Tales from the Trail

The First Draft: Healthcare, Take 1

June 15, 2009

USA/

It’s healthcare week at the White House — the first of what promises to be many.

With debate on a healthcare reform package beginning to take shape, President Barack Obama heads to Chicago this morning to make his case for it to the American Medical Association, an audience of skeptics who will be on the frontline of the battle to overhaul the sprawling U.S. healthcare system.

The AMA, which represents 250,000 doctors, said in a statement last week it would oppose a public government insurance plan that Obama says will drive down costs by creating competition with private insurers. Critics say it would limit choice and amount to a government takeover.

Obama’s speech will be the first of several pieces of the healthcare puzzle this week, with the Senate Finance Committee slated to unveil its version of the bill and the debate sharpening over how to pay for the plan and whether to include the public insurance program.

Obama wants to sign a healthcare reform bill this year, and congressional leaders have promised to get the initial version to the floor and passed in each chamber by the August recess — setting up a fall of debate and compromise as the two chambers hammer out a final version of the plan.

REUTERS/Frank Polich   (Statue of President Barack Obama in Chicago)

Comments
14 comments so far | RSS Comments RSS

It is very distressing to see the government expand a method of paying for health care that has burdened the system to the degree it fails. It is called health insurance; the idea of making more of it available only means the system will cost more to operate. Health insurance costs the system nearly 66% of each dollar, it has added 35% or more to every providers overhead, it delays care, rations resources and leaves you bankrupt when you really need it…it is a tragedy to think the Washington somehow thinks that more of this, that is insurance, will make it better.

Retail systems have the answer for healthcare. There are 150,000 items in a super wal mart, only about 35,000 different things one can do for a human in the medical world, if the choices are presented correctly, and the products available marketed adequately,the solution will revel itself, as it does in all business.

Our company, Equity Health Plan supports the Medical Home Model and retail systems as a method of improving health care for all of us.

 

To heal health care, what is now required is to remove what has become counterproductive business incentives. There are many layers to the problems. Near monopolistic suppliers whose profits are nothing short of stunning cost this system in some very sick and twisted ways. Profits aren’t evil but profiteering is especially in what is a service industry that preys on the most vulnerable of our citizens is. Margins on profits aren’t evil either.

Its obviously clear that health care cannot be run like a toys-r-us on steroids, its vastly more complex. Blaming patients, blaming the front line workers are cop-outs for those who are unable to grasp how profound their failures are in a ‘free market’ enterprise health care system that wasn’t free after all, it was captured. Abuses to those in need of health care (those fortunate enough to have it) abound. Lives are ruined daily financially and permanently. I’ve witnessed too often first hand.

Those self-interested in business, lobbyists and government have failed the publics interest profoundly. Time for some really fresh thinking and stop drinking out of the same poisoned well for people who feet are heavy with the mud in this mess and are architects of it.

Its time for some fresh thinking and change that serves the public rather than endlessly serves them up.

Posted by NS | Report as abusive
 

GOP does not know what it talking about, every person I know wants the Public Option. It is a GREAT idea. We sure can’t trust the insurance companies, and for that matter the senators who are being paid off by them!!!

Posted by John Linehan | Report as abusive
 

It’s gotten to the point where you have to ask yourself if President Obama is a mad man. Why is government trying to compete or take over private industry altogether?

What we have is a person that acts like a rabid dog. Snarling and snapping at everything.

 

It is odd to me that the administration has no plans to curtail the malpractice lawyers. While awards are not a major part of health cost inflation, they are enough to cause physicians to require a raft of teats in order to protect themselves. Will we see a public option for malpractice insurance too? The health care issue is far to complex to be rushed through. Unintended consequences will occur if the plan isn’t carefully thought out and rushed through like TARP was. Do the doctors get paid less? Does medical school tuition and fees get chopped? What incentives will health providers have to treat more people? Will the illegal immigrants in this country be treated in the ERs and the hospitals have to bear the cost of the failure of the government to deal with that problem? Will the alcoholic, the morbidly obese, and others who do not take personal responsibility for their own health be covered in full?

Just a few thoughts.

 

NOTHING is free, people…and if it sounds too good to be true, it probably is. If the government takes on a project, THE PEOPLE PAY FOR IT…mark my words, raised taxes. Now that’s fine if the only people getting treatment are the ones paying, but like auto insurance and school taxes and other such things, you will be paying for yourself AND all the people that have a lame excuse to get away with not paying…
And there are so many ways to cut cost, but the healthcare organization has never HAD to…a bailout is not the answer…teach them to fish, don’t fish for them! Up the work-ethic expectations and people will either work harder at their jobs or lose them…so many hospital and doctor office employees I see shuffle slower than the geriatric patients…and that’s not meant to be respectful to our dear older generation…

Posted by dl | Report as abusive
 

@john linehan
I find it highly amusing that you are wary at the insurance companies b/c the senators are being paid off by them…yet you want the “dirty” senators to decide when/if you deserve healthcare. Government-run healthcare does not equal free healthcare anytime anywhere…it is hurry up and wait in line…oh yeah, and money talks. Why do other countries that have government-run healthcare flock to the US for treatment? Esp when the US healthcare costs are so much higher? (If you don’t know history, you’re doomed to repeat it.) It’s because they can actually GET to see a doctor and it’s quality care. Sure, it needs belt-tightening like every other fat American industry right now, but it’s still the best in the WORLD.
The only people I know of that thought government run healthcare was a good idea are habitual free-loaders…to put it nicely. If you don’t work, you shouldn’t eat.

Posted by dl | Report as abusive
 

People from other countries don’t “flock” to the US for treatment. Yes, people with money who want to see the best-paid specialists head to the US, but that isn’t an endorsement of the US system. Ask anyone from the UK, Canada, France or anywhere else if they would trade their healthcare system for an all-commercial system like the US and they’d laugh in your face.

Posted by dl | Report as abusive
 

eric h ,one of the biggest dreads in LA californa is that you might have to make a call to the DMV it is crazy.last week a had for the first time to visit a social security office,it was a minor thing i had to a contact lady,she gave me an open appointment.i got there 10 minutes after opening time,i was number 102.i asked the security guard politely “could you tell mrs i have arrived “,he scowled “TAKE A TICKET,AND SIT DOWN AND WAITE TILL YOU ARE CALLED” needless to say i just walked out.but the point is this is going to be GOVERNMENT HEALTH CARE.the majority of people that i know are not going to tolerate this type of treatment which is what will happen.

Posted by brian lee | Report as abusive
 

I like the idea that no one has thought about capping the amount that malpractice lawyers get. Retail healthcare may be the answer, I see better, more caring doctors when I go to a $70 clinic in a grocery store (at least for the problems I have) and they also follow up. Medicare and Medicaid are a form of socialized medicine and they seem to work. I’m not saying we should go to Britain’s system of free healthcare but these are a few facts.

Posted by Betty | Report as abusive
 

“up the work-ethic” HA if americans work any more we will all drop dead from exhaustion. we work more and get less than all of the civilized world. we are debt slaves, plain and simple, thats not some left wing conspriacy babble either, look at the debt figures worldwide.

WE ARE THE ONLY, THE ONLY CIVILIZED NATION WITHOUT SOCIALIZED MEDICINE.

we are cruel and uncaring. end of story. rant all you want about work ethic and the evils of caring for the least of our citizens. socialisim is a balance for captitalisim when capitalisim is allowed to run rampant, people suffer, greed takes over. our country is horribly lopsided, we need socialist balance, good people who work hard are in pain and dying and refused care.
homeless people die in the streets with no hope of care.
if you support hmo’s and our current heatlh system, you are a cold heartless machine, out of touch with your fellow citizens. america is in a sad and sorry state when profits outweigh human decency. we all share this short moment and we all end up equal in the end. dead. and you cant take it with you.

Posted by jer | Report as abusive
 

AMEN JER! You’ve said it all, and very clearly! Way to go! I totally agree..

Posted by Andi | Report as abusive
 

Capitalism becomes anti-American when it’s success is achieved by damaging our society. There is a big problem for people who make too much money to qualify for Medicaid but not enough to afford health insurance for their families. This is particularly difficult for single parents. Even folks making $100k a year can’t afford to cover their family unless their employer is picking up a portion of dependent premiums. Healthcare is very complex and there a multitude of factors that attribute to the rising costs that have caused health insurance to become unaffordable and unattainable for millions. Identifying these factors, determining what role they are playing in rising costs and developing strategies to resolve them isn’t something that can happen overnight. Theoretically, one would assume Obama’s push to create a gov’t plan to compete with the private sector makes sense. Certainly, his many worshippers think so. The reality though is that insurance companies cannot fairly compete with the federal gov’t. The fees insurance carriers have to pay providers for service are higher than what the gov’t pays providers for the same service. Therefore, they cannot offer premiums low enough to compete. Most Insurance carriers will bail essentially forcing the gov’t to “socialize” medicine. This “socialized” system that involves trillions of dollars would only make a failing system even worse. “Socialized” medicine works for some countries because their citizen’s lifestyle does not burden the system as ours does. Comparing America to other countries is apples to oranges. GB and Canada I would not consider as being successful socialized medicine by any stretch. The gov’t cannot tax and spend it’s way into resolving problems. In my opinion, the larger the gov’t has grown the more problems we seem to have. Most of the problems we have in this country can be traced back to the gov’t. Healthcare can be and should be reformed without a gov’t health plan. The Mayo clinic provides higher than average care for lower than average costs. Why are they able to achieve this while other provider’s can’t? Why are the fees billed to insurance carriers all over the map for the same service? In TX, Tort Reform dropped medical malpractice premiums in half. Why have other states not followed? Does someone really need $50 million to ease pain and suffering? Would we need PPO and HMO networks if the charges billed for service were consistent across the country? How many millions could be saved if insurance carriers did not have a provider relations dept to negotiate pricing with providers? Why are there no “incentives” available to make American’s get their wellness exams and take better care of themselves? Why are we so fat as a country? Obesity burdens the system problably as much as anything. What about all of the illegal aliens flooding our county hospitals and clinics? Any politicians addressing that issue? Are they going to give them free healthcare too? Why does 250 pills of Amoxycillin cost $100 in the USA, $12 in Mexico and $50 in Canada? How are we going to addess the costs with an aging population? Are we just going to let folks die? The list goes on and on. How can we reform the system, make the charges for services consistent in a manner that allows for premiums to be lowered 50% to 70%, exclude pre-existing clauses, maintain competition and still allow for some profitability so choices remain? It can be done with proper due diligence and time. There are many good ideas floating around out there. Being a benefits consultant, I have lots of my own. Everyone wants the same thing, but we have to use logic in how to achieve it.

Posted by DVM | Report as abusive
 

for Jer –
The words Socialist and American-”anything” (healthcare/etc) do not belong in the same sentence, paragraph, or story. Patriotic Americans did not build this country to be “just like everyone else” and our country is the most philanthropic in the world, so don’t try that. Is there still injustice? Certainly! Should we strive to stop it? Most definitely. But throwing money in a black hole and making lots of laws to protect the lazy and greedy isn’t going to help anyone, let alone the hard-working Americans…it will literally beat them into the ground. I still say, if you don’t work, you shouldn’t eat. There are always exceptions to the rule, but they should be rare, not the norm! My fam is living on my single income…yes, it’s hard! And we have to scrimp and save for necessities, let alone luxuries! But it IS doable and it’s not right to expect someone to give me something for nothing…I have to earn it! It’s the RIGHT thing to do. It is, however, infuriating to see others lazing around saying how bad the economy is, yet their kids have the name brand clothes, the Wii’s, the latest phones, you name it. And how do they afford it? Yeah. The government just deposits it to their bank account…they don’t even have to walk to the bank to cash a check anymore. Disgusting. I understand they don’t know any better, but the government is letting me work hard to provide for my family, taking a LARGE chunk out of the paycheck I EARNED in taxes, and turning around and handing it to the people sitting around doing nothing. Someone needs to teach the next generation about personal responsibility instead of the self-esteem and “you-deserve-it” attitude bull.
And to clarify: the health industry Is out of line, but why aren’t people calling/emailing their senators and fighting the bills they’re pushing through? Anyone can try to sue over anything, sure…but why are the lawsuits out of control being rewarded? And why on earth are the drug companies so intimate with the FDA? And the senators are best buds with them… And on and on the list goes.
DVM, you are correct, it’s very complex! I hope you are successful in seeing some ideas brought to fruition.
The government is here to SERVE and PROTECT our life, liberty and pursuit of happiness…not GIVE it to us out of others’ pockets…we have to earn it.

Posted by dl | Report as abusive
 

Post Your Comment

We welcome comments that advance the story through relevant opinion, anecdotes, links and data. If you see a comment that you believe is irrelevant or inappropriate, you can flag it to our editors by using the report abuse links. Views expressed in the comments do not represent those of Reuters. For more information on our comment policy, see http://blogs.reuters.com/fulldisclosure/2010/09/27/toward-a-more-thoughtful-conversation-on-stories/