OBAMA’S HEALTHCARE REFORM MALPRACTICE
Josiah Swampoodle – The only people Obama and congressional leaders are barring from the table in discussions of healthcare reform are people who advocate healthcare reform. You can’t solve a problem by only talking to those who created it.
James Ridgway, Unsilent Generation – In a much-anticipated statement, Barack Obama announced what is largely a public relations end-run by the health care industry, designed to trim a few scraps off of the nation’s porcine health care budget, while preserving its basic system of medicine for profit.
Executives from the Advanced Medical Technology Association (the medical device manufacturers lobbying group), the American Hospital Association, the American Medical Association, America’s Health Insurance Plans, and the Pharmaceutical Research and Manufacturers of America, as well as the Service Employees International Union, pleged to “do our part” to reduce health care costs. Their vague, pie-in-the sky promise amounts to just a 1.5 percent reduction in the growth rate of health care spending. Such is the explosion in health care costs that even this miniscule reduction represents a potential $2 trillion saving over 10 years. But there’s no guarantee this figure will be achieved. As the Washington Post points out:
“The groups did not spell out yesterday how they plan to reach such a target, and. . . they offer only a broad pledge, not an outright commitment. . . .In addition, White House officials said, there is no mechanism to ensure that the groups live up to their offer, only the implicit threat of public embarrassment.”
Public embarrassment” By Big Pharma and the health insurance companies–two of the most shameless industries in the history of corporate capitalism? In any case, even if the $2 trillion reduction is achieved, it clearly won’t come out of industry profits. The Post reports:
“Signers of the letter said that large amounts could be saved by aggressive efforts to prevent obesity, coordinate care, manage chronic illnesses and curtail unnecessary tests and procedures; by standardizing insurance claim forms; and by increasing the use of information technology, like electronic medical records.”
So let’s get this straight: Saving all this money depends on getting Americans to eat less? Good luck with that one. And the other brilliant cost-saving measures involve getting doctors to create computer records of all the overpriced drugs they prescribe to patients, and giving patients easier forms to fill out before they get turned down six times by their private insurance companies?
Do you see a pattern here? None of these changes would make a dent in the industry’s bottom line – and what’s more, they could even enhance profits, by encouraging government-funded programs to help private companies streamline their bloated bureaucracy (much of which would instantly become superfluous under a public, single-payer system. . .
And what might the industry get in return for this generous “cooperation”? The Kaiser Daily Health Policy report today rounded up the possibilities:
“The [Wall Street] Journal reports that although the groups did not ask for anything in return for the pledge, many of the factions are looking to prevent regulations that could “pose new burdens” or affect their profitability. For example, the health insurance industry is seeking to offset any reductions to their payments by obtaining new rules that would require all U.S. residents to have health coverage, according to the Journal. The Journal reports that health insurers have made several concessions intended to prevent a public option – which they fear could affect their profitability – as part of reform legislation . . .
In other words, the underlying purpose of this PR stunt is to slow or block any meaningful health care reform, which could actually improve care while reducing the price tag by a lot more than 1.5 percent. . .
ABC News -While the country’s health care leaders pledged Monday to reduce the annual growth of health spending by 1.5 percentage points — which they say will save $2 trillion in 10 years — some health policy experts say that it is unlikely that Americans will see any of this money returning to their own pocketbooks, despite the crippling health care costs that some face. . .
Karen Davis, president of the health care foundation the Commonwealth Fund, said the public would likely share the trillions of dollars saved by the year 2019.
“Administration officials calculate that this 1.5 percentage point reduction will produce an average savings of $2,500 for a family of four in the fifth year,” Davis said. “This is clearly a step in the right direction.”
But Ted Marmor, professor of Public Policy and Management at the Yale School of Management, called such expectations “wishful thinking.”
“I think that if you were a betting person, you’d lose a lot on that bet,” Marmor said. “This is utterly unrealistic.”
Part of the problem, Marmor said, is that even with the 1.5 percent reduction, health costs will still be growing at a projected rate of 4.7 percent per year.
Even then, he added, the steps that the stakeholders would have to take to achieve even this reduction would require a significant deviation from the status quo.
“All of [the changes] are much harder to do than is being suggested here,” Marmor said. “Customary practice is very hard to change.”
John Graham, director of Health Care Studies at the Pacific Research Institute in San Francisco, Calif., had an even more pointed response to the effort.
“If the interest groups in any other American industry colluded on a plan to control costs, they’d be charged under the anti-trust laws,” Graham said. “The American people should not tolerate health-care interest groups collaborating with the government to form the mother of all cartels, rationing our health care to adhere to a federal budget.”
Craig Crawford, CQ Politics – While President Barack Obama courts the health care industry his administration is distancing itself from big labor’s plan to expand Medicare. In a round of interviews, Health and Human Services Secretary Kathleen Sebelius completely ruled out making Medicare available to more Americans as part of the president’s health reform package.
But that is exactly what one of Obama’s staunchest campaign supporters, the AFL-CIO, is calling for. The labor giant’s retiree advocates, the Alliance for Retired Americans, is observing Older Americans Month on its website by urging the federal government to lower Medicare eligibility to age 55 from age 65, the current floor for accessing the government-sponsored program.
If Obama were not trying to please private industry, the labor union’s plan would make the most sense. The trouble with expanding Medicare is that such a move diminishes the market share for private insurance companies.
Expanding Medicare, while possibly the best solution for average Americans, would ignite corporate opposition that Obama apparently wishes to avoid.
Clay Burell, Education Change – President Obama and Arne Duncan like to compare U.S. education – unfavorably, typically – to that of Korea, where I currently live. Here’s an educational comparison they don’t share: the number of uninsured people in America is roughly equal to the entire population of Korea, where all 50 million Koreans are covered by national health care.
Maybe, just maybe, health insurance for all is a factor in those dazzling Korean test scores. Maybe the tough love our education “reformers” urge we show toward our underprivileged students should be shown also to our vested health care interests, their lobbying millions be damned. . .
One of the best ways you can help improve public education and erase the achievement gap is to push for affordable health care for all.
The Senate Armed Finance Committee certainly isn’t pushing for it for us – maybe because its chair, Montana Sen. Max Baucus, has taken more money from the health insurance and pharmaceutical lobbies than any other Democrat in Congress, and is excluding single-payer advocates from ongoing health care reform roundtable talks. . .
Do I have to say anything more than that healthy parents and children are likely to learn better than unhealthy ones? And that making health care accessible and affordable to the more than 45.7 million uninsured Americans – and the millions more who are underinsured – will create more healthy parents and children?
Penelope Lemov, Governing – According to the Boston Globe, a state commission is poised to recommend to the governor and the legislature that insurers radically change how doctors and hospitals are paid. They will recommend that the current system, in which insurers typically pay doctors and hospitals a negotiated fee for each individual procedure or visit, be replaced with a set payment for each patient that covers all that person’s care for an entire year.
Variations of such a plan are being discussed for national health reform. Payment reform is seen as one of the more effective ways of taming costs. It could discourage doctors and hospitals from providing unneeded tests and treatments, and it could force the medical community to provide better post-hospital care so that patients who survive, say, heart surgery, aren’t readmitted when their condition deteriorates because they didn’t understand follow-up instructions. Massachusetts would be the first state to broadly adopt such a system.
M.S. Bellows, Jr, Huffington Post – Healthcare will continue to be increasingly expensive for consumers, but not quite as quickly as it was going to be. 7% per year inflation will become 5.5% per year inflation — that is, if the participants keep their promise. Which, according to the officials, they’ll do, not because there’s any kind of enforcement mechanism – there isn’t one – but simply because they’re “Americans.”. . .
The senior administration officials were hyperbolic, if not hyperventilated. One, focusing on the political battle to enact healthcare reform, called this promise by industry trade groups “a game changer.”
The other official, focusing on economic issues, saw this as nothing less than the salvation of the entire federal budget:
“I don’t think there could be a more significant step to help struggling families and to help the federal budget than reducing the growth rate of healthcare spending by 1.5 percentage points per year. . .”
Remember, we’re talking about slightly reducing the rate of growth in health care costs, not a reduction in health care costs themselves. . .
Am I the only one who is puzzled at the Administration taking these groups at their word? . . . Many of the groups participating in this initiative historically have opposed health care reform and are large donors to the Republican and Vichy Dem politicians who are preparing to mount a political and rhetorical battle against health care reform. . .
Robert Pear, NY Times – Robert Gibbs, the White House press secretary, said Mr. Obama had told the health care executives, “You’ve made a commitment; we expect you to keep it.” If history is a guide, their commitments may not produce the promised savings. Their proposals are vague – promising, for example, to reduce both “overuse and underuse of health care.” None of the proposals are enforceable, and none of the savings are guaranteed. Without such a guarantee, budget rules would normally prevent Congress from using the savings to pay for new initiatives to cover the uninsured. At this point, cost control is little more than a shared aspiration.
David Sirota, Open Left – In 2003, Obama said he supports a single-payer health care system, and that the only reason we “may not get there immediately” is “because first we have to take back the White House, we have to take back the Senate, and we have to take back the House” – which, of course, we have. . .
In 2006, I spent a day with Obama in the U.S. Senate, and he said he supports a “debate” on single-payer, but that he also had started having doubts, now that he was in the Senate. . . Obama said that although he “would not shy away from a debate about single-payer,” right now he is “not convinced that it is the best way to achieve universal healthcare.”
By last week, it became clear that Obama and his allies in Congress will use their legislative leverage to prevent even a debate about single payer. . .
The whole idea that single payer is the best option but politically “impossible” is simply unacceptable. Last I checked, electing an African American president was politically “impossible”. . . until Barack Obama went ahead and got himself elected president. The entire notion of “politically possible” and “politically impossible” is a canard that justifies the status quo. So while it’s certainly terrific that Obama is fighting for some sort of universal health care system, and one with a public option (which could ultimately become a single-payer system), let’s just remember: Nothing has been politically possible until it actually happened – and so if that’s the major argument against single payer, it’s not just a poor argument, it’s a fraud.