Monday, July 06, 2009

"Fundamental Reform"

It continues to baffle me how people can discuss the Obama health plan and talk about it being a “reform” of anything; it doesn’t really reform the health insurance industry in any fundamental way, and it certainly doesn’t reform the way we deliver health care to the citizens of this nation, the effectiveness of that health care, or the cost we pay for it.

The Obama plan is not a terrible plan, and it probably should be implemented, but it merely extends our existing insurance plan to people who presently don’t have health insurance; a worthy objective, to be sure. The more honest and optimistic proponents of the plan say that it will lead to reform as the “public option” drives the private insurance industry out of business, but that was said of Medicare (as a "dire prediction") when it was put into place many years ago, too.

Read Paul Krugman’s op-ed piece in yesterday’s NY Times. He says the plan will cost about $1 trillion and that we should not worry about that because, “it’s less than 4 percent of the $33 trillion the U.S. government predicts we’ll spend on health care over the next decade.” He goes on to say that we can “probably” offset that with savings that we can achieve by eliminating overpayments in Medicare and similar "efficiencies," and then adds in a burst of perfectly irrelevant hyperbole,

“So fundamental health reform — reform that would eliminate the insecurity about health coverage that looms so large for many Americans — is now within reach. The “centrist” senators, most of them Democrats, who have been holding up reform can no longer claim either that universal coverage is unaffordable or that it won’t work.”

Well, the plan is a long way from a status that will “eliminate the insecurity” that he speaks of. The people who go bankrupt due to health crisis because they have no health insurance will be able to go bankrupt due to health crisis in spite of having health insurance as millions do every year now, for instance. The people who do not go to doctors because they have no insurance will, in many cases, still not go to the doctor because they cannot pay the initial deductible.

Businesses who cannot afford to provide health coverage for their employees will no longer continue doing business without providing that coverage; they will either cut back their business and hire fewer people, or they will go out of business. People who have no job cannot buy health insurance, no matter how many “health insurance tax breaks” you provide them with. They are not paying any taxes to get the break on.

Dr. Krugman is a little deceptive in tossing off that $1 trillion as being a mere "4% of the $33 trillion we’ll spend on health care." The "we" part in
that is not the federal government, it's the American people, American businesses, plus the government; with the government being a relatively small part of it. So it's not like we are adding a mere 4% to what the government is already spending on health care, and "gee whiz it's easy to trim 4% off our costs to offset that." I'm calling his bluff on that one.

Note that Dr. Krugman even says in his piece that the “fundamental reform” which he so applauds does nothing to address a reduction in the cost of our system, a cost that is wildly out of line with any other nation in the world and he doesn’t even mention the effectiveness of our health care which, when last evaluated, ranked seriously poorly among developed nations.

Yes, let’s extend health insurance to people who don’t have it. Doing that
is better than doing nothing. But please quit insulting my intelligence by calling it “fundamental reform” when it is nothing of the kind.

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