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The idea that Republicans haven’t had a chance to present their ideas on health care reform is a bit mind-boggling. Five separate congressional committees had hearings; each chamber had floor debates. That’s hundreds of hours the GOP had to talk about health care, all of it in public view and televised on C-SPAN. And that’s not even including all of the unofficial channels at the Republicans’ disposal. Generally speaking, the party of Rush Limbaugh and Fox Television doesn’t struggle to get across its message.
But if President Obama is determined to give Republicans one more public forum for presenting their health care agenda, as he will do when he meets with GOP leaders on Feb. 25, maybe that is just as well. For most of last year, Republicans spent their time attacking Democratic plans for reform, rather than describing their own. But now they’ve put a plan on the table. Showcasing that plan--and comparing it to what the Democrats have proposed--might help clarify a few things.
The Republican health care plan is part of the "Roadmap for America's Future." Its chief architect is Paul Ryan, ranking Republican on the House Budget Committee and a rising star in the party. Republicans boast that the Roadmap is serious plan to get the federal budget under control, which turns out to be a fairly large exaggeration. As Howard Gleckman of the Tax Policy Center has observed, the Roadmap doesn't account for trillions of dollars in lost revenue from its tax cuts. Yes, that's trillions with a "t" at the front and "s" at the back.
The health care portions of the plan, though, really would reduce what the government spends on health care. And they would do so, primarily, by extracting money from Medicare. Instead of continuing to provide coverage directly, the government would issue vouchers that seniors could use to buy private insurance. The value of the vouchers would rise far more slowly than Medicare spending is expected to grow if nothing changes.
According to the Congressional Budget Office, Medicare will soak up more than 14 percent of gross domestic product by 2080. If the Roadmap were to be adopted, CBO says Medicare would take up less than 4 percent. As Ryan explained during an illuminating interview with the Washington Post’s Ezra Klein, the hope is that converting Medicare into a voucher scheme would prod seniors to shop around to find the best value--that is, the best insurance policies, the best hospitals, the best doctors--and, in so doing, get health care that is as good if not better than they would have otherwise.
That all sounds perfectly innocuous: Who wouldn’t want seniors taking the initiative and hunting around for the best bargains? But it’s not clear how many seniors really have the ability to navigate the world of health care with the sort of sophistication to really hunt down the most cost-effective care, even if, as Ryan promises, they’d have more information at their disposal. At the very least, you'd want to give seniors ironclad protections when it comes to the design of insurance products--making sure a wide array of services were covered and that out-of-pocket spending were limited.
The Roadmap includes only vague protections along those lines. Combine that with the magnitude of the spending reductions--those cuts are very big--and it's easy to envision a world where seniors simply couldn't afford their medical care. As a preliminary (and still unpublished) analysis of the Roadmap by the liberal Center on Budget and Policy Priorities concluded, “elderly and disabled people with significant medical conditions could encounter serious difficulty securing adequate coverage.”
COMMENTS (22)
Certainly this voucher will be worthless to seniors with medical conditions (eventually, all of them), who cannot shop around because of their pre-existing conditions. Unless they also propose to prohibit insurance companies from discriminating against pre-existing conditions, which will then require a mandate to keep the private insurance market rates from soaring out of control, which will then require ....
Certainly this voucher will be worthless to seniors with medical conditions (eventually, all of them), who cannot shop around because of their pre-existing conditions. Unless they also propose to prohibit insurance companies from discriminating against pre-existing conditions, which will then require a mandate to keep the private insurance market rates from soaring out of control, which will then require ....
Vouchers. Why is it that the Republican solution to nearly everything comes in the form of vouchers? School vouchers, health vouchers, personal savings vouchers. Not only does this not solve anything, but it goes a long way toward showing how bankrupt they are as leaders.
The private market currently guarantees nothing for those of us relying on private insurance to satisfy our basic health care needs. The private market is the problem. Our rates rise anywhere from 8% to 20% per year ... guaranteeing that the paltry 3% raise we receive from our employers is wiped out and we have to figure out a way to live on less every single year.
For those of use that pay our taxes, why are we not g ... view full comment
Vouchers. Why is it that the Republican solution to nearly everything comes in the form of vouchers? School vouchers, health vouchers, personal savings vouchers. Not only does this not solve anything, but it goes a long way toward showing how bankrupt they are as leaders.
The private market currently guarantees nothing for those of us relying on private insurance to satisfy our basic health care needs. The private market is the problem. Our rates rise anywhere from 8% to 20% per year ... guaranteeing that the paltry 3% raise we receive from our employers is wiped out and we have to figure out a way to live on less every single year.
For those of use that pay our taxes, why are we not guaranteed, guaranteed, a basic set of health care options? Why are we not guaranteed that preexisting conditions cannot be used to deny us coverage? Why are we not guaranteed that private insurers cannot bankrupt us?
The Republicans are the problem.
Won't be a fair fight. The Democrats will be trounced! No, not on the merits. On salesmanship. To Democrats, this is all about access to health care, whether for the currently uninsured or future seniors dependent on a solvent Medicare program that actually covers their health care costs. No so with the Republicans. For them it's about controlling the cost (and power) of government. I can already tell you the lead in the NYT on February 26th. "Republican plan guarantees solvency of Medicare while offering choice for Medicare beneficiaries". "Democrats attack Republican voucher plan based on long-range forecasts that even Democratic experts acknowledge are only estimates (critics say ... view full comment
Won't be a fair fight. The Democrats will be trounced! No, not on the merits. On salesmanship. To Democrats, this is all about access to health care, whether for the currently uninsured or future seniors dependent on a solvent Medicare program that actually covers their health care costs. No so with the Republicans. For them it's about controlling the cost (and power) of government. I can already tell you the lead in the NYT on February 26th. "Republican plan guarantees solvency of Medicare while offering choice for Medicare beneficiaries". "Democrats attack Republican voucher plan based on long-range forecasts that even Democratic experts acknowledge are only estimates (critics say guesses) of future events". Sure, the experts will support the Democrats' plan. But they already support the Democrats' plan. So what's the point of having the face-off. Anybody old enough to have watched the Presidential debates in 1980 and 1984 understands. Those well-versed in public policy all thought Reagan "lost" the debates. But polling of the public revealed something entirely different, that Reagan trounced his opponent. Like I said, not a fair fight.
The Republican healthcare plan mixes Robert Mugabe's approach to agricultural distribution with Mao's approach to increasing agricultural efficiency, then just changes every instance of the word "farm" to "health." It's really breathtaking in its audacity: Prices will come down because the government passes a law telling consumers to pay less, and producers to charge less. It's like they're not even pretending anymore: This is Nixonian statism in full force -- which is to say, Maoism with a corporate face.
The Republican healthcare plan mixes Robert Mugabe's approach to agricultural distribution with Mao's approach to increasing agricultural efficiency, then just changes every instance of the word "farm" to "health." It's really breathtaking in its audacity: Prices will come down because the government passes a law telling consumers to pay less, and producers to charge less. It's like they're not even pretending anymore: This is Nixonian statism in full force -- which is to say, Maoism with a corporate face.
pburton, I don't have such a problem with the idea of vouchers, if Republicans offered a voucher to every uninsured American today, I would jump at the chance. I say lets take Ryan up on the voucher program, but use it first for the uninsured and see how effective it is. Something tells me he won't go for it.
Ray, disagree with your analysis. The only thing Seniors will hear is "change" they won't hear the "more choices" since they are happy with their arrangement now and more is simply scary. Tell them they have to hunt for a new doctor all to save money, see how that flies. This whole proposal is a non-starter. It might sound crude but old people are scared of change, I remember how they bi ... view full comment
pburton, I don't have such a problem with the idea of vouchers, if Republicans offered a voucher to every uninsured American today, I would jump at the chance. I say lets take Ryan up on the voucher program, but use it first for the uninsured and see how effective it is. Something tells me he won't go for it.
Ray, disagree with your analysis. The only thing Seniors will hear is "change" they won't hear the "more choices" since they are happy with their arrangement now and more is simply scary. Tell them they have to hunt for a new doctor all to save money, see how that flies. This whole proposal is a non-starter. It might sound crude but old people are scared of change, I remember how they bitched and cried when At&T was broken up, this will be 100 times worse.
Ray, I second Blackton on this and would add another point -- that it's important to have an effective communicator at this stage to really make the public terrified of the notion of replacing Medicare with vouchers. As we saw in his tete-a-tete with House Republicans, Obama can use simple language to explain complex issues if he wants and the discussion of health care vouchers would be a prime example. He can use Congressman Ryan's plan as a foil and simply state, for all those assembled, that what Republicans are proposing is a plan for people to keep shopping around for medical care when they are 80, 85, 90 years old and in increasingly ill health and dementia. Which means that it's no ... view full comment
Ray, I second Blackton on this and would add another point -- that it's important to have an effective communicator at this stage to really make the public terrified of the notion of replacing Medicare with vouchers. As we saw in his tete-a-tete with House Republicans, Obama can use simple language to explain complex issues if he wants and the discussion of health care vouchers would be a prime example. He can use Congressman Ryan's plan as a foil and simply state, for all those assembled, that what Republicans are proposing is a plan for people to keep shopping around for medical care when they are 80, 85, 90 years old and in increasingly ill health and dementia. Which means that it's not just the seniors who will be spending their declining years constantly searching the Internet and newspapers for the best health care deals, kind of like they are expected to search for grocery coupons except with much higher stakes -- it will also be their adult children doing it for them as their elders become progressively more frail and senile. Something tells me that this sort of presentation of the effects of a voucher plan won't cause the general public to rise up and demand Republican health care solutions.
The voucher program was proposed about 5-6 years ago by liberals, Victor Fuchs of Stanford and Zeke Emanuel, now at OMB. Their proposal calls for a national sales tax to fund a voucher for a core insurance policy for everyone. Medicaid and Medicare are eliminated (save those already in Medicare) and anyone who wants additional coverage can by it with their own money. Since everyone is covered there is no adverse selection or pre-existing conditions exception. Other than the political will to enact a national sales tax, I have not seen anyone who can give a good reason why such an approach will not work. I think that Emanuel published in TNR on this matter about three years ago.
The voucher program was proposed about 5-6 years ago by liberals, Victor Fuchs of Stanford and Zeke Emanuel, now at OMB. Their proposal calls for a national sales tax to fund a voucher for a core insurance policy for everyone. Medicaid and Medicare are eliminated (save those already in Medicare) and anyone who wants additional coverage can by it with their own money. Since everyone is covered there is no adverse selection or pre-existing conditions exception. Other than the political will to enact a national sales tax, I have not seen anyone who can give a good reason why such an approach will not work. I think that Emanuel published in TNR on this matter about three years ago.
I should have provided the Fuchs/Emanuel reference. Read it before casting any stones: http://www.tnr.com/article/politics/vouchsafe
I should have provided the Fuchs/Emanuel reference. Read it before casting any stones: http://www.tnr.com/article/politics/vouchsafe
agoldhammer, doing this for Medicare only won't mean that everyone is covered, only that a bunch of old and sick people are added to the private insurance pool. I still don't see how private insurance manages to make a profit by selling insurance for low cost that promises good health care to sick and old people.
A universal voucher system might work, and might keep costs for the elderly down if the value of the voucher is large enough to encourage young and healthy people to buy comprehensive plans. But that would be expensive, and I can't see the Republicans offering that as a real alternative.
agoldhammer, doing this for Medicare only won't mean that everyone is covered, only that a bunch of old and sick people are added to the private insurance pool. I still don't see how private insurance manages to make a profit by selling insurance for low cost that promises good health care to sick and old people.
A universal voucher system might work, and might keep costs for the elderly down if the value of the voucher is large enough to encourage young and healthy people to buy comprehensive plans. But that would be expensive, and I can't see the Republicans offering that as a real alternative.
Hope I am wrong and the other commenters are right. Where I live people like "vouchers" and "choice"; many seniors already participate in Medicare HMOs. And while these commenters may understand the concept of long-range price/cost differences (i.e., rising medical costs outpacing voucher increases), don't be surprised if the public doesn't. We know that the Democrats in Congress would make the concept incomprehensible to the public. These comments assume that Obama can do better. I think the commenters are confusing Obama's grasp of the subject with his ability to explain it to somebody who never had an abstract thought. A real challenge. My reference to Reagan was for his unmatched ... view full comment
Hope I am wrong and the other commenters are right. Where I live people like "vouchers" and "choice"; many seniors already participate in Medicare HMOs. And while these commenters may understand the concept of long-range price/cost differences (i.e., rising medical costs outpacing voucher increases), don't be surprised if the public doesn't. We know that the Democrats in Congress would make the concept incomprehensible to the public. These comments assume that Obama can do better. I think the commenters are confusing Obama's grasp of the subject with his ability to explain it to somebody who never had an abstract thought. A real challenge. My reference to Reagan was for his unmatched ability to reach the public through appealing themes, never complex concepts.
agoldhammer-
Emanuel/Fuchs is great and resembles the Wyden-Bennett bill, which many of us have talked up and the President himself has also mentioned before. Had even a few Republicans shown serious interest in supporting this model, I think it might be what we were debating right now. But except for the GOP co-sponsor (Bob Bennett) and one other GOP senator (Lindsey Graham), the rest of the Republicans turned their noses up at it. Since it wasn't the first choice of many Dems, either, that sealed its fate -- although elements of the two plans are in the current bills.
To be clear, though, this is NOT what Ryan and the GOP are proposing. In a nutshell, the Ryan/GOP proposal gives people vo ... view full comment
agoldhammer-
Emanuel/Fuchs is great and resembles the Wyden-Bennett bill, which many of us have talked up and the President himself has also mentioned before. Had even a few Republicans shown serious interest in supporting this model, I think it might be what we were debating right now. But except for the GOP co-sponsor (Bob Bennett) and one other GOP senator (Lindsey Graham), the rest of the Republicans turned their noses up at it. Since it wasn't the first choice of many Dems, either, that sealed its fate -- although elements of the two plans are in the current bills.
To be clear, though, this is NOT what Ryan and the GOP are proposing. In a nutshell, the Ryan/GOP proposal gives people vouchers, but it doesn't do anything (or, more accurately, it doesn't do nearly enough) to make sure people can actually buy affordable insurance with the vouchers. Contrast this with either Emanuel/Fuchs or Wyden/Bennett, which have huge regulatory structures and much greater subsidies.
The original mistake was excluding single payer from the discussion. All sides got to express their opinions except those with a real solution. Will the President have the decency to admit that mistake and include single payer advocates and economists in the Feb 25 summit?
Will the White house invite Marcia Angell, Margaret Flowers, Steffie Woolhandler and David Himmelstein to his Blair House event? Or perhaps Dr. Johnathan Ross who has a great OP-ED on the need for a nonprofit system in the Feb 07 Toledo Blade.
http: ... view full comment
The original mistake was excluding single payer from the discussion. All sides got to express their opinions except those with a real solution. Will the President have the decency to admit that mistake and include single payer advocates and economists in the Feb 25 summit?
Will the White house invite Marcia Angell, Margaret Flowers, Steffie Woolhandler and David Himmelstein to his Blair House event? Or perhaps Dr. Johnathan Ross who has a great OP-ED on the need for a nonprofit system in the Feb 07 Toledo Blade.
http://toledoblade.com/apps/pbcs.dll/article?AID=/20100207/OPINION04/207...
If the CBO would cost out HR 676 over a 10-15 year period, the economic benefits would be startlingly evident --even to the most monolithic pro-market politician, pundit or voter.
Why assume Obama has strong objections to the Republican's ideas? Are they really farther from the President's own thinking than, for instance, progressive proposals? His actions to date would indicate that they are, in fact, much closer to his own preferences.
Hs insistence on continuing to beat the seemingly dead horse of "bi-partisanship" is begining to look like desperation to pass a reform plan that will not require policy concessions to progressive lawmakers and their constituents. So far, Republicans, with their refusal to cooperate, have made it impossible to lock progressives out of the process. (With some minor concessions to progressives, the Democrats could pass a bill right now) ... view full comment
Why assume Obama has strong objections to the Republican's ideas? Are they really farther from the President's own thinking than, for instance, progressive proposals? His actions to date would indicate that they are, in fact, much closer to his own preferences.
Hs insistence on continuing to beat the seemingly dead horse of "bi-partisanship" is begining to look like desperation to pass a reform plan that will not require policy concessions to progressive lawmakers and their constituents. So far, Republicans, with their refusal to cooperate, have made it impossible to lock progressives out of the process. (With some minor concessions to progressives, the Democrats could pass a bill right now). The only way to do that is to put together a plan that enough Republicans and conservative Democrats will sign onto -- that means a plan based on their ideas.
With this "summit," Obama is providing an opportunity for Republicans to sell those ideas to the public. I don't see anything he has done in the process so far, beyond encouraging wishful thinking on the part of his supporters, to indicate that his intention is anything else.
Reply to agoldhammer:
Zeke Emanuel's voucher plan would perpetuate our inequitable multi-tier system--and the insurers would still be laughing all the way to their next shareholder meeting. Don't you see that we would be given the vouchers in order to BUY insurance policies from the private for-profit insurers.
A voucher plan will not cut costs --except by offering skimpy care, or keeping people from seeking necessary treatment.
We need to improve Medicare and expand it to cover everyone. The savings engendered by creating a large risk pool would then benefit our people and our economy, rather than the profiteers. The insurance companies are lickin' their chops waiting for a universal mandate ... view full comment
Reply to agoldhammer:
Zeke Emanuel's voucher plan would perpetuate our inequitable multi-tier system--and the insurers would still be laughing all the way to their next shareholder meeting. Don't you see that we would be given the vouchers in order to BUY insurance policies from the private for-profit insurers.
A voucher plan will not cut costs --except by offering skimpy care, or keeping people from seeking necessary treatment.
We need to improve Medicare and expand it to cover everyone. The savings engendered by creating a large risk pool would then benefit our people and our economy, rather than the profiteers. The insurance companies are lickin' their chops waiting for a universal mandate or voucher plan that would funnel our money through their coffers.
A nonprofit universal Medicare "mandate" is what we need. The taxpayers would then, in essence, be insuring themselves. The profit-taking (usurious) middleman would be unnessary.
By the way, Zeke Emanuel heads a "think tank" at Stanford called the Fresh-Thinking Project. Representatives from WellPoint and UnitedHealth care sit on his advisory Board. I'm waiting for Zeke to invite whistleblower Wendell Potter (former CIGNA exec) to offer the F-T project his advice.
Has Jonathan written about that Stanford group? ---hmmmm
As a pharmacist who specializes in "Senior care", I can tell you that it would be extremely difficult for the majority of Seniors to find "the best bargain". A significant proportion of seniors enrolled in any medicare part D plan are not even in the most cost effective plan based on their chronic medications. And it has proved very difficult to explain (over and over again) the concept of "the donut hole" to many as well. A lot of these folks have college degrees and worked in complex fields back in their day...
So who will pick up the costs for their care? As is now, hospitals? Or taxpayers (when the patient finally sells their home to qualify for Medicaid as many do now)?
And it's not ... view full comment
As a pharmacist who specializes in "Senior care", I can tell you that it would be extremely difficult for the majority of Seniors to find "the best bargain". A significant proportion of seniors enrolled in any medicare part D plan are not even in the most cost effective plan based on their chronic medications. And it has proved very difficult to explain (over and over again) the concept of "the donut hole" to many as well. A lot of these folks have college degrees and worked in complex fields back in their day...
So who will pick up the costs for their care? As is now, hospitals? Or taxpayers (when the patient finally sells their home to qualify for Medicaid as many do now)?
And it's not really fair just "picking on" Seniors. Many people don't even pick the best benefits plans that are provided by their employers from even those very limited menus.
This is a mindset issue. Comprehensive (not "everything under the sun") healthcare should be one of those things you get as a citizen and taxpayer. Like police and fire protection, a municipal water supply, the interstate highway, access to public education and unemployment benefits. Instead of constantly cutting taxes, how the taxes are spent and whether or not we actually are collecting enough to meet these basic needs should be starting point for discussion. While Belgium goes way overboard in what they provide their citizens for extremely high taxes, there is a way to do this. And the US should try.
hmseil01, don't sell the idea of vouchers short, one, some care is better than no care for the uninsured, and two, it could begin to get people away from the absurdity of employer based health care. For the working age people, I really don't have much of a problem with it. I simply can't see it working for the elderly, for reasons I and wildboy laid out above. If we can't take care of the elderly then what kind of society are we?
As to single payer, hey, you got no argument with me, but there are way, way too many people whose livelihoods are dependent on private insurance market, they ain't going away in the name of efficiency.
hmseil01, don't sell the idea of vouchers short, one, some care is better than no care for the uninsured, and two, it could begin to get people away from the absurdity of employer based health care. For the working age people, I really don't have much of a problem with it. I simply can't see it working for the elderly, for reasons I and wildboy laid out above. If we can't take care of the elderly then what kind of society are we?
As to single payer, hey, you got no argument with me, but there are way, way too many people whose livelihoods are dependent on private insurance market, they ain't going away in the name of efficiency.
Maybe Obama/Dems will take advantage of good timing: many employer-based health plans renew on March 1, meaning a host of people are now being presented with their company's new choices and/or prices for the coming year, which are surely higher premiums and/or less care.
My own company is a case in point: as of March 1, we can choose the old PPO/co-pay model for higher premiums (something like $13K-$14K paid by me, not including employer's share, for family of 4) or we can choose the wave of the future: high-deductible plan with health savings account (and lower monthly premiums). And as of January 1, 2011, the whole firm is switching to the new model, which our Blue Cross rep assured u ... view full comment
Maybe Obama/Dems will take advantage of good timing: many employer-based health plans renew on March 1, meaning a host of people are now being presented with their company's new choices and/or prices for the coming year, which are surely higher premiums and/or less care.
My own company is a case in point: as of March 1, we can choose the old PPO/co-pay model for higher premiums (something like $13K-$14K paid by me, not including employer's share, for family of 4) or we can choose the wave of the future: high-deductible plan with health savings account (and lower monthly premiums). And as of January 1, 2011, the whole firm is switching to the new model, which our Blue Cross rep assured us was the way more of his clients are going. For some people, the new model may be better but it is a big change and my colleagues were clearly alarmed at the prospect of seeing this implemented firmwide.
Some observations on the responses to my post. Victor Fuchs, not Zeke Emanuel heads the Fresh Start Project. Zeke is at the Office of Management and Budget. A single payer plan while supported by liberals will never come to pass unless there is a healthcare catastrophe (and I don't want to be around when that happens). there are too many entrenched interests to allow that to happen. the Netherlands and Switzerland provide universal coverage through private insurers in their countries so it can be done. At its present rate Medicare taxes will have to rise enormously to cover those of use who will be eligible in a few years. You will see a taxpayer revolt among the young that makes toda ... view full comment
Some observations on the responses to my post. Victor Fuchs, not Zeke Emanuel heads the Fresh Start Project. Zeke is at the Office of Management and Budget. A single payer plan while supported by liberals will never come to pass unless there is a healthcare catastrophe (and I don't want to be around when that happens). there are too many entrenched interests to allow that to happen. the Netherlands and Switzerland provide universal coverage through private insurers in their countries so it can be done. At its present rate Medicare taxes will have to rise enormously to cover those of use who will be eligible in a few years. You will see a taxpayer revolt among the young that makes today's tea party pale by comparison.
Most commenting on the Fuchs/Emanuel approach have not read about it (do your homework before posting). funds would be set aside to conduct critical health technology assessment. Too many of our interventions have not been adequately studied and we are wasting a lot of money on high technology solutions that are at best unproven or not as good as what is already out there. The standard policy under the voucher program would be quite robust as the citizenry will demand it. In the same way that the Federal Employee Health Benefits program addresses 2 million employees, there would be a board to insure that the insurers met their obligations (you don't see the Federal employees complaining about their program).
There is a possibility that the GOP will simply try the carpet-bombing method -- just assert stuff, no matter how crazy, and then sit back as the time is wasted with everyone trying to get the basic facts established.
But it's true -- Obama is good at shooting down nonsense. His problem is more that people are predisposed to believe nonsense, if it sounds "truthy" (markets more efficient, government takeover, tighten belts, too liberal, coddling terrorists etc)
Obama succeeded in bringing intelligence back into U.S. presidential campaigning. But as president he needs to make intelligence sound comfortably American, and that -- as he's found to his cost -- is a difficult task.
There is a possibility that the GOP will simply try the carpet-bombing method -- just assert stuff, no matter how crazy, and then sit back as the time is wasted with everyone trying to get the basic facts established.
But it's true -- Obama is good at shooting down nonsense. His problem is more that people are predisposed to believe nonsense, if it sounds "truthy" (markets more efficient, government takeover, tighten belts, too liberal, coddling terrorists etc)
Obama succeeded in bringing intelligence back into U.S. presidential campaigning. But as president he needs to make intelligence sound comfortably American, and that -- as he's found to his cost -- is a difficult task.
Repeating an argument against single payer used by then-Senator Obama in 2006 in an interview with The Nation, blackton says, "there are way, way too many people whose livelihoods are dependent on private insurance market, they ain't going away in the name of efficiency."
We must get President Obama to confront this jobs issue head-on, and let single payer policy experts respond. We've never had that opportunity.
Let's look at the numbers employed in the health insurance industry--not health CARE--right now. The census bureau lists them under insurance and banking. Most of those individuals have skills that can be used in other business sectors (marketing, billing, actuarial analysis, lobbyin ... view full comment
Repeating an argument against single payer used by then-Senator Obama in 2006 in an interview with The Nation, blackton says, "there are way, way too many people whose livelihoods are dependent on private insurance market, they ain't going away in the name of efficiency."
We must get President Obama to confront this jobs issue head-on, and let single payer policy experts respond. We've never had that opportunity.
Let's look at the numbers employed in the health insurance industry--not health CARE--right now. The census bureau lists them under insurance and banking. Most of those individuals have skills that can be used in other business sectors (marketing, billing, actuarial analysis, lobbying, legal defense, etc.)
The Nation actually printed my reponse to Mr. Obama back in 2006:
"Senator Barack Obama expresses concern that a national
healthcare system would cause job loss in the for-profit health
insurance industry. I suggest he look carefully at HR 676, the Conyers
bill. Provisions for job transfer and retraining are spelled out. As
more than 45 million of the now uninsured and underinsured gain full
coverage, healthcare workers will be in great demand. Surely Obama is
not worried about the highly paid CEOs and lobbyists who work for a
healthcare industry that holds us all in bondage."
My position has not changed, and HR 676, reintroduced in the 111th Congress, has more co-sponsors than any other health care bill. In 2010, the need for single payer is even more evident.
In my state, we used to depend on the tobacco industry until we found out it was injurious to our health.
I hate to be like a ol' dog with a bone, but the web site of FRESH-thinking.org shows a photo of its two "Project Leaders," identified as Victor R. Fuchs, Ph.D. and former Co-Project Leader Ezekiel J. Emanuel, MD, Ph.D.
Somebody needs to fix that web site, tell the staff that Zeke has moved on.
Noam Scheiber gave us a revealing TNR article on Zeke, an article that pointed out how the bioethicist convinced Orszag to give him a desk at OMB.
Could Orszag have said "no" ?
On health care, I would like the President to listen to someone other than Dr. Emanuel and Tom Daschle.
I hate to be like a ol' dog with a bone, but the web site of FRESH-thinking.org shows a photo of its two "Project Leaders," identified as Victor R. Fuchs, Ph.D. and former Co-Project Leader Ezekiel J. Emanuel, MD, Ph.D.
Somebody needs to fix that web site, tell the staff that Zeke has moved on.
Noam Scheiber gave us a revealing TNR article on Zeke, an article that pointed out how the bioethicist convinced Orszag to give him a desk at OMB.
Could Orszag have said "no" ?
On health care, I would like the President to listen to someone other than Dr. Emanuel and Tom Daschle.
I think agoldhammer is correct that a single payer system is not likely to happen here unless there is a health care catastrophe. We might get just such a catastrophe if this reform bill dies and we wait another 15 years to try again, meanwhile keeping the present "system". If that does happen, I might be taking up one of those opportunities in Europe, as it could get pretty ugly here. Or maybe Blackton's Mexico strategy will look like a pretty good idea.
I don't know if the Senate has 50 votes today for a single payer system. I doubt it. It was never remotely close to having 60 votes, and barring a fission of the Republican party into a Tea Party and a GOP, competing against each other for t ... view full comment
I think agoldhammer is correct that a single payer system is not likely to happen here unless there is a health care catastrophe. We might get just such a catastrophe if this reform bill dies and we wait another 15 years to try again, meanwhile keeping the present "system". If that does happen, I might be taking up one of those opportunities in Europe, as it could get pretty ugly here. Or maybe Blackton's Mexico strategy will look like a pretty good idea.
I don't know if the Senate has 50 votes today for a single payer system. I doubt it. It was never remotely close to having 60 votes, and barring a fission of the Republican party into a Tea Party and a GOP, competing against each other for the hard right and the wingnuts and handing many seats to the Democrats, it won't ever be for the foreseeable future. I like the idea personally