Category: Social Health Insurance

Miles Mogulescu: Why Not Single Payer? Part 6: New “Health Care For America Now” Coalition May Reflect Divisions in the Movement for Universal Healthcare – Politics on The Huffington Post

Miles Mogulescu: Why Not Single Payer? Part 6: New “Health Care For America Now” Coalition May Reflect Divisions in the Movement for Universal Healthcare – Politics on The Huffington Post

We all saw sicko, but many of us also saw Frontline’s Sick Around the World program : http://www.pbs.org/wgbh/pages/frontline/sickaroundtheworld/

Certainly Single payer can work and might be the best system possible, but I don’t think the Bismarkian systems of Germany, Switzerland and others can be dismissed out of hand. If you go to the frontline website and watch the show, be sure to read the supplementary materials, especially he interview with Uwe Reinhardt. http://www.pbs.org/wgbh/pages/frontline/sickaroundtheworld/interviews/reinhardt.html

I had not given Bismarkian systems much thought until I heard a representative from the Stark Raving Loonie Party (Sorry, that’s Python – I meant the Fraser Institute of Canada) actually confess that he could see working with reform along the Bismarkian lines:http://cmhmd.blogspot.com/2008/03/single-payer-debate-at-duquesne-u-31008.html

Further, Sen. Ron Wyden and others have introduced a plan along these lines, so HR 676 isn’t the only ball in play at the moment.
Wyden Press release: http://wyden.senate.gov/newsroom/record.cfm?id=297073&
Other commentary: http://www.blueoregon.com/2006/12/progressives_re.html

So I guess I’d say not to discount the Wyden plan out of hand as not being “pure” single payer. because we have examples of this system working as well as single payer can.

Cheers,

Report boosts bipartisan health plan – Yahoo! News

Report boosts bipartisan health plan – Yahoo! News:

“Sen. Robert Bennett, R-Utah, the other sponsor of the legislation, said the report confirmed that the plan would not only cut health-care costs but actually save money in the long run.

‘I am convinced we can reach our goal to improve coverage and provide affordable, private health insurance to every American,’ Bennett said at a news conference with Wyden and other Senate supporters of the bill.

The so-called Healthy Americans Act would replace the current employer-based health insurance system with a system in which the government requires, subsidizes, and oversees a system of private health care plans that individuals select. The coverage would be guaranteed to be as good as that which federal employees receive, and the government would subsidize health care for people up to 400 percent of the poverty level.

The plan is paid for in part by changes to the tax code, including a new tax on employers of between 3 percent and 26 percent. Wyden labels the tax ’employer-shared responsibility payments’ and notes that they would replace money employers now spend to provide private health insurance for their workers.
The employer payments are expected to generate up to $100 billion a year in federal revenue.

‘Employers like this plan, and the reason they like it is because it cuts their current and future health care costs,’ Wyden said.”

Obviously, the torpedos are being loaded into the submarines already, but this may represent an opportunity for real reform and, although not single payer so much as Bismarkian/sickness fund style plan, I can live with it. And, more importantly, even many free marketeers can live with it, too.

Sen. Wyden’s press release is here, and it lists current Senate co-sponsors.

Six steps to bring about true health-care reform in Utah – Salt Lake Tribune

Six steps to bring about true health-care reform in Utah – Salt Lake Tribune:

Dr. Joe Jarvis of Utah has written a nice opinion piece for the Salt lake Tribune identifying six important areas to address in health care reform discussions. Some I have addressed here in the past, such as the Moral hazard myth. His number one is:

“Health underwriting: Every critically ill or injured person will be treated in our health system whether they have health insurance or not. Therefore, we should not waste resources trying to identify persons likely to have critical illness in order to exclude them by price or refusal from acquiring health financing. Community rating, guaranteed issue and risk-sharing will increase health system efficiency and eliminate the unfunded mandate that is cost-sharing.”

After seeing the Frontline Sick Around the World Program and web site, and also after attending the Single Payer Debate at Duquesne University earlier this year, it may be that the path to reform in the US might have to be the path of Bismarckian universal healthcare. It seemed that even the far right Fraser Institute’s spokesman at the debate was willing to grant that this might be a reasonable way to provide universal access in the US and not violating the hard charging laissez–faire types ideology too badly.

Household Income, US Census Data

Household Income-2005–Part 1:
“Table HINC-05. Percent Distribution of Households, by Selected Characteristics Within Income Quintile and Top 5 Percent in 2006

[Source: U.S. Census Bureau, Current Population Survey, 2007 Annual Social and Economic Supplement. Numbers in thousands. ]

I always get confused when I hear people talking about middle income families/households, and it alwasy seems to me that if you are in the DC or other elite groups, $100K or even $200K puts you squarely in the middle class.

As you can see by the table (if you can’t read it, follow the link to the Census Bureau), the true middle, is between $37K and $60K for the true middle quintile and between $20K and $97K for the 3/5 in the middle.

Now, just to follow up on something I heard McCain (and the usual propogandists agains National Health Insurance systems of any kind) say is that you’ll be taxed to death. Now, if you are in the middle 3/5, and you are paying, for argument’s sake, $12K for healthcare (either out of your wages or paying it yourself), how, again, do you lose by adopting a single payer or Bismarck style insurance plan?

And I guess I learned something from Frontline and Uwe Reinhardt: I have to add “Bismarckian Insurance Plan,” to my categories/tags.

Cheers,

Single Payer Debate at Duquesne U, 3/10/08

SEPP Organization – SEPP Events

(The link above takes you to the details of the event.)

I attended the debate last night among Dr. Scott Tyson and Gariel Silverman, arguing the single payer case, and Sue Blevins and Nameed Esmail, arguing against at Duquesne University last night. First, props to Duquesne: Great venue in the Power Center, easy parking, nice facility all around. And props to both groups for getting attendance to a surprisingly high level (over 200, I’d guess). Pro-single payer were in the majority, I’d guess, by a significant amount.

I’ll cut to the chase: Jerry Bowyer, moderator, at the end of the evening, asked if the discussion had changed anyone from their pro or anti single payer or undecided camps, and only a handful of hands went up. Sigh. But, not, of course, unexpected.

To those of us who are familiar with the issues and arguments for and against single payer, and familiar with the players (esp. Mr. Esmail’s Fraser Institute), there were not many surprises. My most pleasant surprise was Dr. Tyson’s excellent performance. Powerful, personal and passionate, Dr. Tyson did a very good job of making the moral, practical and economic case.

As my bias is obvious, I won’t pretend to disguise it. I found the same old arguments from the status quo/free market/every man for himself side very tiresome indeed. I’ll just toss out a few “highlights.”

Single Payer advocates see Canada as a Panacea solution for America’s woes. I don’t know of any, but it somehow forces single payer advocates into the silly position of defending Canada’s system, even though it is not the one we would emulate. From now on, we should respond to the Canada graphics with ones comparing us to Germany, France, Belgium, Japan, or almost anyone, and leave Fraser to shit on their own country as they seem wont to do. Heaven forbid they offer constructive solutions. And by this, I mean ones that at least 30 or 40% of the Canadian population would at least consider.

Showing a spending chart showing Canada at the high end of spending on healthcare compared to the rest of the world, and omitting the US, cause we’re so off the charts as to make the chart look laughable.

Arguing that taxation sufficient to pay for healthcare would strangle economic growth. This is just too brain-dead to answer, especially sitting in a country that spends 16.5% of its GDP on healthcare. And especially from an economist who said, specifically, that there is no “government money” only our money in government’s hands.

Waiting times in Canada are intolerable and/or deadly. Please click here.

$32 Billion in Medicare fraud annually is an outrage and a scandal. I don’t know the source or veracity of this figure, but the 2006 Medicare expenditures were $408 billion, meaning 92% of the money gets where it’s supposed to, which needs work, but isn’t awful. And the suggestion that I think Ms. Blevins made was that she preferred private insurer’s solution: deny care first, and then sort out who was trying to scam you, rather than covering claims in good faith and then going after the perps. I’m all for getting the perps, but not until I’ve made sure the patients are taken care of first. Silly me.

Patients in Canada often have to wait 10 or 12 hours to get a hospital bed when admitted through the ER. Imagine our shock. (He did know Pittsburgh was in America, right?)

Veterans Administration hospitals are horrible places. Dr. Tyson did try to set Ms. Blevins right on this one, though I think she didn’t believe him.

You cannot pay for treatment in Pennsylvania outside of your contract with your health insurer.
This one got my attention. I hope somebody will post a comment for me about it, because I’d never heard this before, and it seems exceedingly odd.

The usual “anecdote-off,” for which I’ll just refer you to our special section.

I was pleased to see Mr. Esmail’s praise of other systems, particularly those of Switzerland, Japan, France, Sweden, Germany and some others. He rightly pointed out that the old PNHP proposal, from 1993, was fairly beholden to the Canadian model, but there are newer proposals from PNHP, and besides, they are not the only proposals out there. As has been often pointed out by our side, and always ignored by theirs, we need a uniquely American system, pulling from the best of all other extant systems. Though Mr. Esmail did seem gratified to sear Dr. Tyson say this, I doubt it was the first time he heard it. (You don’t suppose he didn’t watch Sicko, even as an academic exercise?) Oh, and Esmail even admitted we were rubbish for Mental Health care, too.

Oh, and a personal shout out to Scott Tyson for his wonderfully dismissive treatment of HSAs. Made me chuckle and even snort a bit!

OK, folks, that’s all I can remember at this late hour, but please add your comments to remind me of things I forgot to mention….

Cheers,