Posted by We, the American people, find ourselves in quite a conundrum. Our elected officials and the White House who have spent hundreds of hours working on health care reform have lost sight of its original purpose, which is to bring down the cost of health insurance and get as many people who are not currently insured the primary and preventative care that will help them stay well and live long lives. What Congress and the White House have created, however, is a circus of partisan bickering, scare tactics, unfair and outrageous accusations and thousands of pages of federal rules, regulations, fees and taxes.
Whether the federal government should be involved in changing the way we receive health care in America is another issue entirely. Many agree that government works best when government does less, particularly on a federal level because Americans have better and direct access to local and state authorities as opposed to access to the federal government. Others contend that without the federal government, high health care costs will get higher and that medical insurance companies have become increasingly corrupt utilizing unfair and abusive practices that extort money and good health care from the individual, in order to make money beyond what is an already profitable industry.
The current one-party posture of Congress and the White House does not serve the American public well and reflects one-party ideas, when traditionally the federal government works best with a myriad of ideas. Consider important welfare reform legislation which passed under a Democrat President Clinton, and a Republican majority in Congress led by House Speaker Gingrich. Adding to the problem of one-party ideas in the health care debate, is the odd and over the top love fest that many in the media have for anything Obama, we the American people are inundated with biased news coverage making it difficult to discern which ideas will work best.
It is time to call on the federal government and the White House to take a step back. To stop meeting behind closed doors with just Democrats deciding the fate of American health care. It takes courage for an official to admit that while hundreds of hours have been in the making of the legislative proposals circulating Congress (which has undoubtedly been a long and strenuous process); it does not mean that the end result is the best course of action. It is time for Democrats in Congress to show constraint by listening to the American people, and start acting in a bipartisan manner so that health care reform actually works and does not adversely affect individual costs and access to healthcare. Let us go back to the drawing board with ideas from both sides of the aisle.
Unless leading Democrats and the White House move in a bipartisan manner, moving forward, we, the American people have no other choice but to stall and call. Stall the passage of healthcare reform, not because we do not want health reform, but because the health care reform that is on the table is too expensive, unclear, and may very well drive private health insurance costs up and access to healthcare down. Stall until after the midterm elections in November 2010 at which time the American people can lobby their elected officials and candidates seeking representation for the type of reform we think is best. Stall by calling, emailing and snail mailing your local and state representatives to reconsider legislation that does not have bipartisan consent. (Mr. President, with all due respect, one lone Republican Senator from Maine supportive of the Baucus bill does not equal real bipartisan support.)
There is a way out of this spiraling black hole. We must be vigilant, unafraid and committed. Committed to doing what is best for our country but does not trample individual rights, committed to reaching a comprise between political parties and ideas, and committed to being an active member of the American experiment which is representative of we, the American people.
Good blog, Raquel. My position is that health care costs starting going up within a decade after establishment of two government programs: Medicare and Medicaid. In the rest of the world government limits the amount of testing and the kinds of operations people can get. In America, the public health schools and the literature on health reform is largely dominated by socialists who do not consider two issues:
1. The role of market-driven health in innovation. Most medical innovation has occurred in the United States, which is also the only nation with anything remotely resembling a free market in health care.
2. Excessive use of health services is stimulated by tax exemption of health benefits. This is further magnified by government-paid benefits.
3. Health care is one of several government-dominated fields that have not experienced globalization and so have had costs increasing much more rapidly than general inflation. These include higher education and government services (including lower education) as well as health care.
4. Health services can be globalized and can be treated as other products. An operation done in India or Mexico costs one tenth of what it costs here.
5. Americans are willing to pay 10% of gross national product to satisfy narrow-minded chauvinism-that American doctors are better than Indian doctors and so globalization of health services is an absurd idea.
6. In my region and yours, Kingston, NY and New Paltz, NY, virtually all of the physicians were born in India, Arabia and other countries that are likely suspects for globalization of health care.
7. Globalized health care can be regulated through joint treaty by the countries involved and America’s health providers are fully capable of developing quality systems equal to those in other industries such as Japanese car makers.
8. The health care debate is fake. There is no need for health reform if regulation is scrapped and health companies are free to globalize as companies in low cost industries have and high cost organizations in education, government and health care have not.
So long as the American people prefer chauvinism and regulation over affordable health, I have little to say to them about this topic except, as in most every field, the discussion is nonsensical, led by a bird-brained media.
By Mitchell Langbert on Oct 15, 2009
I generally agree with Mitchell.
The entire lesson of planned economies should be clear to anyone with a mind open to inquiry. It does not work, and the big reason is that it is far too complex with so many moving pieces for any organization or collection of people to properly and efficiency maximize use of resources.
Some targeted things can be done to make the process more competitive.
As far as clogging the system, it would take a sustained effort to do this. Even so consider this:
They did not listen to the calls
They did not listen to the townhalls
They did not listen to the 9-12 protesters
I am agreeable to flooding their offices with messages. It should and has to be done but do not be surprised if it falls on deaf ears.
They need removed from office.
By JJC on Oct 15, 2009
Raquel i agree about your sentiments on having one party. Although I was happy when Obama won the election when I saw that democrats had also captured majorities in the senate and house, well it gave me cause for pause. It’s much better if there is a check on one party.
Specifically related to healthcare i agree that democrats should not shut out republicans in the merging of the healthcare as they have as much vested in the healthcare bill as anyone else. But your representation of republican’s role on the healthcare debate is not complete. First i sometimes during this debate have questioned republican’s motives on the healthcare negotiations.
Initially the main objection to the democrates plan was the public option. Ok the Senate Finance committee decides to strip out the public option and then put in a compromise co-ops. during these negotiations Senator Grassley sends out leaflets blasting the plan even though they are negotiating and promotes this silly death panel idea.
Second the bill they come up with the CBO says it is too expensive and would not reduce costs. Republicans use that as a blundgeon to hammer the plan. Ok democrates go change some aspects of the bill and the CBO says the new bill will not add to the deficit and will reduce costs. So what do republicans do they berate the CBO saying their estimates are not reliable.
The fact is the republicans will not EVER vote for the democrates plan no matter what sort of compromise democrates make because they have deep ideological differences with the democrates i.e. the role of government.(only one republican vote on the senate finance bill).so far democrates have incorporated i hear about 160 republican proposals and even the end of life counselling that led to this death panel nonsense was an idea from a republican senator) Isn’t the nature of compromise the notion that you may not get ALL you want but you give and take? And typically don’t you try to negotiate from a position of strength? For all the republicans that do not want a public option do they not realize that there is another section of the population that DO want the public option? Should they or their ideas on the health care debate be ignored as well???? Again we have a compromise bill and I would have had more respect for the republican party as a whole if more had supported the senate finance bill. I for one want democrats to call republicans bluff and incorporate tort reform and interstate competition (which i agree with) and I can bet you we will not see one republican support the bill (maybe Susan Collins and Olympia Snowe). Also on that point if all we need to do was tort reform etc why wasn’t this done by the last administrator when they had their majorities?
By Reggie on Oct 15, 2009
Great blog, Raquel. Keeping my ear firmly to the ground, I have been noticing that many citizens are already totally disenchanted with President Obama. His graceful presence, and dynamic oratory really got peoples’ hopes up. Now, everyone I speak with is keeping a loaded rifle by their bed,shopping till they drop ( retail prices in clothing and fast food are very low), and hoping for the best. Everyone that I speak with is so angry, I don’t think that they can focus on any particular individual issue.Freda B.
By Freda on Oct 16, 2009
The Republicans will most assuredly go along with a bi-partisan plan that incoparates tort reform, interstate competition, individual tax deductions, etc. But such a compromise bill will never happen. Obama threw a crumb to the GOP in his address to Congress by having Kathlene Sebelius HHS czar, “look into” medical malpractice reform. But she was formerly director of the Kansas Trial Lawyers assoc, so good luck on getting tort reform into a bill.
The GOP has in fact enumerated numerous plans to cut costs and insure the uninsured, but the pissant media chooses to ignore it and claims the GOP brings nothing to the table. To say that they just oppose the Democrats becuase they didn’t vote for the Baucus bill is totally nonsense and misinterprets GOP positions. Grassley stated the GOP opposition to the Baucus bill plain as day. The individual and employer mandates that the gov’t forces you to buy healthcare or the IRS is empowered to tax a family $1500/yr is unconstitutional and a reckless idea to all but the most progressive liberals, those wealthy hypocrites who want the best for the great unwashed.
Sen Grassley was in fact trying to negotiate a bi-partisan bill in the Finance committee, but the Whitehouse stopped it, becuase they wanted to push their own “concept” bill throught the Senate committee, so they can re-introduce the public option later behind closed doors when they re-write it in legislative legalese. Don’t be so naive, Reggie. They are intent on ramming the bill with the public option down Americans throats whether they want it or not. Harry Reid says by next month, Ramm Emmanual says absolutely before Christmas, public opposition be dammned. Bi-partisan support, are you joking? How about reconciliation? That’s a 60 vote fillibuster proof majority!
What gets me and many others so disgusted is their downright arraogance and contempt for the opinions of the American people, since the GOP is a minority in Congress now, they think they can walk all over the majority of the voters. You can see that in the language they use describing the Tea Party protesters as “astroturf” and “political terrorists,” etc. But the voters will speak at the polls in 2010 and the Dems will be signing their death warrants if they ram this socialist healthcare agenda through Congress.
There are in fact some very interesting races to watch this year for 2009. The message of the voters will be delivered at the polls. Of course, the NJ race with Chris Christie is one to watch. The upstate special election of Doug Hoffman as well. I am especially interested in this one. It will be a baromter of republican thought processes, since the weak liberal candidate Dede Sacazofazza (or however you spell it) was given the GOP line and not the strong conservative Hoffamn, who is running on the conservative line. I hear that many Repubs are crossing over for Hoffman. The most telling race is Dan Halloran for NY City Council (19) who is poised to win running on 4 lines, against an unknown staffer of Gary Ackerman. I am focusing my efforts on this race since a win for Dan would send shock waves through the Dem machine in NY and make Ackerman, (his newspaper he founded, the Queens Tribune did a disgusting hit piece on Halloran attacking his religion) and his complacent minions sit up and take notice. It will be payback for the townhalls and rallies he never attended.
Now I think someone like Mitch who really thinks outside the box, should run for public office!! Cool idea about globalizing HC!
By Phil Orenstein on Oct 16, 2009
Oh yeah the whole blame the media is getting old. There are numerous media outlets in which they can present their plan. Isn’t Fox News the number one news agency in the country which predominantly features republicans? Isn’t the Wall Street Journal opinion pages littered with republican views?? online National Review,the laura Ingrahm show etc You have not yet answered why the republican party did not do any tort reform and interstate competition when they had the white house and majorities in congress seems it’s so simple? Hasn’t the country been talking about healthcare reform for about 60 years now? What about Grassly promoting this idea about “death panel” which was an idea initially proposed by a republican (end of life care)? Again not negotiating in good faith.
Also you are telling me that both parties do not have deep idealogical differences that no matter what compromises the Dems make republicans would not vote? So you are saying let’s say the finance bill had no individual mandate that republicans would vote for it?? That will NEVER EVER happen. There are 4 other bills in the house and senate without a mandate are republicans supporting that?. NO. Of course they will say those bills have a public option. Democrates for the most part believe that another entity e.g. government option or coops need to provide competition to private issurers and they see it as an essential element of healthcare reform. So what in your mind is a compromise bill huh? No coop, no public option, no mandate, if that is so what do democrates get in this compromise or bi-partisan bill??? So phil please in your words describe to be me what a bi-partisan bill would look like which incorporates democrates and republican ideas? Baucus and Harry reid saying it will pass before christmas menas some version of a healthcare reform bill will pass with enough compromises to get 60 votes.
By Reggie on Oct 16, 2009
Thanks to all for your responses, especially Freda, welcome and come again!
Reggie, I disagree with you that Republicans will not support anything that comes from the Democrats. I just think that what the Democrats have come up with (with or without the public option), are all disasters.
The proposals are all way too much government involvement, way too many taxes and fees, and way too much infringement on personal liberty. I think this type of control hampers innovation as described above by Mitchell.
With regard to the CBO numbers, two prominent and outspoken Republicans Dick Morris and Karl Rove, have explained that the current CBO numbers are based upon 7 years of collecting money without offering services. If this is true, and I have no reason to believe it is not true, the calculations do not reflect real time costs.
I am not doubting the CBO’s sincerity, what I doubt is the vague legislative language and maneuvers that the Democrats have engaged in so that the CBO can conclude a certain dollar amount. Obviously, these are all estimates based on a concept.
The bottom line is health care is expensive. Doctors, nurses, ect. ect. have to be paid for services. I think it is disingenuous for commentators to conclude that covering an additional 30 to 40,000 citizens will not result in a whole lot of money. Money that the government just doesn’t have anymore. We just don’t have it Reggie, we cannot afford to take on this huge entitlement program that may not even work properly.
With respect to insurance abuses I think that the free market handles these issues better than the government. So if the government is going to keep the insurance companies honest, who keeps the government honest??
As far as I’m concerned, the whole thing stinks!
With respect to the Bush admin. might I remind you that the President was busy prosecuting two wars and an enemy unlike we have had before. I give Bush E for effort, he tried to reach across the aisles, with No Child Left Behind and the Prescription Benefit program for Seniors.
Quite frankly, when you are anyone else premise their argument with the blame Bush mantra I become skeptical. Bush is not President anymore. There comes a point in time when anti – Bush people have to start holding the current President accountable for his actions.
Hey Jim, I must admit I agree with you, and when our peaceful protests fall on deaf ears, hopefully the American people will react at the polls next year and in 2012 for that matter.
If Obama keeps ignoring us and playing partisan games, secrecy and intimidation, he will be a one term President.
By Raquel on Oct 16, 2009
Rachael
Again I’ll pose the same question I posed to Phill, please describe to me what a bi-partisan healthcare bill would look like in your own mind that incorporates both Republican and Democratic ideas. The bill from the finance committee incorporates the following republican ideas:
1. Cross-state sales of insurance to individuals and small businesses: The Baucus bill would allow two or more states to form “compacts” that would allow individuals to buy policies from insurers in the other states. The insurers would be subject only to the laws and regulations of the states in which the policies were written. In a separate measure, insurers could create national policies with uniform, federally set benefits that could be sold in any states in which the companies are licensed. The policies would be exempt from state benefit rules.
2. Medical malpractice: The legislation says Congress should consider creating state demonstration programs to evaluate alternatives to the current litigation system. Republicans had called for creating special malpractice courts and limits on damage awards so this is along those lines.
3. High-risk pool for people with pre-existing medical conditions: Within a year of the enactment of the legislation, a high-risk pool would be set up for people with pre-existing conditions. The pool would continue until 2015, when the new state insurance exchanges would be up and running and insurers would be required to sell policies to all who apply, regardless of their medical conditions.
4. Prevention and wellness incentives: Medicare beneficiaries would become eligible for annual “wellness visits” with their doctors, paid for by the government program (again this was part of the genesis of the death panel bruhaha). They no longer would have to pay out of their pockets for certain tests and treatments, such as flu vaccinations or diabetes screening. Financial incentives also would be offered to beneficiaries who completed certain “healthy lifestyle” programs targeting risk factors such as high cholesterol, diabetes or smoking.
By Reggie on Oct 16, 2009
oh by the way Karl Rove and Dick Morriss? Really! not at all partisan, not at all against the democrats plan.Please they praised the CBO analysis on the first version of the plan which the CBO said would not reduce cost and now when the democrats make amendments to the plan to make it more cost effective and the CBO says it will they pan it? Believe whatever legitimate changes the democrates made to the plan to make it more cost effective they would still pan. I read so many of their articles (on the WSJ ),commentary ,watch them on foxnews and they are as partisan as it gets. Even O’reilly couldn’t extract one good thing about the Obama administration from Dick Morris
By Reggie on Oct 16, 2009
I will address your other points a little later Reggie, but for now, let me say that obviously I know Rove and Morris are Republican partisans, but what makes the points they have made wrong. You are shooting down the messenger not the message. The fact that the CBO are basing costs on the Democrats’ plan to collect fees and taxes for 7 years, before any output or services are provided, obviously does not reflect real time costs.
By Raquel on Oct 16, 2009
All the things you mentioned and more would make a good bill, Reggie. Add citizenship verification mechanisms so illegal immigrants aren’t covered, allow individual tax deductions, voluntary purchasing pools, portability, remove current state regulations (called “community rating” which make NYS insurance premiums one of the highest in the country becuase everyone has to pay for coverage of condoms, marriage counselling, acupuncture, toupees, etc. rather than tailoring insurance to the consumer) tax free HSA and high deductible individaul (rather than employer) plans, and many more fine cost cutting and consumer based measures. Then I’ll vote for it! But not if you throw in the public option, or individaul and employer mandates and gov’t access to every American’s medical and financial records with the ability to transfer money out of your account, without notification (that’s in HR 3200). In my book, that’s no compromise, it’s more like pouring vinegar into a fine wine and I say no way in hell.
Also as far as state experimentation with Tort Reform, it’s being already tested sucessfully in Texas and other states. Texas introduced a cap on frivilous (pain and suffering) components to medical lawsuits and premiums plumetted over 20% in 4 years. Some premiums report a 70% drop. 1000′s of Drs. are flocking to Texas to set up shop as the leave NY, NJ and other states, esp OBGYN Dr’s who can’t afford the malpractice premiums and close up shop or move south to Texas.
Talk about incubating these ideas in the states, the public option plan has been tested already in Tennessee, called TennCare and failed miserably almost bankrupting the state in the process. As more and more people left their private insurance and the uninsured rushed into the Tenn gov’t public option, which was designed to be competitive and drive down costs of private insurance, the system collapsed from the overleoad and ultimatley 100,000′s of people were terminated. Some horrific stories of people being terminated mid-surgery since the state couldn’t cover the skyrocketing bills.
The lesson from this is that the gov’t cannot run something as mammoth and personal as healthcare, and we should leave it to some of the good market consumer based reforms you and I proposed above to drive down costs and insure the uninsured. The market approach with minimal gov’t interfernece in something as personal as our healthcare would be vastly superior to gov’t run approach, I’m sure you’ll agree.
The current gov’t plans provide a textbook case of how gov’t solutions lead to massive fraus, bankrupsy and failure. Medicare and Medicaid are nearly bankrupt and with the baby boomer influx, will never be able to sustain the costs and will default without increased taxation, extreme rationing, borrowing and skyrocketing deficits. They are so frought with waste fraud and abuse that the NYT reported $19 billion is paid out annually in fraudulent claims in NY State alone. The national figure is many time more. Let’s fix the current failing gov’t plans before starting brand new gov’t plans which take over even more of our healthcare system in America.
The gov’t run public option is a menace that must be stopped and like Raquel says, don’t trust the politicans on Capitol Hill to do right by the American people. Burn down their phone lines and vote them all out in 2010 if they vote for any measure of a gov’t option in healthcare reform. I am calling my Representatives (Schumer, Ackerman and Gillibrand) every day.
By Phil Orenstein on Oct 17, 2009
The more I think about the whole transformation of the way we receive health care, the more outrageous I think it is.
I am concerned, very concerned, for all of the above reasons discussed here, and elsewhere on my blog.
Where will we go when we need care and there are not enough doctors to provide it (without America)?
Where will we go when the government dictates some kind of equation that looks like worth x age = care (without America)?
And the very last thing I want is to have the government telling me what I should eat, drink or smoke for that matter, it’s none of their business.
When the tax payer starts footing the bill for everyone’s health care see how quickly elected officials will regulate and tax everything from soda to chips.
If the socialists have their way, soon they will be monitoring your carbon footprint, how many kids you have, how often you use your electricity, water.
The prospect is scary and I wish it would stop!
By Raquel on Oct 17, 2009
Phil
My point is the ideas i mentioned are republican ideas which I believe are good ideas, also the ideas which you talk about are for the most part also good ideas. But my point is what about other ideas from the democrats. Why isn’t that included in your pool of ideas. For example;
1. Having a health insurance exchange for individuals and small employers to comparison shop.
2. Having a public option within the exchange for those who can not afford current insurance
3.If no public option having cooperatives provide competition
4. Employers having the option of either providing insurance to employees or contributing funds on their behalf.
5. No more exclusion based on preexisting conditions.
6. Having a trigger to a public option if reforms to not work out
etc
Also another question for you. Should the cost of insurance be a barrier to people seeing their doctor? What i am trying to get to is this notion of the democrat proposal overruning doctors with more patients. Remember this debate is about the provision of Health INSURANCE not govt delivery of medicalcare. Democrats for the most part are proposing the govt to be one provider of insurance not a provider of medicalcare e.g. private clincs, hospitals will still deliver care. a government option doesn’t tell you what you can have. It tells you what it will pay for. You can buy whatever you want with your own money. And any well-designed plan would allow people to purchase private insurance to cover things the government plan doesn’t.Because remember the end game of both democrats and republican ideas is affordable insurance. So from both republican and democrat proposals if insurance is more affordable more people take it and more people will go see doctors so either way the healthcare delivery system gets overrun. Because your argument from TennCare seems to be this… Let’s not get the uninsured insurance because if they do doctors will have more patients to care for than doctors. Wouldn’t the appropriate solution be let’s train more doctors/make medical school more affordable/get more primary care providers/more nurses etc As someone mentioned It is a sad fact that the bottom line should be medical care but the rhetoric and talking points are about insurance. Personally i don’t support a government operated healthcare system where doctors are government employees but a govt health insurance option does not equate to cheap medical care.They are not the same thing.
By Reggie on Oct 17, 2009
The issue is not that the gov’t plan(s) would employ Drs and nurses, but that the gov’t would run things. That is the kicker. The gov’t can’t run anything right. Medicare, Medicaid and SS are going broke and will bankrupt the nation unless we take drastic deficit expanding measures that will ultimately bankrupt future generations with debt. Do the math. These gov’t run entities don’t employ medical professionals but have massive administrative structures which cause 40% of their budget to be lost to waste, fraud and abuse and mismanagement. Fannie Mae and Freddie Mac went bankrupt and had to be bailed out. They don’t employ the bankers they insure, but the gov’t runs the agency and has run it into the ground. The US Postal Service is broke and had to outsource $1 trillion of its operations to Fedex and private contractors.
The point I’m making should be clear. We don’t want the gov’t to take any more ground in the healthcare industry, than it already has. Go back to your 6 points above and I’ll give you regulations based on #5 only. The other points involve gov’t entities running the show, and I am dead set against it and I’ll stand against any RINO Republican who goes for it like Sen Snowe.
In answer to your other concerns about the uninsured, there are viable consumer based, market driven approaches that we discussed above that will cut costs and insure all, or almost all. None of the current HC bills in Congress insure everyone. 83% of the American people who are now satisfied with their current healthcare, per Rasmussen polls, is a good starting point. Not perfect but getting there. Have faith in the ingenuity and wisdom of the ordinary hard working majority of American taxpayers to get the job done, hopefully with less of a tax bite in future administrations.
By Phil Orenstein on Oct 19, 2009