Obama's health reform fudge

Maybe President Barack Obama, instead of portraying opponents of his
version of

stethascope.jpg

heath-care reform as liars, should cast out the mote in his
own eye. From him and his White House has flowed a never-ending stream
of misinformation, disinformation, exaggerations and just plain baloney.

Take the oft-repeated claim that 50 million, 60 million or whatever --
take your pick -- Americans have no health insurance, as if our
uninsured population is expiring in the nation's gutters because no one
(read: Republicans) cares. But what the Obama and Democratic operatives
don't tell you is the whole story, and by omitting it, they are
themselves lying. Here are the facts:

The estimate of the uninsured comes from the U.S. Bureau of the Census'
Current Population Survey, with analysis of the 2007 survey provided by
the National Institute for Health Care Management Foundation. The total
uninsured was 45.7 million (and is likely higher now), but of those,
9.5 million were non-citizens or illegal immigrants; 12 million were
eligible for other public health programs but hadn't bothered to sign
up; 7.3 million were in families that had income exceeding $84,108 a
year and chose not to be covered and 9.1 million were only temporarily
uninsured. That leaves 7.8 million lower-income American citizens who
are uninsured long-term.

That of course is a lot, and steps must be taken to get them good health care.

The Obama administration wants you to believe that covering these 45.7
million people of unequal needs is America's highest health-care reform
priority. Truth is, most Americans don't agree. A Kaiser Family
Foundation survey last year found half of U.S. voters say making health
care and insurance more affordable is the No. 1 health issue; that's
twice as much as the second priority, which is expanding coverage for
the uninsured.

The biggest deception by Obama and congressional Democrats is that you
must explode the current system. And all of this without knowing
whether the new structure will provide better shelter or collapse into
the basement. What information we have on the workability of such
grandiose plans comes from the more expansive and intrusive health-care
systems in Canada and Europe. The comparison favors Americans: They are
more likely to survive cancer, receive medical treatment sooner and
have more intensive-care units and technology such as MRIs available.

These facts and arguments were brought together by a coalition of
moderates, including U.S. Rep. Mark Kirk (R-Ill.), who have offered a
compromise package that doesn't presume that you have to destroy the
health-care system to save it. I lay them out here because they don't
receive all that much attention in the media. Kirk, Rep. Charlie Dent
(R-Pa.) and members of the centrist Tuesday Group have proposed the
Medical Rights and Reform Act, which more narrowly and reasonably
targets the system's ills and proposes problem-specific solutions.

According to Kirk's Web site, the proposal would lower health-care
costs by fostering "state innovation through insurance market reforms,
high-risk pools, community health networks and new association options
for small businesses." It would provide other reforms, the most
important of which I believe would impose legal reforms "to end the
practice of defensive medicine while ensuring fair compensation for
injured patients." The high cost of liability insurance that doctors
and health-care providers must pay is a huge factor in the exorbitant
cost of health care.

I'm not necessarily endorsing this specific set of reforms because
there may be better ones out there. One would allow competition across
state lines for medical insurance. Another is a return to the idea that
health insurance is just that -- protection, as homeowner's insurance
is, against unforeseen and large expenses. Home insurance doesn't pay
for such preventive expenses as painting frame houses and hiring
exterminators. Just so, health insurance isn't meant to pay for every
preventive expense imaginable.

The White House propagandists -- the chief one being Obama -- would
have us believe that dropping, say, the demand for a "public option"
would be a compromise (albeit unacceptable to the left). That's more
baloney. It would leave us with the rest of the mammoth and unworkable
proposal. Centering the debate on such proposals as Kirk's is real
compromise. And a good way to cut the baloney.

This column also appeared on the Chicago Tribune's op-ed page

Comments

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  • The breakdown of uninsured people deserves further comment. For example, legal aliens deserve to be included. Those who have not signed up will increase costs once they are included. And those temporarily uninsured may also need treatment at some point.

    The current system does need a major overhaul. Insurance is the problem. Because people are covered by it, there is no incentive to shop around for a better deal. Since providers are reimbursed by it, there is no reason for them to offer a lower price. So costs keep escalating at 2-3 times the rate of inflation. Someone has to step in and put a stop to it.

    Letting the states run it is a typical conservative nostrum. However, not even providers and insurance companies want 50 separate systems. That will only increase inefficiency.

    The issue of lawsuits is overblown. Malpractice awards amount to only 1-2% of total health care costs.

    A public option would provide one thing the current system lacks --competition.

  • Dennis, you appear to be somewhat of an expert on the subject. Please enlighten me. I can't tell if your are a) correct, b) misinformed, c) very sly with your facts, or d) just sloppy. My questions are sincere and simple. I assume prior to publishing your piece in a major newspaper, you would have considered:

    1. Do you believe 12 million people can't be "bothered" to enroll in "other public healthcare programs?" Are these "other" programs legitimate, viable alternatives for quality healthcare?

    2. Are the 7.3 million people in "families" or "households" I believe there is a difference.

    3. If 9.1 million people are "temporarily" uninsured, but there are perpetually 9.1 million of them without insurance at any given time, can you really remove them from the equation?

    4. You mention Americans are more likely to "survive" cancer. Do you consider overall cancer rates of the populations you compare? (If Americans are more likely to "survive" an auto accident, but 10x more likely to be in an auto accident, is that a meaningful comparison?)

    5. The print version of your piece (but not online) states that "American women receive better preventive care." Is this all American women or just those with expensive group plans? Why was this omitted from the online piece?

    Finally, do you believe there is an inherent conflict with for-profit health insurance?

    Thanks

  • In reply to gr8skape:

    You might try this: www.nihcm.org/pdf/NIHCM-Uninsured-Final.pdf

    Some things there will support you, others will not.

  • In reply to DennisByrne1:

    Thanks for the reply. The NIHCM paper focuses a lot on "insurance" and "income." I find it curious the focus is not on "health care?"

    I'm someone who makes more than $80,000 per year and I do elect to be covered. I purchase private insurance for my family because I am self employed. People like me are not considered among the ranks of the uninsured. However, I can be dropped or not renewed by my insurance company if I or one of my kids gets very (read: expensively) sick. Essentially, this is uninsured.

    So, I ask again, why is your focus on "insurance" rather than "health care?"

  • In reply to gr8skape:

    Actually, my focus is not on insurance, but on health care, as I have said in previous columns. The focus on insurance isn't mine, but is the backers of HR 3200. The end isn't getting insurance for everyone, but getting good health care for every one. Insurance is only a means to an end. I don't think we've debated enough all the ways that might be done.

  • In reply to gr8skape:

    Obviously you have good health care and don't really understand the problem. It's the cost stupid. Lot of folks making a lot of money on a system that does not work for we the people. The bigger the group the lower the cost. Eliminate the profit and reduce the cost. Stop trying to justify a flawed system. Some things belong in the private sector ... some things don't.

  • In reply to gr8skape:

    Here's the crunch question, Dennis. In the next 10 years the US Census Bureau reports there will be for the first time in history more people 65-and-older than 5-and-under. Doesn't that staggering statistical reality justify the administration's courage to grapple with this NOW rather than later? Yes, the devil is in the details, but you gotta start by admitting there IS a statistical devil in the room! Critics like you might do better facing down rather than arguing over this fact...

  • In reply to jackspatafora:

    I absolutely agree. Action is required, now. Which is why I supported Social Security reform when George W. Bush tried to reform it. It was beaten back, some would argue, on its merits. Which is to say, urgency doesn't mean that we must surrender rational debate and pass(ed) it, as Obama wanted, four weeks ago.

  • In reply to jackspatafora:

    Well, that's at least one piece of common ground we share. Action now. Many of us agreed with your support of Social Security reform. The problem -- as always in a society -- is that reform is one of those words which tend to mean: Lets change YOUR situation, but never MINE.

    This hangup with our species started right after Eden! Perhaps the only way to achieve the cure of reform is to stick it like mom's do medicine. In the long run, even the critics will appreciate it. Only never admit it...

  • In reply to jackspatafora:

    True, true. I'm a senior on medicare and social security and I expect the complaints from my peers to be loud and long.

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