Ezra Klein opines in his recent editorial in the LA Times that conditions are, if not ripe for a move towards universal coverage, at least we’re getting closer to harvest time.
A couple of (relatively) minor nits. Hospital profits are not exactly “skyrocketing”. Yes, they’re healthier than they have been of late, but low-single-digit margins are not even out of sight, much less out of the troposphere. Second, Ezra claims that the nation won’t countenance a continuation of today’s health care mess. I disagree – as one who said “we can’t take it anymore” ten years ago, I’ve been amazed by Americans’ ability to take it, at least when it comes to over-priced health care of mediocre quality.
Those points aside, Ezra’s inventory of environmental and political factors is compelling. There is no doubt that we are getting closer. There is also no doubt (at least in my mind) that Americans’ ability to tough it out, endure, and/or ignore this problem is akin to the legendary endurance of the Russian peasant.
Until and unless a plurality of major corporations, labor groups, and middle-class voters decides this is really important, it’s highly unlikely we will have a major move towards universal coverage in the next year or two.
Therefore, I’ll stick with my prediction of last year – we’ll have some form of universal coverage before 2011. And not too much before.
Jan
2
I can assure you after having been in the healthcare industry, and specifically working with healthcare networks of all sorts for 20 years now, that universal healthcare in America will be a disaster. We need only to look at the past examples of government interference to see the mass of problems that healthcare has had to “overcome” because the government regulated in one form or another. Going back to the 60’s when Medicare was forced on the medical community; or requirement of billing on standardized forms. What practice in America can really say they are enjoying the transition to electronic billing and payments mandated by the Federal Govt. right now? Did we not enjoy the compliance with HIPAA that was recently placed on our industry? What provider in any of the states around the country can say they appreciate the State Mandated Workers’ Compensation Fee Schedules that have been mandated!
More importantly because of any of these regulatory requirements can we honestly say that the quality of care has gone up? By regulating costs can we honestly say that access to care has increased?
America through the bias of the media and the spin masters may be diluded into thinking that universal healthcare is the solution, but in the end it will be a travesty to our nations. No other country on the globe with a form of socialized medicine brags about the free access their citizens have. Why do we think our experience will be different?
No, America will do best when it remembers and follows it’s roots. The free market system will develop the solutions needed for healthcare, we need only for the Government bodies to stay out of the way.
President Ronald Reagan said it best “In this present crisis, government is not the solution to our problem; government is the problem!”
Good to see that not all the wing-nuts are concentrated on my blog! But at least the local gays love him…even if the feelings aren’t mutual.
What in the hell is a wing nut? If you are talking about a useful and essential piece of hardware that keeps everything together- then yes, he is a wing nut.
At any rate, Dorrence makes complete sense to me. And, he knows healthcare.
I was referring to this rather amusing article about Dorrence’s political career
http://www.nashvillecitypaper.com/index.cfm?section=9&screen=newsprint&news_id=24551
Meanwhile a wing-nut is one of these http://en.wikipedia.org/wiki/Wingnut_%28disambiguation%29
And if Dorrence really thinks that foreigners hate their universal health care systems then why do the right wing consverative parties in those countries all unambiguously want to maintain those systems?
You’re not per chance related to him, and trying to get on his good side. are you Kelly?
Matt: Don’t know if you live in Nashville, but yes I ran an “interesting” campaign for local city council several years back at the urging of some friends. I didn’t win, but hey at least I tried! What is amusing is that this article is still posted 3+ years after the race.
I did not say that foreigners hate their universal health systems. I’m sure that those in reasonably good health find them to be quite adequate. However, in my career I have seen many people from these countries coming to the USA for healthcare that they simply cannot get, or cannot stay alive long enough to recieve. I believe reform is possible but not in the direction of socialized medicine, but rather incentives to have the free market correct problems. The best point out of this proposed legislation is to pool groups rather than doing underwriting. That is a suggestion that needs exploring.
Anyway Matt, thanks for the “blast from the past” and I look forward to furthering the conversation.
PS: Yes, Kelly is my wife and I’m proud of that too!
Personally, I’m weary of the name-calling that substitutes for rational discourse for Matthew Holt. “Loonies”, “wing-nuts” and “racists” are the labels he reserves for those who advocate liberty in health care and oppose his single-payer propaganda.
I agree. Too many want to take the conversation off topic. We need to have a rational discussion of professionals about the impact any legislation will have on the American Healthcare System and find the best possible solution for the American public. Let’s keep this discussion on – topic and maybe the legislatures will be copied in on such.
Thanks for your help in having a rational discussion.
It would be more than nice if commentators were careful to be clear about the fundamental difference between health care and health insurance. But many commentators – unfortunately even well-known ones such as Ezra Klein – aren’t so careful.
Instead, they often seem to mean the term “healthcare” as a codeword that refers to and mixes together both health care and health insurance. It confuses health care with health insurance, it confuses the different problems associated with each, and it confuses the readers. I think it’s carelessness.
For example, why is health insurance expensive? Because “profits” are high? Piffle. The cost of health care is clearly the most important factor in the cost of health insurance. Health insurance is expensive because health care is expensive. The cost of health insurance is rising because the cost of health care is rising. The cost of health care is the deeper problem. Blurring the difference between health care and health insurance obscures these important distinctions. That gets in the way of analysis. It results in misunderstanding. It results in fruitless debates among people who are confused over the facts. It eventually leads to faulty policy recommendations.
Why would analysts blur the difference between health care and health insurance? Who knows? I can think of several possible reasons. (1) they don’t understand the difference (2) they don’t care (3) they have an agenda that is served by confusing the public about the issues (4) they truly believe that any difference doesn’t matter. (5) they truly believe that there is no difference. IMO, taking any of these positions is an embarrassment to anyone who wants to be a thought-leader in health care.
An example – look at the end of Klein’s 5th paragraph:
“And so they did, creating the employer-based healthcare system.”
Does anyone believe that we have an employer-based “healthcare” system? Health care in this country is provider-based, NOT employer-based. And thank goodness for that. Group health insurance is employer-based. Is that what Klein means? Then why doesn’t he say so?
Another example? Look at the start of Klein’s 6th paragraph:
“But healthcare was simpler in the 1940s, and far less expensive. In the 21st century, it’s not simple at all. Once a perk of employment, health insurance is now a necessity”
What is he talking about? “Healthcare”? “Health Insurance”? How can anyone tell?
From the 6th paragraph on Klein is in full cry about health insurance, not “healthcare” If the goal of this article is to present the reader some persuasive argument about health insurance then why does Klein seem to want his readers to think he’s talking about health care?
The confusion on this point is important, because it diverts attention from the deeper problem to the symptom. You would not accept a doctor’s failure to treat the ailment, instead being satisfied to treat only your symptoms. Why accept the same failure from health care analysts – or politicians?
This nation truly faces a crisis of health care costs that cries out for solutions. The symptoms of this crisis include unaffordable health insurance and millions of uninsured Americans. Solutions to the problem of high health care costs must explicitly address health care costs. Duh. Addressing other problems that do not relate to the cost of health care – but at the same time pretending that they are about “healthcare” – will not solve the health care cost problem. Duh again.
I’m a benefits manager who would welcome a practical solution to the problem of high/rising health care costs. I don’t know how that would happen. So I must rely on policy analysts and other thought-leaders to figure out some kind of solution. But when I read articles like Klein’s, I must admit I grow terribly discouraged.