When I began reading an article by Kevin Sack in Friday's New York Times entitled For Public, Obama Didn't Fill in Health Blanks, my preconceptions about the American public broke from the gate and were off to the races.
True, as the Financial Times reported, President Obama's performance in his press conference about health-care reform may have been "uninspiring": "His points may have been true but they were not new, and he restated them in an uncharacteristically lackluster way." But maybe he's tired of trying to convince us to accept what may be, to his mind, benefits he seeks to bestow on us.
After all, hasn't the public been to hell and back with health-care costs and policies? How much more suffering from inadequate care, including the needless losses of loved ones, does it take before we agree to health-care reform?
The first family Sack wrote about, the Browns, are conservatives. The husband:
How much will this health care plan really cost, he asked. How can we cover nearly everybody without higher taxes or debt?His wife:
"What we do know is there is going to be more government control, and with more control you're going to have fewer choices. It's an innate part of being American to have those choices.""Taxes" and "choices" are, of course, conservative talking points: The Browns are speaking reflexively, not reflectively. But then the tenor of Sack's piece shifted. The two other families interviewed make it clear questions about the Democratic administration's health-care plan remain unanswered to the public.
Although she may well benefit from Mr. Obama's plan to subsidize health insurance for the working poor, Rowena Ventura, [an] uninsured worker from Cleveland, wondered whether she could afford it. "I'm worried because they're talking about forcing people to buy insurance," said Ms. Ventura, a registered Democrat and part-time health care worker. "You just can't ask any more of me. You just can't."Her concerns couldn't be more apparent, not to mention poignant. "Required-to-buy" resounds with about as much discordance as a note can. How does that jibe with a benefit? Meanwhile, a small businessman has no idea of the shape of health-care to come.
[Dean Raschke] worried that Washington would end up taxing the health benefits he provides to his 50 employees. He said he also feared that Congress would raise his income taxes to pay for the plan, although his earnings are well below the $1-million-a-year threshold now being considered.Besides the confusion, Obama's conciliatory tendencies subvert his plan. Back to Ms. Ventura:
"You see,� she said, gesturing at Mr. Obama on the television, "he's saying he wants to continue private insurance, but then he says they're part of the problem. Well, which is it? It's just ridiculous."As psychologist and neuroscientist Drew Westen wrote earlier this month:
If Obama's storytelling has a flaw, it's that he prefers to leave out the antagonists [like private insurance -- RW]. In his AMA speech, he never called the group on its opposition to Medicare in the 1960s. Nor did he mention that the insurance and pharmaceutical industries blocked reform for decades, even as their profits rose.Still, if you're like me, it's hard to imagine a change that's for the worse. (In other words, give us something, anything.) In a report at American Progress today titled Health Care Premiums Run Amok, David Cutler writes (emphasis added):
Health care costs are expected to grow 71 percent over the next decade, which will in turn drive premium increases for health insurance.� � average family premiums will grow to more than $22,000 by 2019, up from $13,100 today. In some states with higher-than-average premiums, family premiums will exceed $25,000 in 10 years. Of course, a family's total health care costs will be even higher once co-payments and other out-of-pocket expenses are calculated into the total.For all except a lucky few whose companies pick up the bulk of their premiums, our premiums are already -- as I'm wont to repeat -- like a second rent (or mortgage, as the case may be). Who can pay a third?
More at Memeorandum.
Doing nothing is not an option, nor is doing the wrong thing. We need to get the right people at the table to identify and develop solutions to address the real cost drivers. If this stays in the political realm, it will be watered down and inefficient by default.
ReplyDelete"Still, if you're like me, it's hard to imagine a change that's for the worse."
ReplyDeleteWell, a 'reform' that doesn't lower costs, reduce waste and cover more people would be worse. It would be tantamount to an inoculation against serious reform at a moment in which the public is demanding reform.
I think we are looking at a kabuki performance with one goal, a "public option." Take away everything else and that is the alternative to for-profit insurance. With that keystone in place the rest of the arch will hold. It will take time, but after four or five decades there is no need to rush. In time, with something like "Medicare for all" (**whispers**single-payer**like**Medicare/Medicaid**) half the problem is on the way to resolution. Part Two can wait on the back burner if that much happens.
ReplyDeleteLook at the shape of the struggle: the insurance industry versus everyone else. I expect the conflict to become ugly between now and Labor Day.
jmho...we'll see...
Ahh, but the public option will stall or fail unless large numbers of people sign up for it. And nearly all negotiations at this stage that involve a public option are concentrating on how to minimize the number and categories of people who can enroll in it. It's about devising ways to exclude people rather than ways to attract them to the public option.
ReplyDeleteGood point. It calls for a second-class level of care, devoid of bells and whistles (whatever those might be for those with late-found cancer, advanced kidney disease, or a bone fractures that healed wrong in the absence of prompt emergency care). I suppose that would be better than the current response to the uninsured: drop dead.
ReplyDelete