Sunday, August 30, 2009

The Time is Now -- Health Care Reform

The American political system is neither pretty nor efficient. Democracy never is -- not even republican forms. The Founders, so distrustful of the people, tried to throw as many checks and balances into the system (as well as limit suffrage to land owners), have made passage of important legislation difficult.

We stand at the edge of an important set of legislation -- legislation that has been bouncing around for more than half a century. It has emerged in various forms and the one that may emerge from these discussions is likely to be less dramatic than the ones that have emerged before. Remember that Richard Nixon proposed expanding Medicare to include all Americans -- and he was a Republican. This legislation will not be as expansive as that proposed under the Clinton's either.

While it would be nice to have a bi-partisan bill, that's not likely to happen. The only moderates left in Congress are conservative Democrats. The Republican Party has become more and more conservative, running out its few remaining moderates (they hail from Maine, I think). I agree with the New York Times editorial -- the Democrats need to abandon getting GOP support -- they're going to get little if any, even if they compromise the bills to death. So, it's time, I think, for the President to sit down with the Blue Dogs, remind them that the GOP won't budge, and then find something they can support, that the rest of the party can support. Then, they need to sell this thing to the American public.

One of the first things that needs to be done is to point out that our system is incredibly inefficient and dysfuncional. Nicholas Kristoff shares the story of a couple forced to divorce so that the husband can get needed care without bankrupting the family. It happens all the time. It's also a reason why there's a growing trend of seniors living together without getting married -- they'll lose their social security/medicare benefits.

When I read these statistics about 86% of Americans being satisfied with their health care options, I wonder who we're talking about. I rarely run into them. And as for those Single Payer plans up there in Canada, the ones that are so horrible. I just returned from Canada, talked with an American working in Canada, heard a very different story. Indeed, he's thinking now of retiring in Canada because the health care system is so much better there than here. He spoke of the importance of comparing apples to apples. What we usually hear is the horror stories and then compare them to the best in America. But, let's compare best to best and worst to worst. If we do that Canada sounds like it comes out ahead.

As for rationing. Come now, we already experience rationing. The insurance companies will decide what they'll pay for. Then you have to decide if you have the money to cover additional treatment or go without. The cost of medicine here is triple that in Canada -- why? I don't know. Of course, taxes are higher in Canada. But I wonder if in the long run our rising medical costs far outstrip any tax differences.

The reality is this. If we're to get meaningful health care reform it'll have to happen this year, because once the campaign season starts next year, no one will do anything that will disrupt their chances of getting re-elected. So, now is the time!!

9 comments:

Greg Johnson said...

Well said. Thanks for taking a stand for faith and justice. We have started a group on facebook for People of Faith for Health Care Reform and would love people to join us and share information as this. I will repost your post on the groups page at http://www.facebook.com/group.php?gid=133024077776 .

Know that you are loved,
@PastorGreg

Anonymous said...

How about we reform by getting the government out of all health care? How about no payment for health care for anyone and we return the current money to the people. This is extreme, but my point that I can't accept reform simply for the sake of reform. There has to be meat and a real proposal. I feel I am getting brow beaten to make these changes, but the details seem to be more "trust us". Medicare is basically going bankrupt, so why I should I believe this would do any better? Cash for clunkers has been a logistical disaster and that is just for a car.
Everyone agrees that the system is inefficient. Yes, health care is already rationed... but the HMOs do prevent fraud in the system that will be RAMPANT with a government control.
This is an incredibly complicated subject that won't win my support with pleas of "we have to do something..." There are often unintended consequences with big changes like this and its important we all know what they might be.

-Chuck

Pastor Bob Cornwall said...

I'm not sure how getting the government out of health care would help. Are you suggesting we get rid of Medicare -- don't tell the seniors who depend on it -- medicade (which would essentially pass the cost of caring for the poor back on hospitals) -- and the VA (don't tell the soldiers who depend on it). I'm assuming government employees would also be on their own.

The reason why Medicare is hemorrhaging money is that health costs are rising so fast, the government is unable to negotiate for drug costs, etc. The cost of presecription drugs is 3 times what it is in Canada, which is why many Americans order their drugs through Canadian pharmacies.

If we could control costs, negotiate better deals, then well maybe we can do better with the budget.

Mike L. said...

I'm struggling to continue supporting the current suggested plan. It is looking more and more like a compromise that will simply expand the mistakes of the current system and create a windfall for insurance companies. At what point do progressives push back? Would it be better for a real single payer system and lose, than to settle for a crappy solution?

Anonymous said...

Sorry Bob.. my point was simply to say the rally cry of "reform" isn't enough. Reform can mean anything and it is very important for me to know what the end product is. As Mike is saying... you can end up supporting a "bill of goods" and end up making things worse than if they were left alone.

The VA may be a good example of complete government health care and it has been a disaster. Remember the falling apart buildings? I just don't know where this all ends up.

Chuck

Mike L. said...

A "VA for all" or at least a "Medicare for all" would be fine by me. I'd support either of those if it was actually on the table.

Pastor Bob Cornwall said...

Chuck, I would say that part of the reason why the VA has fallen short is that it was run by an administration that didn't believe in government. Since the days of the Reagan administration, which was marked by its commitment to dismantle government, things have been left to fall apart. I don't think government is the problem -- I think poorly run government is the problem.

Remember New Orleans -- the Bush Administration, which disdained the very government organization it ran, put political hacks into important posts -- like Mike Brown -- rather than put knowledgable folks into important positions. Interestingly, Barack Obama has kept some holdovers from the previous administration -- people of substance like Robert Gates.

Is government perfect? No. But, is the alternative to government better? I don't think so.

roy said...

the bottom line under the current for profit system is just that, the bottom line. A for profit insurance system has as it primary goal, the amassing of profits. By definition that means rationing care and denying it whenever possible. There is no impetus for long term prevention because the insurers hope you'll have switched to another company before they have to pay the piper... and then they'll just deny you coverage because you are too big a risk.
I'd rather have a government bureaucrat who is answerable to the public making decisions than a corporate bean counter who only cares about the bottom line.
FWIW, I'd rather see a good plan fail - let the Republicans & Blue Dogs explain why they shot down a good plan - than a half-ass plan pass

Anonymous said...

My sister is at the Mayo clinic (another sister is with her). She was sent there for heart surgery that her Michigan doctors said she needed, but couldn't do. I heard last night that the results of her tests told them she could live with the condition. Hopefully they're right, but I heard they really do things right there. Less unneeded tests and procedures because the doctors corroborate much more than at other hospitals, learn from each other and as a result give better care and save money too. I'm so pleased, but I knew this would happen somehow. David Mc