The truly strange thing about the war over the "public option" is that it is probably the most market oriented facet of the whole health care reform package. The wrong guys support it, the wrong guys are opposed.
Normally, the left would simply resort to regulation: "Though shalt not charge more than..." and screw up the economics of health care more than they are screwed up.
"At a minimum, there should be very strict regulation of all insurers, on and off the exchange, to promote competition and fair prices and substantial subsidies to help low-income people buy insurance..." editorializes the New York Times, again illustrating how the left doesn't "get" economics. To promote competition you don't regulate insurers, you guard the markets, reduce "barriers to entry," etc.
There are many market forces in place that drive up the cost of health care "as a system." Doctor owned diagnostic centers, for example; lack of competition in any one geographical market; insurance oligopolies; no standardized charting.
The antidote is to introduce forces that can systemically drive down prices, and that is best achieved through competition. That competition is best enhanced with public options, consumer choice, consumer consequences, all of which are lacking in the current environment.
And maybe for that reason alone, the brains of the Republican right are so opposed. The public option might actually work, because it really is a market-based tool. A tool they should favor.
On the other hand, if they can kill the public option and force the left into its comfortable role of law-based decision making, they will be able to point out that the left does want to deny choice, favors government over the individual. It is a long term strategy to get back into power.
The administration needs to grab this process. It can not be left to the right, nor the blue dogs, nor the far left. This administration is in a unique position to take all the good ideas and rework the health care landscape, with or without "compromise." Their plan could be the compromise.
There are many good ideas out there. Public option. Co-operatives. Tort reform. Transportability. Elimination of rules that limit plans to "in-state." Standardized, transferable electronic records. Perhaps they all need to be given a chance.
It is time to get to work.
Showing posts with label public option. Show all posts
Showing posts with label public option. Show all posts
Wednesday, August 19, 2009
Sunday, August 16, 2009
The public option
On Friday, Sarah Palin joined Republicans nationwide in opposition to public libraries.
Funded by major publishing companies, book store chains and a large seller of books over the Internet, the right wing has declared libraries to be "socialist, communist, and not the American Way."
Libraries, they say, threaten the ability of Americans to buy books, and could lead to government control over what is read, by whom and where.
"If government buys books, government will decide what books to buy. It is clear that this is a threat to democracy," said (former) prescription drug addict Rick Limberger on his radio show.
Will O'Kelly, on his television program and between ads for exotic Swedish sponges, said that people who go to libraries may be affiliated with Al Queda, he didn't know that and wasn't saying that, but librarians should be investigated, and those who publicly deny the fact should be required to prove it isn't true.
Shamus Hennesy said that it is clear that library books are a vehicle for disease, and only pristine, white pages with virginal paper unsullied by unknown hands of other possible color were good enough for his daughters. He compared libraries to crack houses and the sharing of library books to the sharing of needles.
"Tea Baggers," the unfortunately named movement of people afraid of an educated populace, have protested at town hall meetings nationwide. Funded by the book sellers, mobilized by radio entertainers, they shout into microphones provided by the government that people being able to read books purchased by government represents an infringement on their rights.
But it is the darling brunette of the far right who has captured the essence of the debate. Not that her looks matter. If she was a moose with dewlaps and dimples, she would still command attention for the power of her ideas.
"We don't want to pay taxes so other people can read," said Palin, who also said that she would definitely take up arms against public education when she might run for president in 2012, though she said she isn't saying that, nor what she was saying, but said that too with her famous coy smile.
"Government is bad. Taxes are bad. Tax supported 'public' schools are bad. 'Public' libraries are bad. Anything with the word 'public' is bad, because it has most of the same letters as pubic, and will give our young people ideas and lead them down a path of moral decay," Palin said with a wink that instantly drew millions of conservative men down that very same path.
"If I can't afford to pay for my child's education, I should not have an educated child," she added, pointing again with pride to her own family. "Besides, I don't read that much."
Others have not been so direct.
"Libraries threaten the profits of national book store chains. Without profits, they will fail, throwing thousands of sales clerks out of work at a time when the economy can ill afford additional unemployment," said Pewt Heinrichs, former Republican strategist.
Those in favor of libraries have remained for the most part silent. "We just think people should have access to books, even if they can't afford to buy them," said one quietly, asking to remain anonymous, afraid his neighbors would show up to burn down his home.
Funded by major publishing companies, book store chains and a large seller of books over the Internet, the right wing has declared libraries to be "socialist, communist, and not the American Way."
Libraries, they say, threaten the ability of Americans to buy books, and could lead to government control over what is read, by whom and where.
"If government buys books, government will decide what books to buy. It is clear that this is a threat to democracy," said (former) prescription drug addict Rick Limberger on his radio show.
Will O'Kelly, on his television program and between ads for exotic Swedish sponges, said that people who go to libraries may be affiliated with Al Queda, he didn't know that and wasn't saying that, but librarians should be investigated, and those who publicly deny the fact should be required to prove it isn't true.
Shamus Hennesy said that it is clear that library books are a vehicle for disease, and only pristine, white pages with virginal paper unsullied by unknown hands of other possible color were good enough for his daughters. He compared libraries to crack houses and the sharing of library books to the sharing of needles.
"Tea Baggers," the unfortunately named movement of people afraid of an educated populace, have protested at town hall meetings nationwide. Funded by the book sellers, mobilized by radio entertainers, they shout into microphones provided by the government that people being able to read books purchased by government represents an infringement on their rights.
But it is the darling brunette of the far right who has captured the essence of the debate. Not that her looks matter. If she was a moose with dewlaps and dimples, she would still command attention for the power of her ideas.
"We don't want to pay taxes so other people can read," said Palin, who also said that she would definitely take up arms against public education when she might run for president in 2012, though she said she isn't saying that, nor what she was saying, but said that too with her famous coy smile.
"Government is bad. Taxes are bad. Tax supported 'public' schools are bad. 'Public' libraries are bad. Anything with the word 'public' is bad, because it has most of the same letters as pubic, and will give our young people ideas and lead them down a path of moral decay," Palin said with a wink that instantly drew millions of conservative men down that very same path.
"If I can't afford to pay for my child's education, I should not have an educated child," she added, pointing again with pride to her own family. "Besides, I don't read that much."
Others have not been so direct.
"Libraries threaten the profits of national book store chains. Without profits, they will fail, throwing thousands of sales clerks out of work at a time when the economy can ill afford additional unemployment," said Pewt Heinrichs, former Republican strategist.
Those in favor of libraries have remained for the most part silent. "We just think people should have access to books, even if they can't afford to buy them," said one quietly, asking to remain anonymous, afraid his neighbors would show up to burn down his home.
Tuesday, August 11, 2009
The health care onion
First, there is the debate about fixing this nation's health care. Inside that, there is the debate about the health care debate, whether it is being rigged. Inside that, there is the possibility that Republicans don't care so much about health care, but want to hand Obama a loss. Any loss.
Where to begin?
First off, the lie that we have the best health care system in the world needs to be dismissed. We do not have the best health care system in the world. Look up the statistics on your own. Infant mortality? We rank ninth in the industrial world. Efficiency? Thirty percent of our health care dollars go into the paper work war between doctors and insurers. Etc.
Add to that the power of corporate oligopolies; the drug companies, insurance companies, the physician-owned hospitals and groups of prescribing docs who own radiology centers, etc. We have a recipe for profit, not efficiency nor patient care.
It is important to realize that there is a difference in our "health care system" or lack of it, and the quality of care one might receive from an excellent doctor. That may indeed be world class.
But that is not what we are talking about.
One of the really wrong ideas in this debate is that "the market" will provide health care. It won't. Markets need a tight relationship between money spent and service received. You don' t have a rational market where the payer for service (insurance companies) is not the recipient (patient) of service. Patients want the best care available. Insureres want the lowest cost.
And yet, one of the closest ideas we have to bringing "market" dynamics to the table is being thrown away. Having a "public option" would fit quite well with market economics. If the public option is no good, it will fail. If it is good, it will help bring down costs, while still allowing people to choose.
And we already have "public options." Medicare. Medicaid. Most of the noise about the "pubic option" is based on fear that the gravy train won't stand up to real competition.
Even sending our poor to hospital emergency rooms is a form of "public option." An insanely inefficient option. It slows down "emergency" rooms. It is expensive. It shifts costs, so that those of us with insurance fund the system by paying $6 for a single aspirin. That is a "public option" of irrationality.
It is amazing that Republicans are again able to convince people to scream against their own interests. The men and women working at the gas station and the sporting goods store and driving truck, the retired, and certainly those who have been fired from jobs where they had insurance, should support health care reform. But misinformation, fear mongering and the politics of hate (look at those screaming faces) remain effective weapons.
We can't afford to spend more of our income on health care. It is breaking our finances, draining our future. We can't leave our neighbors without health care: That is immoral.
The time has come to look at alternatives.
Where to begin?
First off, the lie that we have the best health care system in the world needs to be dismissed. We do not have the best health care system in the world. Look up the statistics on your own. Infant mortality? We rank ninth in the industrial world. Efficiency? Thirty percent of our health care dollars go into the paper work war between doctors and insurers. Etc.
Add to that the power of corporate oligopolies; the drug companies, insurance companies, the physician-owned hospitals and groups of prescribing docs who own radiology centers, etc. We have a recipe for profit, not efficiency nor patient care.
It is important to realize that there is a difference in our "health care system" or lack of it, and the quality of care one might receive from an excellent doctor. That may indeed be world class.
But that is not what we are talking about.
One of the really wrong ideas in this debate is that "the market" will provide health care. It won't. Markets need a tight relationship between money spent and service received. You don' t have a rational market where the payer for service (insurance companies) is not the recipient (patient) of service. Patients want the best care available. Insureres want the lowest cost.
And yet, one of the closest ideas we have to bringing "market" dynamics to the table is being thrown away. Having a "public option" would fit quite well with market economics. If the public option is no good, it will fail. If it is good, it will help bring down costs, while still allowing people to choose.
And we already have "public options." Medicare. Medicaid. Most of the noise about the "pubic option" is based on fear that the gravy train won't stand up to real competition.
Even sending our poor to hospital emergency rooms is a form of "public option." An insanely inefficient option. It slows down "emergency" rooms. It is expensive. It shifts costs, so that those of us with insurance fund the system by paying $6 for a single aspirin. That is a "public option" of irrationality.
It is amazing that Republicans are again able to convince people to scream against their own interests. The men and women working at the gas station and the sporting goods store and driving truck, the retired, and certainly those who have been fired from jobs where they had insurance, should support health care reform. But misinformation, fear mongering and the politics of hate (look at those screaming faces) remain effective weapons.
We can't afford to spend more of our income on health care. It is breaking our finances, draining our future. We can't leave our neighbors without health care: That is immoral.
The time has come to look at alternatives.
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