Health Care Reform

[Fifthfiend]

Huh, he actually sounds serious:

At Summit, Obama Urges Solutions for Rising Cost of Health Care

By Ceci Connolly and William Branigin
Washington Post Staff Writers
Thursday, March 5, 2009; 4:15 PM

President Obama launched a campaign today to reform health care in the United States by the end of this year, telling a White House summit on the issue that that fixing the troubled system is "no longer just a moral imperative, it is a fiscal imperative."

Joined by lawmakers, health industry executives and a handful of "average Americans," Obama vowed to press for legislation this year that dramatically expands insurance coverage, improves health care quality and reins in skyrocketing medical costs.

"The same soaring costs that are straining families' budgets are sinking our businesses and eating up our government's budget, too," Obama said in an East Room appearance.

"At the fiscal summit that we held here last week, the one thing on which everyone agreed was that the greatest threat to America's fiscal health is not Social Security, though that's a significant challenge," he said. "It's not the investments we've made to rescue our economy during this crisis. By a wide margin, the biggest threat to our nation's balance sheet is the skyrocketing cost of health care. It's not even close."

At the same time, the White House unveiled a new Web site, www.healthreform.gov, and said it plans to hold town-hall-style meetings across the country to rally public support for what is expected to be a protracted and arduous legislative battle. The meetings will be hosted by Democratic and Republican governors.

Medical spending, now about $2.3 trillion, consumes about 16 percent of the gross domestic product. And although the United States spends more per capita on health care than any industrialized nation, Americans do not live longer or healthier lives, according to a range of international measures.

As an opening maneuver, Obama set aside $634 billion in his proposed budget to be dedicated to health reform. The 10-year reserve fund could be used to provide health insurance to some of the 46 million Americans who do not have it today. To raise that money, Obama would cut itemized tax deductions for the wealthiest Americans and trim federal payments to hospitals, home health aides, drug manufacturers and some physicians.

The budget must be approved by Congress, and already lawmakers and lobbyists are objecting to certain provisions.

Describing the budget proposal as a "significant down payment" that "does not add one penny to our deficit," Obama nevertheless said today that he is open to other ideas.

"Every option must be on the table; there should be no sacred cows," he told the gathering, which included many of the industry lobbyists who have killed previous reform efforts. "Each of us must accept that none of us will get everything that we want, and that no proposal for reform will be perfect. . . . But when it comes to addressing our health care challenge, we can no longer let the perfect be the enemy of the essential."

Obama added, "The status quo is the one option that's not on the table." He said that while everyone has a right to participate in the discussion, "no one has the right to take it over and dominate." And he warned that "those who seek to block any reform at all, any reform at any cost, will not prevail this time around."

He said the purpose of today's forum is to start determining how to lower costs, improve quality and expand coverage to all Americans.

"And our goal will be to enact comprehensive health care reform by the end of this year," he said.

Among those attending the summit were seven average Americans selected by the White House from among thousands of people who hosted and attended meetings on health care in December in response to an appeal for input from the Obama transition team.

Text of Obama's speech

"We are here today to discuss one of the greatest threats not just to the well-being of our families and the prosperity of our businesses, but to the very foundation of our economy -- and that is the exploding cost of health care in America today.

"In the last eight years, premiums have grown four times faster than wages, and an additional nine million Americans have joined the ranks of the uninsured. The cost of health care now causes a bankruptcy in America every thirty seconds. By the end of the year, it could cause 1.5 million Americans to lose their homes. And even for folks who are weathering this economic storm, and have health care now, all it takes is one stroke of bad luck -- an accident or illness; a divorce or lost job -- to become one of the nearly 46 million uninsured or the millions who have health care, but can't afford it.

"We did not get here by accident. The problems we face today are a direct consequence of actions we failed to take yesterday.... [T]here are those who say we should defer health care reform once again -- that at a time of economic crisis, we simply cannot afford to fix our health care system as well.

"Well, let's be clear: the same soaring costs that are straining our families' budgets are sinking our businesses and eating up our government's budget too. Too many small businesses can't insure their employees. Major American corporations are struggling to compete with their foreign counterparts. And companies of all sizes are shipping their jobs overseas or shutting their doors for good.

"Medicare costs are consuming our federal budget. Medicaid is overwhelming our state budgets. And at the Fiscal Summit we held here last week, the one thing on which everyone agreed was that the greatest threat to America's fiscal health is not Social Security, though that is a significant challenge; and it is not the investments we've made to rescue our economy; it is the skyrocketing cost of health care.

"That is why we cannot delay this discussion any longer. And that is why today's forum is so important. Because health care reform is no longer just a moral imperative, it is a fiscal imperative. If we want to create jobs and rebuild our economy, then we must address the crushing cost of health care this year, in this Administration. Making investments in reform now, investments that will dramatically lower costs, won't add to our budget deficits in the long-term -- rather, it is one of the best ways to reduce them.

I'm amazed, this is the kind of rhetoric people usually reserve for the semiannual effort to run Social Security into the ground. It's sort of amazing to see it being tied to an actual for-real problem.

I'm still not super-sure about the eventual outcome of this given that any meaningful solution pretty much requires someone drinking the insurance industry's milkshake. But if Obama's actually willing to stand up and paint the issue in terms of national emergency then who knows maybe he actually might be willing to get that done.

Or I mean alternately he'll go back to that weaksauce 'lets make health insurance like car insurance' nonsense he was pushing during the election, in which case urgh, I'd really rather we didn't.

...Just to unpack another thought but so far the opposition response to Obama's speech has been generally including something to the effect of "something something free market something something socialism something something competition." And the crucial point here I think is that the purpose of competition and markets and all that shit is that it's supposed to ultimately, via invisible hands and down-trickles and all that other shit, produce the socially desirable result. And health care is an area where the market has completely and utterly failed to do so.

So I think it just bears restating that the actual goal of a health care system is not to ensure that enough private corporations have the chance to enrich themselves, or that people kowtow sufficiently to some God of the Market, but rather to make sure that people are able to go see doctors so that they can prevent or treat their illnesses. It just seems effed up that some parties see the latter as sort of an optional side effect and the former as the primary, critical goal.

[Wigmund]

Just ask Representative Zach Wamp of Tennessee what he thinks about health care in America.

[Fifthfiend]

Depressingness from that story:

Later on MSNBC, former Senior Health Care Adviser to Bill Clinton Chris Jennings said Wamp’s comments are just “their talking points every time the debate over health care comes up.”

He added that Obama is not suggesting getting rid of employer-based health care, and it’s a fallacy to suggest otherwise.

“I don't see how anyone can read that as anywhere close to socialism,” Jennings said. “Most people outside the very far right wing of the Republican party agree with that. … There's an attempt to throw fear-mongering into this debate, because” Republicans don't have any “policy ideas.”

Obama absolutely should be talking about getting rid of employer-based health care because that's the entire goddamn thing wrong with our system of health care. The key point about Socialism in this regard being that it ding dang works a whole eff of a lot better than what we've got right now.

[Mannix]

It's not just that competition has failed to produce desirable results in the health care field. It's that competition is actively the problem, because insurance as a for-profit industry works by taking your money and then giving you little to nothing in return, not entirely unlike a casino. Competition therefore is to see who can take the most money possible while providing as little actual care as possible and still have customers. What we need them to be competing for is to see who can give the most while taking the least, which is in direct opposition to any sort of capitalistic solution. We are not going to have anything even remotely resembling medicine in the US until people, especially lawmakers, can wrap their heads around that.

[Magic_Marker]

Originally Posted by Mannix

It's not just that competition has failed to produce desirable results in the health care field. It's that competition is actively the problem, because insurance as a for-profit industry works by taking your money and then giving you little to nothing in return, not entirely unlike a casino. Competition therefore is to see who can take the most money possible while providing as little actual care as possible and still have customers. What we need them to be competing for is to see who can give the most while taking the least, which is in direct opposition to any sort of capitalistic solution. We are not going to have anything even remotely resembling medicine in the US until people, especially lawmakers, can wrap their heads around that.

This is not entirely true however, while I will agree that most health care insurance companies are for-profit. There are also many not-for profit insurance companies that have to use almost ALL of their funds or declare themselves for profit. HCSC (Health Care Service Corporation) for example is the third largest health care provider but is a not-for profit business, and is my place of employment.

But let me say this: I DO work for a health care insurance company (Claims Processing), but I am still for Government insurance, just not in this point in time. America has for too long suffered under layer of bureaucracy and dismantling as much as we can without hurting people would be the best plan of action in my humble opinion.

Good Example: Medicare, A great solution for elderly and people with renal and other terminal diseases, in fact it works great for the people who have it. They have this ability to say that the patient is not liable for services, they essentially say "haha! you can't bill me" they also set their own reasonable price for service that doctors HAVE to accept to prevent it's members from being overcharged. Medicaid, however is a mess. They (almost) never get their paperwork right and as such processors like myself are forced to deny claims (which at my job you want to do as little as possible) because you are not allowed to contact Medicaid for information.

I think one of the first steps is to further regulate the industry until the pieces are in place for Federal Insurance (it would be best on a federal level, state level would have too much conflicting coverage and there would be little sense of cooperation or coherency). This would hopefully require most of the insurance companies to become not for profit organizations thus requiring them to pay the top level CEOs less and apply any surplus to the member and other entry level employees through organized gain sharing programs.

I honestly can't wait until we are able to pay everyone's bills. Nobody should have to suffer because they cannot pay for treatment. But I think that jumping into it would do more harm than good in the short game, but if the Obama(which the spell check on this forum doesn't recognize as a word) administration plans it out well enough I think we could make it work.

[Nique]

Would competition be healthier (oh! A pun!) for us if consumers/patients had more control? I mean, the whole trap of insurance is pretty distasteful, not seeing how something that is basically considered an essential should cost people so much and then not even do what it is supposed to do half the time...

[shiney]

The fact that they can arbitrarily deny claims based on non-published cretieria such as something dumb like "you visited someone who lives close to a coal power plant" or whatever nonsense they claim these days really doesn't help their position much either.