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April 30, 2007

Health Care, Health Care, Health Care

by at 5:06 pm.

I didn’t have time last week to talk about Niki Tsongas’ response to the questions raised from her comments at Greater Lowell Area Dems (boy, is that a convoluted sentence or what? to say nothing of the links therein). But if I had, it probably would have been a lot like Charley’s response:

As to the substance of her post … well, there really wasn’t much. She correctly identifies the problem (47 million uninsured, more underinsured, high cost of coverage). But her proposed solution is not that of a leader who understands the issues at hand, but of a blind follower: Just do what Massachusetts did — after all, it’s good enough for Deval Patrick, Obama, and Edwards, and they’re all good people.

Besides the fact that the jury is still definitely out regarding the Mass “universal” (and I put that in quotes because it’s not entirely true) care plan, there were serious red flags even as the thing got out the starting gate. For instance, is the most efficient way to deliver health care to go through the private industry? Isn’t that just one more middle man getting his cut before the care is delivered? Not a good use of taxpayer money, in my opinion, just a revenue-stream giveaway to big business that addresses none of the real issues, like cost of care (and big pharma), and doesn’t seem to address quality problems either. So what will we be getting? Well, basically, an individual mandate forcing people who cannot afford it to buy health insurance from the very same people who suck at delivering it in the first place. And Tsongas expresses confidence in this plan?

Maybe this is the emerging “issue” in this race - certainly, I bet we can distill differences on each candidate’s position on how to end the war, or on trade and foreign policy - and perhaps health care doesn’t deserve to be the all-consuming pivot point. However, I do know how important this issue is to me personally, after six years of being one slip-n-fall shy of medical cost hell as an uninsured self-employed worker, and I know it’s real key to the wages and budgets of workers, businesses, and governments alike.

Dick has more on the Sun article which came out today looking at each candidate’s position. I note that Eileen Donoghue has rather echoed Tsongas. Sure, she and all the others support “universal health care” in principle, but that devil is in the details. How is this not going to be a giveaway to big business? How do you address the inherant conflict of interest between the core right to quality health care versus some HMO’s bottom line? That conflict plays itself out in cutting out the riskiest members (or making them pay through the nose), in denying care outright, or in tying a patient up in red tape so deep Jacque Cousteau couldn’t dive it.

Is it any more “impossible” to get the private health care industry reformed (read: regulate them properly so they can’t screw people in this most important of services) than to get single-payer health care? Not until the candidates that pander to the health care industry lose enough elections. Because those corporations have lots of money to fight to keep the status quo, which suits them - and their ever-increasing profits - just fine.

I know it would be a tough slog to totally remake our health care system now that the big corporations are entrenched. I know reform should go slow, if only because reducing private insurance means thousands of layoffs of health insurance workers (that 20%+ administrative overhead employs a lot of people). But if we give in before we even begin, then we start from a position of total weakness and once again, nothing will ever change except the exact details of what bandaid to use the next time. The Mass health care plan is the biggest bandaid yet. And inevitably, we’ll be back in another decade or two, with this same lament about how little quality even insured citizens get for their hard-earned dollar, never mind the thousands of uninsured, and how much it’s costing our economy. Do we ever learn from our mistakes?

[Update: Regarding this phrase from Tsongas - “…Massachusetts Universal Health Care Plan, which was supported by Deval Patrick when he was a candidate for Governor and that he continues to strongly support today” - Patrick always spoke of it with serious caveats. He supported the plan as a first step. He also talked about its major flaws and gaps, too. I wouldn’t quite say that’s a ringing endorsement of the MA plan.]

11 Responses to “Health Care, Health Care, Health Care”

  1. Robert Recht Says:

    Single payer is the only solution. HR 676, John Conyers, Mich. His proposed bill is the best I’ve seen in 20 yrs.
    web site: healthcare-now.org. fighting for its passage in congress–site has summary of the law. 62 Democrats co-sponsors so far in his congress. This org is nat’l and growing. Kucinich is co-author.

  2. Jim Says:

    Help make May about health care ideas not empty attacks.

    http://5dollarsforhealthcare.blogspot.com/

  3. Beyond 495 » MA-05 Healthcare Throw-down Says:

    […] t, 2007 by Susan M.

    First the shout outs: Dick Howe, BMG, Lowell Sun, Left in Lowell, and little ole me have all written about the continui […]

  4. waittilnextyr Says:

    Copied from misplaced response of April 30th.

    To begin, I don’t know what the best answer to the health care problem is, although it seems that a single payer system may be the most efficient. But, I wouldn’t jump into Medicare as a solution to all the ills, as we all understand that it currently operates on the principle that more-pay-in-than-receive-benefits, so its funding is not unlike a ponzi scheme, which eventually (when all become beneficiaries) apart.

    Consider your statement:
    “Not a good use of taxpayer money, in my opinion, just a revenue-stream giveaway to big business that addresses none of the real issues, like cost of care (and big pharma),…”

    The “big pharma” won the battle with Medicare with language that prevents Medicare from negotiating drug prices with them. That is one example where the competing private plans beat the politically-operated system, and I am sure there would be others if that were the only choice.

    It may be better to attack the cost-drivers of the Health Care system than the system itself, and I would bet they would include incentives for added tests and care, whether it be the liability insurance, unnecessary health risk aversion, profits for new equipment sales, etc.

  5. Lynne Says:

    The only reason Plan D failed however, is because the US Medicare government-run health care insurance wasn’t allowed to compete by negotiating for lower drug prices, like every private company already does. I’d say that’s a failure of policy, not of the idea of single-payer itself. Fix that problem, you fix Plan D.

    Medicare is not exactly a ponzi scheme. What you have is one group of people who are no longer productive (the retired) having their health care paid for by productive workers (the retired having themselves paid for the previous group of seniors via their own previous productivity). What I am advocating is in addition to that, you create a revenue stream for current workers to be insured via the single payer system. The only reasons there’s a problem with Medicare is that there’s one generation (the baby boomers) which is larger than normal and they’re all going to be requiring a smaller pool of subsequent generations to be taxed for their care. It appears this problem can be solved by small increment increases in the payroll tax for Medicare, or at least that was true for Social Security before Bush raided the SS surplus for his stupid war and huge deficit spending. (Remember Gore’s lockbox?) Of course, we’re on the hook for that money we borrowed against that surplus anyway. For Medicare, I suspect we’ll be biting the bullet a little bit, but if you spread that burden fairly (like, progressive taxation so that rich people who don’t spend a huge percentage of their income for necessities take on a progressively larger burden) I doubt it’ll be too economy-dragging. The alternative is to let our parents and grandparents die off of things that they could have otherwise survived, because the private insurance companies sure don’t want to put these riskiest of populations into their pools. (That’s why Medicare was invented in the first place.)

    The fact is, that if you replace your private health care premuims with a tax (let’s say we tax corporations for 1/2 the revenue for insuring non-seniors as well, and individuals through a payroll tax the other 50%), it appears you end up saving money. You no longer pay private premiums, so that’s a good $250-$600+ you get to keep, but your payroll tax via a single payer should, by many calculations, actually be smaller (especially if the single payer system addresses cost and quality issues and because it is universal, preventative and early care will stave off many serious cases that would have burdened the system much more had they been left to become serious). That means more money in the pocket of the worker, and more money in the pocket of the employer too, so maybe they could invest in their businesses and give their workers raises. (Or, in the case of most conglomerates, give their CEOs bigger bonuses. *sigh*)

  6. Jay Booth Says:

    I’m not an expert but from what I know of the situation, Plan D was pretty much written by pharmaceutical and insurance lobbyists. Somehow we wound up with a plan that spent more money on providing less care and someone’s pocketing the difference.

    Nice post though Lynne and you’ve gotta give it to the Sun for writing that article on healthcare - the more issues-based articles, the better.

  7. Jay Booth Says:

    Oh, and Lynne the medicare future liabilities problem is much bigger than the SS one, mostly because healthcare costs keep going up so much faster than the cost of living. The last set of numbers I saw, medicare is not really addressable by a small bump in the payroll tax (and that tax is super unfair anyways - only taxes the first 90k of income?).

  8. Mr. Lynne Says:

    Here is a comparison of other systems:

    http://www.prospect.org/web/view-print.ww?id=12683

  9. Mr. Lynne Says:

    The sad part about the Iraq war is that the medicare problem would have been cheaper to address.

  10. Lynne Says:

    Well, yeah, Mr. Lynne’s got that right…

    Defund the war and cover our seniors!

    I also think we should consider raising the minimum age for Medicare/SS. People are living longer and healthier lives (my grandparents, long live ‘em, have been retired now for going on 30 years and still kickin’) so I don’t think reexamining the age of retirement is off the table, both for cost and for reasons regarding the sheer # of retired vs worker problem.

    Jay: I do suspect you’re right (don’t have the #s in front of me). However, our economy is growing by how much again? CEO pay and the top 1% of income earners are getting how many more times the average worker again? This is not just about the average person giving a little more, it’s about the rich giving a LOT more. Because they can, and still be filthy rich.

    RE the Sun article I agree. It was a really GOOD article, and substantive, and about the issues. I like the fact that I can praise the Lowell Sun for doing the right thing in this circumstance. It makes my job so much easier and happier. :)

  11. Daniel Says:

    I couldn’t understand some parts of this article Health Care, Health Care, Health Care, but I guess I just need to check some more resources regarding this, because it sounds interesting.

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