Shelter from the storm
The health care industry, inside the tent
Shelter from the storm
Dick Polman, Inquirer National Political Columnist
Lyndon Johnson famously observed during his presidency that the best way to tame one's antagonists, or at least to mute their mischief, is to keep them close. In LBJ's characteristically inelegant words, it's always better to have the mischief-makers "inside the tent pissing out," rather than "outside the tent pissing in."
The LBJ aphorism came to mind yesterday as President Obama stood at the White House with the major players of the health care industry - all of whom, under different political circumstances, might ideally be tempted to urinate on health care reform from a great height... just as the major players did back in 1994, when they hooked up with the ascendant congressional Republicans to bury the Clinton reform plan.
But it's not 1994 anymore; the congressional Republicans have been driven to the margins of governance, and the polls show strong public support for government-driven reform. In February, for instance, a CNN-ORC poll asked, "In general, would you favor or oppose a program that would increase the federal government's influence over the country's health care system in an attempt to lower costs and provide coverage to more Americans?" The response: 72 percent favored, 27 percent opposed. Meanwhile, in early April, the CBS-New York Times poll reported that 57 percent of Americans are "willing to pay higher taxes so that Americans have health insurance they can't lose, no matter what." Granted, the devil is always in the details, but the general mood is unmistakable; as a subsequent the CBS-NYT poll reported, 87 percent of Americans support either "fundamental changes" in the health care system, or prefer to "completely rebuild" the system.
All of which is why the medical, pharmaceutical, and private insurance players have decided (with goading from the Obama administration) that it would be far wiser to position themselves inside the tent. Which is why they showed up at the White House yesterday with a good-faith pledge to lower their own costs by $2 trillion over the next 10 years ($2500 per typical family), clearly hoping (to borrow a Dylan phrase) that this gesture will give them shelter from the storm.
And at the White House event, Obama took full rhetorical advantage. He was in bipartisan mode: "This is a historic day, a watershed event in the long and elusive quest for health care reform...(which will) require all of us coming together, as we are today, around a common purpose - workers, executives, hospitals, nurses, doctors, drug companies, insurance companies, members of Congress. It's the kind of broad coalition, everybody with a seat at the table that I talked about during the campaign." (Obama is following up today with a business roundtable on ways to cut employer health-care costs.)
Obviously, the health care industry is entering the Obama tent with its own best interests in mind. It's a bit vague on how it plans to achieve those voluntary, unenforceable savings (which, after all, could wind up shaving their own profits), and clearly the industry figures that it can best achieve one of its most self-interested goals by working from the inside, as opposed to lobbying from the outside.
That goal, of course, is to topple one of the pillars of health care reform: the creation of a "public option," whereby Americans would have the choice of buying into a public health insurance plan, as an alternative to the plans offered by private insurers. More specifically, those Americans who can't get coverage at work or who can't qualify for Medicaid would be able, under the public option, to buy some health coverage.
All the details of a public option plan would have to be hashed out in the congressional sphere during the summer, but here's the bottom line: Such a plan would create competition for the private health insurance industry. And the industry doesn't want competition.
So the industry will fight that reform as it always has. But it's hard to see how the lobbyists can obstruct as effectively from the inside, with Obama hugging them close. Yes, they're pledging voluntary savings merely to slow the reform momentum. But they're going to look particularly craven a few months from now if they suddenly leave the tent. And it's questionable whether, as outsiders, they would get any traction from crafting a new version of the "Harry and Louise" TV ads that worked so well 15 years ago, in a different political era.
Granted, there was much talk back in the early '90s that the political moment for national health care reform had arrived; in 1991, the editor of the American Medical Association's Journal wrote that such reform had the air of "inevitability." But the health care industry's top players never stood shoulder to shoulder with Bill Clinton at a White House event; they never gave Clinton a golden opportunity to drive a wedge between themselves and their traditional Republican friends. They have done so with Obama. The political optics today contrast sharply with those of 15 years ago.
This hardly means, of course, that substantive reform ultimately will be enacted to everyone's satisfaction; it does mean, however, that the political prospects are brighter than before. And health care industry aside, if you really want an accurate barometer, just check out Arlen Specter.
On TV nine days ago, the new Democratic senator from Pennsylvania said he opposed a public health insurance option that would compete with private insurers. But now, in a letter to a progressive health care group, he says he is open to a public health insurance option, that he looks forward to "discussing and considering" such an option.
Forgive me for rewriting Dylan:
You only need an Arlen to know which way the wind blows.
Comments (75)
djoko, the recession isn't as severe as the GD (nice campaign talking point though) & will be over by early 2010 or the White Houses budget numbers will be in big trouble, again:) The 'tax and spend' dems may be cliche', but usually cliche's are grounded in the truth and this one is spot on. Just look at the 'stimulus/porkulus' bill (or the omnibus bill) for proof that the dems do not know how to hande themselves, now that they are in power! Americans are tightening their belts in the bad economy and they expect the same of their govt., not exploding govt. growth on every level. I'd be willing to bet a beer that the repubs will gain seats in 2010 in both houses, once the dems run up $3 Tril in debt the 1st 2 years they are in office! I can almost see the commercials now :) Poll numbers change over time and the Pres. Obama is much more popular personally than any of his programs are. So the projected demise of the repub party is much exaggerated, much discussed but IMHO much ado about nothing! We'll be seeing you in 2010 and I look forward to the debate until then, my friend:)— NEPhilly- places to look to improve govt http://www.whitehouse.gov/omb/expectmore/2008Performance.pdf they are not nor have been efficient. If the govt is 77% efficient why should we be considering expanding any programs or allowing any tax increases. GET effective and efficient NOW!!!— Fisher
- NEPhilly, you would make a good leader! Mainly because you like Newt, Mitch, Mitt, Michael, et al cling to the old formulations – the tax and spend Dems. Well, my friend, the old formulations are out. We’re spending to get the nation out of the most severe recession since the GD, courtesy of the old-formulation spend and borrow Repubs (while they talk about small government and fiscal responsibility, LOL). And people understand this. I wouldn’t count on making gains in 2010. The people aren’t listening to you anymore. Look at the poll numbers. That’s why I’m concerned about you and your pygmy party, NEP. You need to change. Now, before you disappear all together. Keeping your head in the sand and hoping people will “come back to you” is not policy, NEP. It’s insanity.— Djoko Pritza
The rewrite that I might like slightly better is also a little more accurate to the song: You don't need an Arlen to know which way the wind blows.- ***Under the administration's new budget estimates, the $1.84 trillion deficit for this year will be followed by a $1.26 trillion deficit in 2010 and will never dip below $500 billion over the next decade. The administration estimates the deficits from 2010 to 2019 will total $7.1 trillion. The current record deficit was the $454.8 billion imbalance recorded last year.*** This is with the rosiest of forecasts by the White House budget team! http://www.msnbc.msn.com/id/30706398/— NEPhilly
- djoko, your worry for us is touching, but if I were you I would be more worried about your party running up a $1.8 Tril deficit this year and at least a $1.2 Tril deficit next year. That is going to make people look at the GOP again, no matter the leaders! If the GOP can offer up alternatives that cut spending and govt. at every turn, that would be a great 1st step to showing the country the difference between the parties! The GOP shouldn't run to the left, but stay to the right of center and wait for the dems to overreach (oh, they already did and are doing so, you say:) and the country will come back to them! In the 2010 elections the dems will lose seats in both houses if the president's budget is passed intact and even more if it is passed by 'reconciliation'! As you know, the party in power usually loses seats in midterm elections, so this is not out of the realm of possibility and is probably likely! As for the leader, I'd like to offer up my services and 'be this platoon's big toe', because Sgt. Hulka isn't always going to be there for us!, with apologies to Stripes!— NEPhilly
- "The big challenge for Republicans is to make a strong case against Democratic policies, without appearing as obstreperous or angry. They have to avoid being stigmatized as a bad bunch of people” -- Richard Bond, former RNC chairman. I think it's too late. Bobby? Kit? Secessionist Rick? Todd? Mitch? Liz? There must be someone you righties like ...— Djoko Pritza
- I can't wait to read Mr. Yoo's 1st article, finally some balance to the coverage at the Inquirer! You would think some/one big city newspaper(s) would swing back to the center/right to gain readers as their lurch to the left has left them almost broke:) Maybe Mr. T!erney is going to give it a whirl (given his backround) and it would be very interesting to see if it would help!— NEPhilly
- I can't wait to read Mr. Yoo's 1st article, finally some balance to the coverage at the Inqy! You would think some/one big city newspaper(s) would swing back to the center/right to gain readers as their lurch to the left has left them almost broke:) Maybe Mr. Tierney is going to give it a whirl (given his backround) and it would be very interesting to see if it would help!— NEPhilly
- "The Republican Party is largely occupied at the moment with finding compelling leaders to make the case against the Democrats going into the 2010 midterm elections" -- Adam Nagourney. Just like I've been asking you righties: Who's your leader? Dick? Sarah? Rush? Newt? the well-tanned John? Whenver I ask, NEP says let the primary decide. But you can't wait till 2012, can you? Smike always I shouldn't worry, it's Repub family business. But, that family is shrinking. I do worry about you righties. This country needs a sane, positive opposition, not a raft of nutjobs. C'mon, who's you daddy?— Djoko Pritza
- liberal get reading some facts social security 1. Social security does have a trust like most govt programs. http://www.ssa.gov/OACT/ProgData/assets.html 2. LBJ, Carter and Clinton use SSA as a checking account. http://www.snopes.com/politics/socialsecurity/changes.asp 3. Carter cared so much for others, he robbed from today, so now we pay. http://www.socialsecurity.gov/history/carterstmts.html#system— Fisher
- Hey, tom, the Inky hired Yoo to reach out to right wing extremists like yourself -- you know, fair and balanced. Someone you can worship.— Djoko Pritza
- still--your thinking about the ss trust fund is confused. There are in fact, real assets in the ss trust fund. Back in the 1980s when the fund was set up, there was a moment when Congress considered putting private stocks and bonds in the fund, but this plan disappeared when they figured out how much of the US economy would be owned by the government by 2016. So they decided to use Treasury securities. It's true that when the securities are retired, the government may have to borrow money to retire these securities. This is exactly the same as for Treasury securities held by the general public. If you were to figure out the actuarial present value of retiring current Treasury securities held by the public it would of course be astronomical, but meaningless since the security is the entire faith and credit of the US government, which presumably will be a continuing entity indefinitely. For a pension plan, it is customary to make present value calculations since some costs can be easily predicted. The scary numbers that result, however, are just as meaningless as an estimate of all future defense spending, all future paint jobs for theWhite House, etc. We all expect the government to continue in business and the economy to generally prosper. if this expectation is not met, it's not just Social Security that's in trouble--it's the whole enchilada of American life.— liberal
- Until the government and specifically the democrats gets these kinds of matters eliminated they should not spend one more dime of our money. Apparantly there is an "airport to nowhere" in Johnstown Pa named the John Murtha airport that is receiving $ 800,000 to repave a runway. http://www.washingtonpost.com/wp-dyn/content/article/2009/04/18/AR2009041802128.html
- Still Independent- So you think we will be better off by forcing employers and employees to continue to pay into social security once wages have exceeded the cap? Currently $ 102,000 per year. Number one the cap goes up every year. Number 2, this is like doubling down on a failed pension system that is routinely robbed to fund stimulus bills that none of our elected leaders are affored the opportunity to read before signing. Not to mention the extra money taken out of the economy by essentially taxing both the employer and employee more. The whole system should be fazed out.
- Did I say Schakowsky was from California? My bad, she is from Illinois. In other news, the Inquirer has hired John Yoo, one of the "torture memo" authors, as a columnist. I wonder if Polman will resign in protest. What a shame that would be.— tom - wilmington, de
- liberal: I'm no opponent of social security, nor have I "fallen" for any CATO way of thinking. However, to most people, "trust fund" denotes actual funds sitting somewhere. Even IOUs (i.e t-bills) may be meaningful, if the payer and payee weren't the same. I know they won't default. My point is that money is fungible. The trust fund is truly meaningless. We (the government) have borrowed money from ourselves, and pledged to pay it back so that we may pay off our future commitments. It makes no sense whatsoever (nor could businesses use the same accounting methodology). Surely you could admit that whether we are paying off t-bills owned by the trust fund or paying benefits directly out of the general fund is immaterial. ... As an aside, I am a proponent of both raising the retirement age as well as removing the cap on income subject to the tax. Both would cost me personally, but am I not being continually told by all my Republican friends that progressive taxes are unfair?— still_independent
- swedesboromike: we are in agreement, except for one thing. D of Education - 1.9%. D of Interior - 0.4%. D of Commerce - ??? didn't make the chart, so it's less than 0.4% (under $10B). Cut all the useless departments you want - barely makes a dent. DoD - 17%— still_independent
- Smike, the government is there to "provide for the common defense' but the Constitution also lists: "establish justice, insure domestic tranquility,........, promote the general welfare, and secure the blessings of liberty to ourselves and our posterity,". We are really responsible for all that stuff.— JimR
- Hey tom from wilmington, Jan Schakowsky represents the 9th congressional district in Illinois. What other "facts" are you making up?— clarktacular
- Just to clarify my point--US Treasury bonds, despite our current economic troubles, have been and continue to be considered one of the safest investments in the world. And THERE ARE NO FUNDS SET ASIDE TO RETIRE THOSE BONDS. They're in exactly the same status as the bonds in the social security trust fund. The Cato Institute people created the myth of the mere IOU because they don't like social security--it ties the people to the Democratic Party and undermines conservative values.— liberal
- still--you've fallen for some of the Cato Institute's anti-social security propaganda. Yes, there is a social security trust fund. Those "IOUs" are Treasury bonds issued for the purpose. Now of course it is possible that the government might default on those bonds, which are payable to this country's own elderly citizens. However, the Treasury has never defaulted on its bonds, even those payable to enemy aliens. The notion of a default on these bonds is fairly ridiculous.— liberal
- liberal: which brings up another point - THERE IS NO SOCIAL SECURITY TRUST FUND, other than in an accounting sense. There are a bunch of IOUs in a filing cabinet somewhere in VA. The moment (2016 is projected now) that social security pays out more than it takes in, we will be paying for some benefits out of the general federal budget. Who cares when the "trust fund" is depleted? It's an accounting thing - there is no money set aside to pay for social security in the future.— still_independent
- Still Independent- you are all for slashing the military budget so long as they don't close the military base in your congressional district. Right? Bottom line is that the Department of Eduction,Commerce, Interior is useless. I would eliminate non essential things before I would consider military cuts.
- liberal- I don't disagree with you. We are still in Japan and Europe more than 60 years after WWII. When I here of military shortages for our operations in Iraq and Afghanistan I can't help but wonder why they just don't close down those bases.
- swedesboromike: because defense is such a huge slice of the pie. It is by far the largest single piece of discretionary spending (more than 1/2). In 2008, counting "off budget" items like the wars, we spent $741 billion on the DOD. In addition, we continue to arm ourselves against the Soviet Union circa 1980. Why do we continue to build so many fighter aircraft? Whose air force are they going up against? Why do we still build attack subs? Rust has killed that Russian "boombers" long before we could. DO we potentially need more troops? Yes. SHould we lavishly equip, train, support, and pay those troops? Absolutely. Should we continue to build Zumwalt class destroyers at $3.5 Billion each that were designed to counteract a twenty year old threat? Probably not. ... Should we be spending nearly as much as the rest of the world combined?— still_independent
- Fisher--your comment on the Social Security Trust Fund is very strangely ahistorical. It was under Reagan, not Clinton, that the Trust Fund was incorporated into the federal budget to help conceal the deficit. And it was Reagan, the small-governmenters' hero, who started increasing the debt as a percentage of GDP, after a long decline from 1945 to the Carter administration. You think you can fool the idiots out there by rewriting history, but unfortunately the facts are the facts.— liberal
- Swede--I'm in favor of a strong defense. The problem is that all over the world we're in an offensive position militarily, even though there is no country that is currently threatening us militarily. We have military bases all over the world--dozens of them. Why? Maybe the sheer momentum of building up the military for WWII and the Cold War.— liberal
- Liberal- I think you answered your own question. But why is that the left singles out defense spending as the first cut they would make? I would eliminate most of our Federal Departments, initiate hiring freezes, line item vetos etc. Stop giving our tax payer money away for any and all causes around the world. Like Tsunami relief. Very sad there was a tsunami but sorry, not our problem-go ask China. I just don't think we can sustain this kind of spending. Our government is there to provide for the common defense, nothing more and nothing less.
- Nobody wants competition, Polman. You dolt. If real competition forces the private carriers to sharpen their pencils and provide a better, more cost-effective product - that's a good thing. If the govt squashes competition - that's a bad thing. You're an ivory towered pinhead, Polman.— A Friend
- Tom, cute line (and essentially true) but the health care problem is not caused by providing bypass surgery for 75 year old smokers. The numbers are so convoluted that few know what the real costs are. The insured are paying for the uninsured, just in a different place. Anyone who has insurance is getting rationed care now. Anyone in an HMO knows the tradeoffs that get made. Insurance companies are in business to make money. The CEO's get huge bonuses for running it right, that being maximum in - minimum out. The rules on preexisting conditions keep people who need care out of the system. (anyone over 40 out there without a "preexisting condition?)A bean counter is the one who determines when you're cured - usually when you're out of money.— JimR
- If the existence of the deficit means that we can't afford government programs, why would you single out health care as something government can't afford? Our incomprehensibly activist (and very expensive) foreign policy seems like something that needs trimming. Why, exactly, is it any concern of ours what Iran is doing, now that the Cold War is over? Why should we be spending all this money to protect the oil supply, when rationally we ought to be phasing out oil? And what about agriculture subsidies to huge agribusinesses? There are lots of highly-lobbied government expenses that are far less important than healthcare.— liberal
- Tom--what universe do you live in? I have the best health insurance there is, thanks to my unionized spouse, and I have waiting periods to see the doctor--2 months for a dermatology appointment in a major city; a friend of mine in Maine had a 6-month wait to see the skin doctor, and had to drive 50 miles to see him. incidentally, the conditions involved were fairly serious though not life-threatening. The same pattern applies for almost all specialists. Even my primary care physician requiress a couple of weeks wait. you often have to go to the emergency room for treatment even if you have the best health insurance. So stop with the sob stories from Canada, France, etc. From actually talking to people in these countries, it seems to me they've got less waiting time. As for 'rationing." if you think private health insurance companies don't ration care, you must believe in the tooth fairy.— liberal
- Countries with Universal Health Insurance have waiting periods for coverage. Countries with Universal Health Insurance have rationing of care. Heck, even in Massachusettes they are beginning to find that the only way to control costs is to ration care. It was even posted on this site that, and allow me to paraphrase, until we stop giving double by-pass surgery to a 75 year old two-pack-a-day smoker we will never be able to control cost. That is an argument in favor of rationing care, but a truer word may not have been uttered.— tom - wilmington, de
- Medicare is in even worse shape.....es, in terms of funding, but not administration. It would have been nice is Bush didn't expand Medicare by 700 billion over 10 years, but what the heck, the neocons loved him.— chasing history
- Swedesboromike – regarding this astonishing statement: “I have always been highly skeptical about the number of uninsured considering it includes illegals, people who went at least one day without health insurance during a calander year, or younger people who opt out of health insurance.” I work in the health care industry and from what I understand, each state is required to report to the government monthly their uninsured stats after an individual is without health coverage of any kind for more than 3 months. The latest national statistics available are from 2006 and do not reflect your assertions in any way. http://aspe.hhs.gov/health/reports/07/uninsured/index.htm ,,,, Please provide your reference for your statement— Abbey_Robe
- When you look at the debt numbers they increased every year under Bill Clinton. Tis a great myth perpetrated by the state run media and the Democrats that Clinton ran a surplus. He did get within 20 billion of balancing the budget between 1999 and 2000 but the federal dept increased 1.2 trillion under Bill Clinton. What took Clinton 8 years to add to our federal debt, Obama is going to out do in year one by adding 1.8 trillion in debt. Until we are running massive surpluses to pay off the federal debt any discussion of increase government speding except military is comical at best. http://www.treasurydirect.gov/govt/reports/pd/histdebt/histdebt.htm
- Did I miss something? Has Obama paid off the debt ? Are we running a surplus? To be fair I know Bush couldn't didn't run a surplus either. How can the citizens of this country keep giving blank checks to our elected leaders? This is like prescribing alcohol to the alcoholic.
- "Trustees of the programs said Tuesday that Social Security will start paying out more in benefits than it collects in taxes in 2016, one year sooner than projected last year, and the giant trust fund will be depleted by 2037, four years sooner. Medicare is in even worse shape. The trustees said the program for hospital expenses will pay out more in benefits than it collects this year and will be insolvent by 2017, two years earlier than the date projected in last year's report." --Oh, the quick will blame Bush, but Clinton in his last three years raiding these trust accounts to have budget surpluses. Many people on both side argued it was not wise but... http://www.cbsnews.com/stories/2009/05/12/politics/main5009169.shtml— Fisher
- Fisher- I am not so sure that I would consider us a graying nation with less skilled and educated workers. It seems now more than ever that kids go to college. So much so that the evil capitalists at our liberal insitutions of higher learning charge gross amounts of money for 4 years of College. But they are charging what the market will bear for their services. What people forget is that our government receivables keep going up but our costs go up at a much higher pace. If we could just freeze government spending then we could pay off our debt in very little time. Then and only then can we have a discussion about more entitlments. We need priorities. Why do we need the Dept of the Interior, Commerce Dept, Dept of Educ. ( Ed. is paid for at the local level), Dept of Homeland Security. If government wants to create a new entitlement then something has to go.
- The greedy Health Insurance companies need to be neutralized. They do not offer competition. They increase the cost to consumers with their exorbitant overhead and administrative costs and control measly payments to physicians. They are the heart of the problem with the health care system today. It is the Health Care Insurance lobby that has perpetually derailed any sensible health care reform in this country for years, all in the name of obscene profits and share dividends to their stockholders! They must go! Our government CAN provide coverage that will deliver health care services, cheaper, more efficiently and more safely – they do it for all members of Congress, and they can do it for every man, woman and child in this country as well, and it would cost the Government a fraction of what it costs today.— Abbey_Robe
- "cash for clunkers" - how is Obama going to pay for that? Why should taxpayers fund this?— CD75
- swedesboromike I can agree with your thinking. One thought though, is we are a graying nation with less educated and skill workforce. Thus, healthcare growth will outstrip benefits of a single Department. Also, if deficits continue to grow, healthcare will be first in first out. Each administration there after will rethink the decision.— Fisher
- We cannot afford the entitlments we have let alone create new ones. I have always been highly skeptical about the number of uninsured considering it includes illegals, people who went at least one day without health insurance during a calander year, or younger people who opt out of health insurance. Whatever the cost is should have to be offset by eliminating foreign aid or elminating one or most of our Federal Departments. Such as the Department of the Interior, Dept of Education, or Department of Homeland Security, freezing government hiring, pay raises, pork etc. Not to mention if government healthcare is run anything like the V.A. then I think we can all agree the healthcare will be inferior care at a greater cost.
- djoko, I knew you were out there, how goes it:) When Polman writes about the GOP in 4 out of 6 blogs it can't be that marginalized, right? Why is Catholic tradition, grubby? You may not agree with it, but IMHO, the church does more good than harm in the world:) I agree it should have come clean about its pedophile priests sooner, but that is not reason enough to tear down the whole thing! The Catholic Church will have to change eventually to allow married men and women to be priests, the demographics will demand it eventually! Christ be with you!— NEPhilly
- MGI finds that the United States spends approximately $480 billion ($1,600 per capita) more on health care than other OECD countries and that additional spending is not explained by a higher disease burden; the research shows that the U.S. population is not significantly sicker than the other countries studied. Instead, MGI found that the overriding cause of high U.S. health care costs is the failure of the intermediation system — payors, employers, and government — to provide sufficient incentives to patients and consumers to be value–conscious in their demand decisions, and to regulate the necessary incentives to promote rational use by providers and suppliers. http://www.mckinsey.com/mgi/rp/healthcare/accounting_cost_healthcare.asp Thus, how does govt taking over healthcare help, when really the driver should be proper usage not coverage of healthcare. Too much is spent on people not see the right doctor at the right time. They wait and go to the emerency room when really they need to see a regular doctor. Again the liberal way fails to produce citizens, which produce responsible people whom can make and take good decisions.— Fisher
- Hey, NEP, how good is your seniority in a marginalized, disintegrating party?:) On a more humorous note, I thought Obama's jibe at Boehner -- skin of a color not of a known hue -- to be the funniest. Although the shot at Texas was not bad. I also loved that critics thought some of Wanda's stuff was over the top! Cutting-edge humor is over the top by definition. See Lenny Bruce, George Carlin, Richard Pryor, Louis C.K. You may not find it funny, but over-the-top-ness is not the issue.— Djoko Pritza
Comment removed.- The argument that reform is too expensive right now does not compute. If many businesses are struggling due to healthcare costs, and there is a public option that they could (theoretically) dump their employees onto, how much money would they save that could be reinvested elsewhere? Or could be used to pay down costs and reduce any further job losses?— CutterMcCool
- This is the big test for the Obama administration on health care reform: the public option must remain nonnegotiable. Without the government getting into the health-insurance business, there will be no incentive for private insurers to shape up and fly straight. Since the government option will not play by the same rules (profit first) they will be able to outcompete the private insurers in many markets, but not all. (There are some who will overpay for anything because they think they're getting better quality because it has a brand name on it. Like those who insist on sending children to private school. Even substandard private schools.) And some private insurers who are particulary clever may adapt, as UPS in example, to be cheap enough to compete with the goverment. Or even cheaper. But they might have to get rid of their denial of care practices to do it, heaven forbid.— CutterMcCool
- Liberal: How do you pay off Obama's 2009 1.8 trillon dollar deficit, which is before any money has been spent for "universal" health care? Since you have all the answers, please educate me.— CD75
- Liberal; I though you are smarter than that. A poll which simply says to the pollee "higher taxes" without quantifying the cost is misleading and is nothing more than propoganda. A better poll question would be "do you want universal healthcare if your total tax bill would be 50% of your income?"— CD75
- chasing history unfortunately, this problem started with FDR (he was a democrat. Secondly, JFK to now every president has run a deficit of around 2% of GDP. Obama is runing one of close to 9%. Bush (43) increased the deficit at 1/8th Obama. So, until we stop voting for Presidents and congressional leaders who take one and borrow 2, we will become a poorer country. Our political system is broken, as it negects economics when making decisions. Both parties are making and have made these mistakes. Until we change vote for me so I can spend more philosophy, we are going to be poorer— Fisher
- Comment removed.
- Only Poleman could write the following in the same article: "Republicans have been driven to the margins of governance" AND "at the White House event, Obama took full rhetorical advantage. He was in bipartisan mode".— rbpeeple
- Fisher: funny thing. The seven "richer" countries all have some form of unified health care (as do several countries below the US). And property values are correcting - they had several years of unjustified gains.— still_independent
- How can you provide more care while spending less money? Answer: Rationing.— sleepy
- Pete317, if the cheaper healthcare option is of "less quality," then people (and their free will) will go back to the more expensive, "better" options, won't they? Isn't that how the market works? Let's take this quality challenge for a test. When I lived in Germany for 2 years, I was covered by the public plan. I had to see the doctors twice, and it went quickly and effectively. My girlfriend who lived in Italy had the same experience down there. And finally, Tom, who would you believe about the plans for "Obamacare" as you call it - Jan Schakowsky or Obama himself? Why don't you take a look at: http://news.yahoo.com/s/ap/20090505/ap_on_go_co/us_health_overhaul;_ylt=AiEsfJuWV1oTLI8by.TJrIiyFz4D. Let me quote: "(Max) Baucus (Finance Committe Chairman, D-Mont) and many others, including President Barack Obama, say single-payer is not practical or politically feasible." Just admit that Obama has been much more middle of the road on many things (guns, torture rhetoric, etc.) than all of the paranoid wahoos talking about "Obamachev communism" want to realize, because they would rather shake their fists furiously, because they still think that politics is some sort of game or debate team match. Finally (and this is my personal opinion), it is a fundamental flaw of the American collective mindset to frame healthcare as a commodity. Health care needs fixing. Maybe Tom doesn't believe it, but Tom was also the one who posted in the Summer that the economy was doing just swell.— puttinonthefoil
- jwad, you switched party's i see :) i assume you weren't going to let the primary voters decide your fate after 29 years in the senate, how dare those voters! you understand you will lose all your seniority on this blog, right? you will be behind, djoko, talvenada and janann, well then, good luck to you :)— NEPhilly
- These facts and factors all lead to a poorer America than egos believe.....Thanks GOP!— chasing history
- Liberal some facts so you realize we are not the wealthist nation in the world nor have we been since Carter. 1. We are the 8th wealthiest country in the world. 2. property values are lowering . 3. We import more than export. 4. We run a federal deficit twice our revenue base (first time in US history this high). 5. We do not make the products people in the world desire. 6. our taxes are increasing taking dollars out of the loop, which decreases the money multiplier and potential income for people. These facts and factors all lead to a poorer America than egos believe. http://www.aneki.com/richest.html— Fisher
- Comment removed.
- It seems to me the best hope large companies like GM, Lockheed, Boeing, Ford etc have is to have a public option that takes the healthcare costs off their books. Imagine how much more capital all the companies above have if they're not locked into paying for retirees' medical care let alone those on the payroll currently. It seems to me that those on the right who continuously say we can't afford universal healthcare are disingenuous at best and outright dissemblers at worst. Imagine the money that can be poured back into R&D and imagine the people who are locked into jobs they hate because of golden handcuffs. There really is a lack of imagination on the right.
- Private insurers spend .30 of every dollar on administrative costs, Medicare spends .03 of every dollar on administrative costs. CMS is a well run entity and I would much rather have a government paid beaurocrat make health care decisions for me than a employee of a insurance company whose sole goal is to make money.— chasing history
- How can the US afford universal healthcare? This is surely a joke since we're the richest country in the world. And, we already pay more for healthcare per capita than anywhere else. So obviously the problem is a faulty structure of the system, not a need for more money. Just think what you're already paying for health insurance, and realize that you are picking up the cost for a couple of uninsured people either on that tab or on your federal, state and local taxes.— liberal
- This is reminiscent of the first SCHIP bill passed. It was supposed to enroll only children in poverty, but soon escalated to 300% (and in some states 400%) of the poverty level, and many children left the private insurance plans to be enrolled in SCHIP. Therefore, it ended up costing billions more than first envisioned. Polman is also telling a half truth about the public option. Many Democrats (including Obama) want EVERYONE eligible to the public option. The Lewin Group, a health care consulting firm, estimates enrollment in a public option will reach 131 million people if it is open to everyone. Also, Medicare pays about 30% less to providers than private plans...so who would want to be a doctor making that much less money. Lastly, as stated by Jan Schakowsky (D-Calif) the ultimate goal of Obamacare is to put the private health insurers out of business. In other polls, Gallup December 4, 2008, Americans by 49-41% wanted to maintain the current system over a government run system. In the same poll, by 58-39% most people were satisfied with the cost of their health care. As for the polls Polman cited, talk about "framed questions". Of course people are going to favor lowering costs. However, in that same CBS-NYT poll, only 14% said healthcare costs was a top priority for them, only 3% said healthcare costs was the most important ECONOMIC problem facing the country, and in the April 9 CBS-NYT poll, I could not find the quesion mentioned in this post. Perhapd it was in another poll in early April.— tom - wilmington, de
- pete, right you are! Same thing happened when Fannie/Freddie competed with private company's, the GSE's led the whole financial sector over a cliff! Why not have all the private insurance companies compete for all of the govt. business? The govt. could give out percentages of the new business to each of the private companies! That would achieve the desired result of universal healthcare (if that is the desired result & not taking over healthcare entirely), but keep the business in private company hands not in competition with the govt.! Now this is a much better topic Mr. Polman, and you can still get in your partisan shots while we can discuss the topics of the day, a win/win :)— NEPhilly
- CD 10:56 post: the text reading software must be on the fritz, since one of Polman's polls did in fact pose higher taxes in return for healthcare. Another sign of serious breakdown; I'd suggest uninstalling and then reinstalling--might help.— liberal
- pete--can't compete with the government? UPS is doing OK last I heard. And the feds have been privatizing every government program in sight for the last 20 years or so--funny how that story is off the media's radar screen. Also--although health insurance companies are "private" entities, they pay very little in the way of taxes for the most part. But the bottom line is, I can't understand a conservative, free-market guy essentially admitting that the government can provide something cheaper than the market. And that's the essence of your argument, casting the insurance companies as victims of "unfair" competition.— liberal
- Dick, you say "Such a plan would create competition for the private health insurance industry. And the industry doesn't want competition." But you are being glib with your explanation here. Its not just competition. The industry wouldn't mind fair competition. This is an organization (the government) with an endless supply of borrowed capital (i.e. our tax money). The industry cannot, I repeat, CANNOT compete with that. No public organization can compete with a government controlled entity. They will all fail as the government can undercut all of them, and many people will go for the cheaper healthcare option, unaware of the lack of quality that they will get, and this will essentially destroy any semblance of a competitive capitalistic system, and healthcare will end up 100% controlled by the govt (i.e. socialism, bordering on communism). Why are liberals like yourself either too stupid to realize this, or evil enough to lie about it to the less liberal who would be against this to bulldoze this through without a bit of real legitimate popular support.— pete317
- If you promise people stuff without telling them the cost of the stuff, of course they want the stuff. Thus, Polman's cherry-picked polls mean nothing.— CD75
- Show me how to pay for it first, then, I am open to universal healthcare. By the way, Obamachev is borrowing 50 cents for every dollar it also spends. That is not a way to run a country. How can the USA afford universal healthcare? By the way, social security is running out of money faster than predicted.— CD75
- Comment removed.
- I'm comfortable turning far more than 20% over to a liberal government.— HandNik
- Comment removed.
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Cited by the Columbia Journalism Review as one of the nation's top political reporters, and lauded by the ABC News political website as "one of the finest political journalists of his generation," Dick Polman is a national political columnist at the Philadelphia Inquirer. He is on the full-time faculty at the University of Pennsylvania, as "writer in residence." Dick has been a frequent guest on C-Span, MSNBC, CNN, NPR and the BBC. He covered the 1992, 1996, 2000, and 2004 presidential campaigns.
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