Democrats and Republicans Agree on Health Care
August 26, 2009
Lots of folks argue that the health systems in Canada and the UK are wonderful. They are wonderfully free to use, but don’t think for a minute they are without cost. The biggest confusion comes down to two distinct issues:
- Delivery of health care services
- System of payment for health care services
When my friends from Canada and the UK suggest their health systems are great I pause. After a longer conversation I learn that, well, the fact that they don’t have to pay for health care is great. The delivery of the health care services leaves a lot to be desired. Canada’s admits their system is imploding. In the UK each year more than 4,000 mothers can’t get hospital beds and are forced to have their kids on elevators, offices and on toilets. These socialized systems have their share of mistakes as well.
Now when I talk to various people from the U.S. (Democrats and Republicans) I ask them about their health system. The Democrats all will tell you it is terrible. The Republicans will tell you it is the best in the world. What is the disconnect? It is actually a very simple disconnect, but often hard to uncover while everyone is yelling at each other (i.e. you are unamerican, you are a racist, yadda, yadda and so on).
When you actually scratch the surface of the debate between Democrats and Republicans it is clear that everyone thinks the health care delivered to them is great. They like their doctors. They like the medication they receive. They like their hospitals. In fact both Democrats and Republicans seem to LOVE the delivery of health services in the US. Now ask either a Democrat or a Republican about our system of payment for health care services and both sides agree 100% that our system sucks. Ironically, we agree – we have the best health system and the worst payment system.
Now this is where the debate gets sticky (i.e. Democrats and Republicans disagree). Conservatives want to fix the existing insurance system to better deliver the existing health care services. The Democrats want to scrap the existing insurance system for a single payer system (i.e. government run). The good news is that NO ONE wants to lose the existing system of delivery of care. We all want to keep our doctors, the cool medications, the advanced surgery centers and so on.
Conservatives aren’t heartless bastards who want millions of Americans to die, instead we are just like Democrats. We want to keep our world class health care system. Our biggest concern is that a single payer system (i.e. government run option) would preclude us from keeping the current delivery system. We believe that the current payment system (private insurance) can be reformed. Lots of us have plans, here is my plan. Conservatives don’t want to risk our health care delivery system. I think Democrats would agree with us. Now if we could just come up with a set of reforms that fix our current system and expanded access to those who need it most.
10 Comments
RSS feed for comments on this post.
Sorry, the comment form is closed at this time.
I think the point is that the American health care system works great if you can afford it. The Democrat opinion is simply that we can’t let 15% of our population die like stray dogs in the street. Supposed “Conservatives” who disagree with that should crack their New Testament and give the words of Christ another read.
You have some fine points in your plan. In fact, I’m headed to NHIN in DC to try and do something about the automation part. What I don’t see is a modicum of care for those who were not so blessed as you have been. Protecting doctors from lawsuits and increasing profit margins is good for business but that won’t watch over the widow and the orphan.
Comment by Ean Schuessler — August 26, 2009 @ 10:27 am
Ean – I am glad you posted. First, I think we agree. We need to figure out how to help 15% of our population receive the same sort of health care delivery we enjoy. Conservatives believe that reform will save money, money that can be used to pay for the 15% who aren’t getting what they need.
Protecting doctors from lawsuits will reduce costs by $100-200 billion each year (i.e. less defensive medicine). We can decide how to use the savings. I pray that we don’t screw up our current delivery system just because our payment system sucks. Lets fix the bitch!
Comment by Alexander Muse — August 26, 2009 @ 10:34 am
On that count, I certainly agree. I don’t see the harm in a state option that provides coverage for life-threatening situations and procedures necessary to keep you active in the workforce. The additional economic output yielded from not having workers unnecessarily laid up should compensate. If we want to deliver this level of coverage through a state-mandated aggregation of private services, so be it. The main point is to get people patched up and back to work… perhaps even the occasional illegal alien (I’m sure some wandering American hippy gets the same treatment in Mexico, Cuba or even… gasp… Venezuala).
I also do agree that the lawsuits get a bit out of hand, but at the same time there are some unscrupulous jokers in the medical biz that don’t deserve a magical government force field around their activities.
Comment by Ean Schuessler — August 26, 2009 @ 12:25 pm
Two points:
(1) capitalism allocates resources through dollars as votes. Just how does the “government competition keep industry honest”? I think Officer Free Market and Deputy Adam Smith have got that covered. Isn’t the global market evidence that competition really works to deliver the best product for the lowest price? So unbridel private insurance from the regs and let them compete. Give them rewards/kickbacks to snitch on the fraudulent filings. They have the best view of the business.
(2) Everyone in the US has coverage now. Not so much preventative care, but anyone can go into an emergency room and get care. The law says they cannot be turned away. And they can’t be asked questions which might reveal that they are an illegal resident. They get care regardless. Avoid this expense to the public. Convert these “emergencies” to routine care through a government subsidized plan for those who can’t pay. AND so the dems can get their illegal votes, even make something available on a short term basis a subsidized plan for the illegals. That’s humane. Medicade is available to all but many don’t apply for it.
Comment by Bryan Knox — August 26, 2009 @ 2:07 pm
I agree our values and goals are the same.
But, Obama and the democrats aren’t proposing a single payer plan.
Alot of the weirdness around this debate is due to conservatives arguing against an imaginary plan that has single payer, death panels, wait lines, and forces you switch health care providers.
While Obama is proposing a pretty moderate set of insurance reforms and a public option for a subset of Americans that fall through the cracks.
Comment by brian — August 26, 2009 @ 2:12 pm
@brian I agree completely. Obama hasn’t proposed anything in writing. His speeches from the election indicate he supports a single payer plan or at the very least a transition to a single payer plan. Pelosi and Reid both indicate that a public option (i.e. optional single payer play) is a prerequisite for any bill. The main written bill is H.R.3200:
http://thomas.loc.gov/cgi-bin/bdquery/z?d111:h.r.3200:
I reviewed the bill. It is a mess. It isn’t a minor overhaul or reform of our current insurance system. It doesn’t include any of the reforms that I cite in my plan. It doesn’t include anything that would reduce costs or improve care. Instead it creates a public insurance system. Provisions in the bill ’sunset’ private insurance after five years, requiring everyone eventually move to the public ‘option’. The death panels stuff is in there, vague as it is. Pelosi and Reid have pledged to remove the provisions that have caused the ‘death panel’ upset.
I would be very excited for Congress to implement sweeping insurance reforms that would allow for expanded coverage for Americans who can’t afford insurance. HR3200 is basically a clusterf*ck. Have you read it? Obama claimed he had NOT read it himself. Reid and Spector suggest that HR3200 has nothing to do with what the Senate will support.
Comment by Alexander Muse — August 26, 2009 @ 4:52 pm
Hey Alex,
Yep I’ve skimmed 3200 a bit and I think you missed a few things.
A) 3200 does try to move towards electronic health records ( which is one of the reforms in your plan )
B) The national health insurance marketplace sounds a lot like your interstate health insurance plan in your reforms.
C) The ’sunset’ private insurance claim is false. Here is a better debunking than I could give: http://angrybear.blogspot.com/2009/07/wingnut-102-how-hr3200-outlaws-private.html
D) The highly touted death panel thing has also been shown false.
E) Obama did not support single payer in the election. I think he was pretty clear about that. He thinks it is nice as a pie in the sky daydream idea, but in the election he supported a practical moderate plan like those being discussed.
F) I don’t understand what you mean by ‘optional single payer’. Isn’t that by definition an oxymoron?
Again I think the health care plans being discussed are pretty moderate and have some good ideas in there. You should give them a chance
Comment by brian — August 27, 2009 @ 10:08 am
@Brian If 3200 implements electronic records that is a great step (not sure I read that the way you did, not sure what ‘move toward’ means). National insurance marketplace? If it simply removes state-by-state regulation I am all for it (not sure I read it the same way either). The “Limitation on New Enrollment” section will sunset private insurance as written. The legislative intent may be different. The Ways and Means Committee clarified the provision:
“The provision would indeed outlaw individual private coverage. Under the Orwellian header of “Protecting The Choice To Keep Current Coverage,” the “Limitation On New Enrollment” section of the bill clearly states: “Except as provided in this paragraph, the individual health insurance issuer offering such coverage does not enroll any individual in such coverage if the first effective date of coverage is on or after the first day” of the year the legislation becomes law. So we can all keep our coverage, just as promised — with, of course, exceptions: Those who currently have private individual coverage won’t be able to change it. Nor will those who leave a company to work for themselves be free to buy individual plans from private carriers.”
With regard to the death panel I think I explained that the Finance Committee had removed the ‘death panel’ language from the bill: http://hotair.com/archives/2009/08/13/breaking-finance-committee-drops-death-panel-provisions-from-senate-bill/
With regard to Obama’s support of single payer I think you are wrong. Watch this video of Obama: http://www.youtube.com/watch?v=fpAyan1fXCE
I agree, ‘optional single payer’ makes no sense. It is one of the statements Obama made in the Portsmouth town hall. Literally, I don’t understand.
Comment by Alexander Muse — August 27, 2009 @ 6:36 pm
To clarify on the sunset provision – you CAN keep your existing plan for its life. But as you may or may not know, plans change yearly. The plan we are on this year isn’t the same one as last year. The insurance companies change them every year. So the way the bill is written ALL private insurance will eventually sunset. Not that this can’t be fixed, it can. But it is in there. The article you cite from Angry Bear is plain wrong (it was sort of a nightmare to try to get through).
Comment by Alexander Muse — August 27, 2009 @ 6:38 pm
@brian – just because the bill doesn’t say “there shall be wait lines” doesn’t mean there won’t be wait lines. Conservatives aren’t saying “Obama wants you to wait in line”, we’re saying “A unintended side effect of Obama’s plan is that you will wait in line”. In my view – the Dems always argue about the intentions of a bill and never think about the actual effect of the bill. Their response to this talk about the problems and accuse your of being heartless. The existence of hardship is not evidence that the bill is a good idea.
Another issue I have with the Dems is the attitude that “we have to do something”, as if any action to correct the situation will be an improvement. There is a lot of legislation, written with the best of intentions, that has actually exacerbated the problem it was designed to address. Take a look at most any legislation targeted at the housing market over the last 15 years. Take a look at African aid.
This bill gives the government the power to dictate prices. Dictating prices will reduce the number of people entering medicine which will reduce the availability of health care.
This bill reduces the cost of health care for the consumer, which will increase the demand for health care services.
There are already a health care shortages (particularly primary care) – an unintended side effect of the bill is that it will exacerbate this problem by reducing supply and increasing demand.
As for death panels – the government will have to reduce health care costs – a very effective way to do this is by limiting care for the old and the very young. It’s a lot cheaper for a premie to just pass on, or for grandma to just take pain pills. The government has the power to do these things and has incentive to do them. It makes me uncomfortable.
Comment by Steve Brewer — August 28, 2009 @ 11:53 am