual states would improve upon? There are a lot of different systems out there with proven track records, and with well documented issues, solutions, and nagging problems. Why the need to reinvent the wheel and discount all of that out of hand?

[just me]

Originally Posted by lisarea

What specific powers do you think the states need to implement health care reform on their own? Because they already have a fair amount of leeway, and they haven't really done anything much with it.

Before I begin I want to thank you for a very nicely worded, intelligent response.

In terms of what specific powers the states need, they really do not need any powers not granted under the US constitution. Under the constitution the states have all the powers they need to tackle health care reform. The problem is they only have that power in theory. To give a little example, the city I live in was out of compliance with federal regulations because we have an airport (a small one) with a road that is a few feet too close to the airport. This road has been around for many years and there has never been any problem on this road. The federal government said it would deny road improvement funding unless this road was closed. It got closed because the local government is dependent upon state/federal funding to maintain roads.

This is just a tiny, single example of how the federal government wields power. Individual communities/cities/states might think they have a good thing going, but ultimately the federal government controls the money and therefore states/cities comply with the feds or they are cut off from funding. It simply is not the case that states have any real power these days because the federal government can simply extort them if they do not approve of the actions of the state.

What Obama would need to do is make it clear that things like federal dollars would not be granted or withheld on the basis of what states did with health care. This would free states to pursue their own solutions without fear of repercussions.

And even if we were to remove whatever barrier stands in the way of states instituting their own healthcare systems, state plans would suffer from having a smaller pool of 'insured' as well, so they'd have that to overcome. Whatever innovations states were to come up with on their own would have to account for the losses incurred by having a significantly smaller risk pool. And, of course, poorer states would have a far greater burden, and frequently have a greater need as well for health care services (think coal mining in West Virginia, for example).

I agree with you, but I do believe you are underestimating the power of a single state's population and we aren't yet talking about multiple states joining together upon a solution. Folks who work for small companies generally have to deal with the awful 'pre existing condition' clause, but folks who work for large companies usually do not. The difference is a company with 1,000 employees versus one with 100,000. The larger company has more power to control the conditions of the insurance and any state, no matter how small it's population, is larger than any corporation. The individual state can and in my opinion should be negotiating health insurance for it's citizens.

And what are the flaws as you see them of the Canadian and assorted European health care systems that the individual states would improve upon? There are a lot of different systems out there with proven track records, and with well documented issues, solutions, and nagging problems. Why the need to reinvent the wheel and discount all of that out of hand?

I am not really looking to reinvent the wheel, rather I am wanting to avoid copying a wheel with already known issues. I don't have any fundamental problem with Canadian or European systems, but they all have their problems. My point is that by empowering individual or collective states to implement reform allows for multiple approaches to the problem instead of a single approach. The approach that does the best job can reveal itself over time and then be adopted nationwide.

Today the federal government is attempting to reform health care and it is failing to do anything meaningful due to all the negativity and necessary compromise to appease all the senators and reps from each state. There are some states that simply view health care reform as a really bad idea and they are standing in the way. I don't think it is likely this is going to change. It does not need to change. The states that want reform can implement it and those that do not want reform can avoid the issue.

Health care is ultimately about the individual and their families. I see no reason to have a broken health care system affecting individuals and their families while waiting on a federal response when states should be able to deal with this issue with a lot less fuss.

[godfry n. glad]

Originally Posted by Garnet

Well, I'm looking for a different job because of the way my employer slashed my health insurance and basically hung me and everyone else who works in Lansing out to dry. I have heard of stories of people being trapped because of a medical but I think that's far from the norm. What I see happening is that employers are making huge cuts in medical insurance benefits because of escalating costs and the effects of the recession. My own company just had the worst year ever and is about a heartbeat away from being delisted from NASDAQ.

I really can't see that employers who do offer medical insurance would be too terribly upset if that whole bureaucratic nightmare went away.

I'm trapped. It's call 'pre-existing conditions'. If I transfer to any other insurance company, I might as well not be covered. Between health insurance and retirement programs, it's called 'golden handcuffs'.

Insurance coverage is part of the discipline tool which some employers use to keep some workers docile.

[lisarea]

Oh, sorry, Garnet. I missed your post somehow.

But yeah, like godfry says, it isn't uncommon for people to keep or even get jobs in the first place just for the health insurance. As bad as many group policies are, they're better than private insurance, which is little more than a polite fiction people use as a placeholder to prove they had continuous coverage. In the industries I've worked in, a lot of people are prevented from freelancing or starting their own businesses primarily or solely because they wouldn't be able to get even remotely useful health insurance on their own.

And any kind of universal or near universal healthcare coverage plan would effectively eliminate the option for businesses to cut back or eliminate those costs, as your employer and many others are doing now.

[Garnet]

Originally Posted by godfry n. glad

I'm trapped. It's call 'pre-existing conditions'. If I transfer to any other insurance company, I might as well not be covered. Between health insurance and retirement programs, it's called 'golden handcuffs'.

Insurance coverage is part of the discipline tool which some employers use to keep some workers docile.

I have a boatload of pre-existing conditions as well which effectively means that I must get insurance through an employer. So, in that sense, I'm trapped as well meaning that I can't go hourly or contract to hire.