View Full Version : The Health Care Reform debate

08-18-2009, 02:14 PM
I think Bob Herbert of the NY Times pretty much sums up the debate to this point. I would have to agree with him. Looks like big business might win again. To bad, I thought we really had a good chance of some serious health care reform.

It’s never a contest when the interests of big business are pitted against the public interest. So if we manage to get health care “reform” this time around it will be the kind of reform that benefits the very people who have given us a failed system, and thus made reform so necessary.
Forget about a crackdown on price-gouging drug companies and predatory insurance firms. That’s not happening. With the public pretty well confused about what is going on, we’re headed — at best — toward changes that will result in a lot more people getting covered, but that will not control exploding health care costs and will leave industry leaders feeling like they’ve hit the jackpot.

The hope of a government-run insurance option is all but gone. So there will be no effective alternative for consumers in the market for health coverage, which means no competitive pressure for private insurers to rein in premiums and other charges. (Forget about the nonprofit cooperatives. That’s like sending peewee footballers up against the Super Bowl champs.)
Insurance companies are delighted with the way “reform” is unfolding. Think of it: The government is planning to require most uninsured Americans to buy health coverage. Millions of young and healthy individuals will be herded into the industry’s welcoming arms. This is the population the insurers drool over.
This additional business — a gold mine — will more than offset the cost of important new regulations that, among other things, will prevent insurers from denying coverage to applicants with pre-existing conditions or imposing lifetime limits on benefits. Poor people will either be funneled into Medicaid, which will have its eligibility ceiling raised, or will receive a government subsidy to help with the purchase of private insurance.
If the oldest and sickest are on Medicare, and the poorest are on Medicaid, and the young and the healthy are required to purchase private insurance without the option of a competing government-run plan — well, that’s reform the insurance companies can believe in.
And then there are the drug companies. A couple of months ago the Obama administration made a secret and extremely troubling deal with the drug industry’s lobbying arm, the Pharmaceutical Research and Manufacturers of America. The lobby agreed to contribute $80 billion in savings over 10 years and to sponsor a multimillion-dollar ad campaign in support of health care reform.
The White House, for its part, agreed not to seek additional savings from the drug companies over those 10 years. This resulted in big grins and high fives at the drug lobby. The White House was rolled. The deal meant that the government’s ability to use its enormous purchasing power to negotiate lower drug prices was off the table.
The $80 billion in savings (in the form of discounts) would apply only to a certain category of Medicare recipients — those who fall into a gap in their drug coverage known as the doughnut hole — and only to brand-name drugs. (Drug industry lobbyists probably chuckled, knowing that some patients would switch from generic drugs to the more expensive brand names in order to get the industry-sponsored discounts.)
To get a sense of how sweet a deal this is for the drug industry, compare its offer of $8 billion in savings a year over 10 years with its annual profits of $300 billion a year. Robert Reich, who served as labor secretary in the Clinton administration, wrote that the deal struck by the Obama White House was very similar to the “deal George W. Bush struck in getting the Medicare drug benefit, and it’s proven a bonanza for the drug industry.”
The bonanza to come would be even larger, he said, “given all the Boomers who will be enrolling in Medicare over the next decade.”
While it is undoubtedly important to bring as many people as possible under the umbrella of health coverage, the way it is being done now does not address what President Obama and so many other advocates have said is a crucial component of reform — bringing the ever-spiraling costs of health care under control. Those costs, we’re told, are hamstringing the U.S. economy, making us less competitive globally and driving up the budget deficit.
Giving consumers the choice of an efficient, nonprofit, government-run insurance plan would have moved us toward real cost control, but that option has gone a-glimmering. The public deserves better. The drug companies, the insurance industry and the rest of the corporate high-rollers have their tentacles all over this so-called reform effort, squeezing it for all it’s worth.
Meanwhile, the public — struggling with the worst economic downturn since the 1930s — is looking on with great anxiety and confusion. If the drug companies and the insurance industry are smiling, it can only mean that the public interest is being left behind.

08-18-2009, 03:34 PM
Just think of all the conservatives who are delighted with the recent turn of events.

Some of them, if there is any justice in this universe, will lose their jobs and their health care benefits, and get sick with a very expensive chronic illness that they can't afford to pay for.

So, "incorrect" political views should be punished with a chronic illness..?

Interesting idea of justice.

By any chance, would you be averse to the idea of you losing everything and spending the rest of your life as a beggar in India -- just in the interests of global justice, of course..?


08-18-2009, 03:46 PM
So, "incorrect" political views should be punished with a chronic illness..?

Interesting idea of justice.

By any chance, would you be averse to the idea of you losing everything and spending the rest of your life as a beggar in India -- just in the interests of global justice, of course..?

KaaIf he'd spent goodly chunks of his life working like hell to keep Indian beggars poorer than dirt first, you mean ...

Actually, I think you'd find quite a few people in India who'd make quite an interesting discussion of karma.

08-18-2009, 03:51 PM
If he'd spent goodly chunks of his life working like hell to keep Indian beggars poorer than dirt first, you mean ...

Not necessarily. All you need to do is be "delighted with the recent turn of events."

For example, you might be delighted with the fact that some customer-support centers are moving back from India to the US. :-)


08-18-2009, 04:09 PM
the public pretty well confused about what is going on

Dear American public, allow me to explain what is going on. Your health care is run by corporate entities who's principal goal is to provide you with the least amount of care for the most amount of money. And in the case of pre existing conditions, to provide no care whatsoever to those who are likely to need it the most. It seems odd to a non-American that so many of you defend such a situation as essential to your freedom. But that's your business. Other countries define freedom somewhat differently.

08-18-2009, 04:17 PM
Your criticism of my sentiment might have some validity. All you'd have to do is demonstrate someone...

What exactly does my opinion about your sentiment have to do with what some person might or might not think in some specific circumstances?

As they say, there are no atheists in foxholes...

Which is false, of course. You really think atheists run like little kids to God-daddy at the slightest whiff of personal danger?

if conservative's politicians aren't supporting an alternative plan, then, by definition, neither are the conservatives.

So, Norman, if the liberals' politicians are not supporting single-payer (and they don't seem to), so, "by definition", neither are liberals?


Milo Christensen
08-18-2009, 04:40 PM
The health care reform debate is over. It is so, so tempting to do the Joe CSOH you lost, we won, bwaaaahaha thing, but the reality is we all lost.

Keith Wilson
08-18-2009, 04:44 PM
The health care reform debate is over. Don't be so sure. the convetional wisdom about this issue has been wrong so many times I've lost count.

Milo Christensen
08-18-2009, 05:22 PM
Health care reform is dead. The possibility of "reforming" private health insurance for the vast majority that has health insurance may still happen, extremely watered down. It's looking more and more like there will be mandatory health insurance, ala Massachusetts, but with much lower income levels for the insurance subsidy. I wouldn't be surprised if the bill comes out with a cost of $500 billion over 10 years. That's way down from the $1.6 trillion the CBO said the original committee's bill would cost, which was scaled down to a trillion dollars by lowering the income level for the subsidy.

08-18-2009, 05:46 PM
The Democratic party is a 'wide tent' party, unlike the GOP (where politicians who dare to dissent from Rush Limbaugh end up apologizing). Therefore, there's a wide range of opinion. Sure, the more liberal members of the Democratic party would like to see a true single-payer health care system... the more conservative Democrats do not. However, until the GOP (and their corporate money men) launched an utterly unprecedented disinformation campaign a few months back, ALL Democrats were more or less supportive of the Obama plan. The money men got to the Blue Dog Democrats, in a classic 'divide and conquer' move.

LOL. So, let's see.

There are major differences among Democrats with regard to health care -- you're saying the liberal wing would like single-payer, while the conservative wing is opposed to it, right?

However ALL Democrats supported the Obama plan :D Ah, magic. I guess that's because the wide tent supports a wide range of opinions...

And now, purely because the GOP and evil, EVIL corporations "launched an utterly unprecedented disinformation campaign" -- UTTERLY UNPRECEDENTED!!eleven! :D -- there are Democrats who no longer support the "Obama plan". Did the wide tent get wider? Hell, by now even Obama doesn't support the Obama plan, he's been backpedaling so fast he gets all the exercise he needs from it! I guess the money men got to him as well, eh?

So, what is it, Norman? Is it the case that there are serious differences between Democrats about health care and the the current misshapen monstrosity of a mess in Congress reflects these differences along with Obama's inability to prod, cajole, and buy enough unity? Or were all Democrats united, huddled together in a small tent until the morbid machinations of the money men split them asunder and some Democrats just couldn't resist the siren song of money? Pick one.


High C
08-18-2009, 06:27 PM
.... Have you forgotten the Obama campaign, and the incredible money machines (Unions, Soros, foreigners) who marketed his lies and disinformation in order to sell him to the "'low information' voters" who elected him?


Bob (oh, THAT Bob)
08-18-2009, 06:41 PM
I'm cutting and pasting this because articles in the NYT are usually viewable only for 24 hours without membership.

August 17, 2009
Op-Ed Columnist
The Swiss Menace

It was the blooper heard round the world. In an editorial denouncing Democratic health reform plans, Investor’s Business Daily tried to frighten its readers by declaring that in Britain, where the government runs health care, the handicapped physicist Stephen Hawking “wouldn’t have a chance,” because the National Health Service would consider his life “essentially worthless.”

Professor Hawking, who was born in Britain, has lived there all his life, and has been well cared for by the National Health Service, was not amused.

Besides being vile and stupid, however, the editorial was beside the point. Investor’s Business Daily would like you to believe that Obamacare would turn America into Britain — or, rather, a dystopian fantasy version of Britain. The screamers on talk radio and Fox News would have you believe that the plan is to turn America into the Soviet Union. But the truth is that the plans on the table would, roughly speaking, turn America into Switzerland — which may be occupied by lederhosen-wearing holey-cheese eaters, but wasn’t a socialist hellhole the last time I looked.

Let’s talk about health care around the advanced world.

Every wealthy country other than the United States guarantees essential care to all its citizens. There are, however, wide variations in the specifics, with three main approaches taken.

In Britain, the government itself runs the hospitals and employs the doctors. We’ve all heard scare stories about how that works in practice; these stories are false. Like every system, the National Health Service has problems, but over all it appears to provide quite good care while spending only about 40 percent as much per person as we do. By the way, our own Veterans Health Administration, which is run somewhat like the British health service, also manages to combine quality care with low costs.

The second route to universal coverage leaves the actual delivery of health care in private hands, but the government pays most of the bills. That’s how Canada and, in a more complex fashion, France do it. It’s also a system familiar to most Americans, since even those of us not yet on Medicare have parents and relatives who are.

Again, you hear a lot of horror stories about such systems, most of them false. French health care is excellent. Canadians with chronic conditions are more satisfied with their system than their U.S. counterparts. And Medicare is highly popular, as evidenced by the tendency of town-hall protesters to demand that the government keep its hands off the program.

Finally, the third route to universal coverage relies on private insurance companies, using a combination of regulation and subsidies to ensure that everyone is covered. Switzerland offers the clearest example: everyone is required to buy insurance, insurers can’t discriminate based on medical history or pre-existing conditions, and lower-income citizens get government help in paying for their policies.

In this country, the Massachusetts health reform more or less follows the Swiss model; costs are running higher than expected, but the reform has greatly reduced the number of uninsured. And the most common form of health insurance in America, employment-based coverage, actually has some “Swiss” aspects: to avoid making benefits taxable, employers have to follow rules that effectively rule out discrimination based on medical history and subsidize care for lower-wage workers.

So where does Obamacare fit into all this? Basically, it’s a plan to Swissify America, using regulation and subsidies to ensure universal coverage.

If we were starting from scratch we probably wouldn’t have chosen this route. True “socialized medicine” would undoubtedly cost less, and a straightforward extension of Medicare-type coverage to all Americans would probably be cheaper than a Swiss-style system. That’s why I and others believe that a true public option competing with private insurers is extremely important: otherwise, rising costs could all too easily undermine the whole effort.

But a Swiss-style system of universal coverage would be a vast improvement on what we have now. And we already know that such systems work.

So we can do this. At this point, all that stands in the way of universal health care in America are the greed of the medical-industrial complex, the lies of the right-wing propaganda machine, and the gullibility of voters who believe those lies.