Thanks to the snow day I had the opportunity to watch a lot of this live. It was truly fascinating, I really enjoyed it and I thought it was very iluminating. We needed at least 20 or 30 of these in 2009, why not let the American People hear these arguments and debates live on tv and let us decide if we want or don't want the healthcare bill?
The President made a huge blunder by keeping the negotiations a secret from us. Yesterday for the first time I personally felt that doing something about our healthcare system is paramount and probably pretty urgent. The notion that $1 out of every $3 spent on Medicare is fraud and abuse was not surprising but definitely a wake up call. The fact that 50% of the money in Medicare is spent by 5% of recipients is astounding. Things like coordinated care could dramatically reduce this figure. But these are just a few of the examples that come to mind, I'm sure there are thousands.
One of the things that kept coming up was the notion that pooling everyone together and making the pool incredibly big by definition should reduce the cost of premiums by spreading risk. That made sense to me. One counter argument I have to that is that there is an inherent assumption that a higher percentage of uninsured is healthy and therefore the risk would be diluted. What if we really are adding a bunch of sicker folks to the system? That may increase the cost of the premiums.
The entire debate on pre-existing conditions was very interesting and it made me see more clearly why you have to mandate people getting coverage. Without mandating coverage what would prevent people from not getting insurance until they get sick?
One thing I have a big problem with is coverage and deficit. I don't know who to believe on this one. One thing is for sure, you can't add 30 million people to the system for free. In fairness to BO, he said that again and again. The question in my mind is, can we really afford it?
It bugs the heck out of me that I feel we have wasted an entire year, kept the public out of this and now probably wasted a tremendous opportunity to effect real and productive change. In the end the President will do what he has done so far, impose his will and do what he thinks is the right solution to the problem. I'm convinced that a real positive solution exists out there but the partisan bickering will kill any possibility of arriving at that solution.
A lot of good points here.
ReplyDeleteI think the blame for the log-jam rests more with Congress than the President. That institution is owned by the insurance and pharmaceutical companies. That is why the bill is so convoluted, complex and ineffectual.
Obama dropped the ball by not forcing the debate into the open early, but he can't predict when a blizzard will put us in front of the TV.
The question now is whether this bill is worth the paper it's printed on, and I have mixed feelings about that. If I felt that dumping the current bill would lead to real debate, and a bill the majority of Americans seem to want [single payer], I would favor scrapping the lame effort in front of us now. My fear is that the Congress would throw up its collective hands, plead that they had done all they could, and return to the important work remaining: collecting donations from lobbyists.
Meaningful reform would cover everyone in the country, and would provide preventive, palliative, acute, and chronic care. Exclusionary coverage, as practiced under the current patchwork system of providers, brokers and payers, can only lead to excess costs and lack of proper care for segments of the population.
That sounds mighty costly, and it's true there is no free lunch, but cost projections that account for benefits and savings from simply being a healthier population will not be promoted by groups that would stand to lose out - middle men, trial lawyers, some insurers.
Other developed countries that have single payer systems [that is, all of them except us], spend far less per capita on health care than we do, and are as healthy as we are.
The one weapon we have to influence policy is the fear Congressmembers have as elections near - e.g. November 2010. Call, write or email your representatives, and urge them to solve the problem in the way you would like. It doesn't take a tea party; just many frustrated and motivated individuals.
If we end up starting again from scratch, I would like to see an end to employer-based health coverage. I've never understood the connection, other than as a recruiting and retention tool for employers. My opinion is that it has resulted in indentured servitude; as employees are not free to work part time, or split their employment between different companies [or different industries].