Brian Klepper has exercised his editorial authority and tightly focused this biweek’s edition of HWR on the fading promise of health reform. Whether you agree with his perspective or not, Brian’s work is thought provoking at the very least.
I’d be remiss if I didn’t note that other bloggers, and in particular Maggie Mahar, have a much more positive view of reform. Her take provides a worthy counterpoint to those of us less sanguine about the impact of reform.
Jan
7
Joe–
Thanks for the kind comment.
I am sorry to see Brian Klepper use HWR’s brand name to try to create a list of which bloggers should be read–and who should be ignored–based on their politics.
I would add that there are other bloggers who should be included in a round-up of the best health care bloggers of 2009: Merrill Goozner, Jon Cohn, Gary Schwitzer, Bob Wachter and Ezra Klein come to mind.
As he indicates in his post, Klepper sees Bob Laszewski as the model for health care blogging. From the beginning, Bob was adament that health care reform must be “bi-partisan”. Since there are virutally no moderate Republicans left in Congress, this means that reform must reflect a conservative ideology.
For my part, I thought the Republicans had little or nothing to offer in the way for ideas for reform. They don’t want government involved in healthcare, and have made that very clear.
I should add, I am hardly thrilled with the Senate bill. As I wrote yesterday on my blog:
“At the moment, I am just a bit weary of Washington’s war on health care reform. (Yes, I mean “on”). So many seem bent on “winning” what they perceive as best for themselves or the small group they represent. Narrow self-interest carries the day.
“To be sure, a core of courageous legislators fought hard for the public good [Here I am thinking of people like Jay Rockefeller] and they won on some important points:
“Insurers will no longer be able to shun the sick. Most low-income and lower-middle income families should be able to afford care.
“But, by and large, this fight has not been about patients or medicine. It has been about money and politics as liberals and conservatives battle to see who will hold power in Washington over the next three years. The differences run deep, and are not limited to the Capitol. The electorate is more polarized than at any time since the 1960s.”
I was happier with the House bill–though I saw that as a case of the glass “half-empty, half-full” (see my three posts on this point on http://www.healthbeatblog.org)
Could the legislation rein in healthcare spending? Klepper et. al, ignore the fact that the legislation calls for serious cuts in Medicare spending that would come about if Medicare begins cutting the waste– using financial carrots and sticks to steer doctors and patients away from over-priced inefficient care and toward value.
Medicare reform could pave the way for structural reform in how we pay for care, what we pay for, and how it is delivered.
This would be much easier if therE were a public option that could incorporate Medicare’s reforms—as the House bill proposed.
But as Peter Orszag has said, not everything has to be in the legislation.
We’ll see what Medicare does on its own.
I also anticipate amendments and further legislation.
Finally, as you know, I think that the biggest problem in our health care system is that, unlike every other developed country in the world, we have chosen to turn it into a largely unregulated
for-profit business.
Inevitably, this creates a conflict of interet and
profits trump patients.
As businessmen, both Brian Klepper and Bob Laszewski see health care as a business opportunity. Though I realize Brian hopes to “do good” while “doing well.”
Unfortunately, the past four decades of attempts to use “the market” to deliver high quality, affordable health care to all have failed miserably.
That’s why other countries have gone in another direction.
Thanks for giving me an opportunity to express another point of view.
Public option? I think we need one single payer plan which will control costs and accomplish all the goals of health reform with only a few pages of legislation not thousands. This bill is bordering on absurd.
Maggie, what do you say to the millions (if not the majority) of Americans who are happy with their health insuance and care when you say, “Unfortunately, the past four decades of attempts to use “the market” to deliver high quality, affordable health care to all have failed miserably.”
That’s a broad statement.