With the Democrats' loss of their 60 seat, filibuster-proof super-majority, the Health Care reform measures that have been the focus of so much fighting over the last year are essentially DOA. As a result, Congress either needs to get back to work to come up with something that everyone can support, or we squander this once-in-a-generation opportunity to usher in the changes that so many agree are desperately needed.
Assuming that everyone has been sincere in their stated desires to reform the health care system in America, as opposed to simply pandering to win votes, why not pass something that the vast majority of all Americans can support?
Congress works for us and, as usual, they seem more interested in winning votes than in governing. I have, therefore, decided to create this group as a challenge to our leaders in D.C. - Are you capable of doing your job?
As a former, active Republican who now considers himself an independent progressive pragmatist, I (perhaps naively) believe that most reasonable folks who are *truly* interested in reforming health care can all agree on these 5 simple principles that must form the foundation for a common ground/common sense health care reform proposal:
1) Prohibit insurance companies from dropping coverage based on pre-existing conditions;
2) Repeal of the anti-trust exemption, allowing for sale of health insurance across state lines to increase competition and control costs;
3) A subsidy to purchase health insurance for, or an expansion of medicare to include those who cannot afford to purchase health insurance on their own;
4) A deficit-neutral way of paying for #3; and
5) Medical malpractice reforms such as caps on recoveries and pre-litigation expert screening panels., to just throw out a couple of ideas.
Item number 1, in my opinion, is a no-brainer. After all, what's the point of insurance if you're only going to lose your coverage when you get sick?
Item number 2 is necessary to control costs. It's a simple market principle that increased competition results in lower costs. There is no justifiable reason why insurance companies should enjoy an anti-trust exemption that no other industry besides Major League Baseball does.
Item #5 is also a necessary component of driving down costs. The exponentially rising costs of medical malpractice insurance premiums are preventing more and more quality doctors from entering fields such as primary care and obstetrics, due to the oppressive costs of doing business. I've personally seen first hand the results of doctors who are essentially forced to practice defensive medicine out of fear of being sued. only for the very thing they thought would protect them to become the cause of their being sued. Trial lawyers (like John Edwards - just sayin') make a killing off of destroying the careers of good doctors and other health care professionals who either did nothing wrong or made accidental mistakes. While there are, unfortunately, true cases of professional negligence for which compensation is absolutely just and equitable, outrageous jury awards have become the new national lottery at the expense of the very people we turn to at our worst of times. Unfettered litigation, just like unfettered capitalism, leads to grossly inequitable results and a whole slew of unintended consequences, driving up the costs of health care for everyone. So, to my progressive, liberal, leftist, and socialist friends out there I say: there truly are noble concessions to be made here.
The really hard part is finding common ground on #3 and #4. Nonetheless, I'd like to believe that nobody believes that anyone should go broke to obtain health care. I'd also like to believe that most people agree that those who cannot afford health insurance on their own, for whatever reason, still deserve quality care. Obviously, someone has to pay for the costs of health care that others cannot. This can be accomplished in any number of ways: expansion of medicare, requiring insurance companies to contribute a portion of their profits to an insurance pool for the uninsured, increasing taxes on the top 1% of income earners, etc. Personally, I don't really prefer any one particular idea over another, however; I strongly believe that we need to stop pretending that we can provide necessary services without paying for them. Thus, regardless of the approach eventually agreed upon, the plan must be paid for. Putting blame aside, our national debt is our national disgrace and any health care plan that is ultimately passed must not be allowed to serve as gasoline poured on a raging fire.
That's it. How difficult can it really be to find common ground on these 5 principles? It seems to me that these basic guiding principles can attract support from the vast majority of Americans - my challenge to Congress is to see if they're capable of acting like grown-ups for a change by working together to get something done.
Are there other health care issues that need to be addressed? I'm sure there are tons, however; the kitchen sink approach has been a disaster. Will these reforms have unintended consequences that nobody can accurately predict? Probably so - but so does all legislation. Every choice we make has consequences - inaction IS also a choice - one we've allowed our elected servants in Washington make all too often, regardless of which party is in charge. This issue is way too important to simply punt down the political field yet again - we elected these people in Congress to do a job - we must insist that they find a way to do it.
We all have to choose our battles wisely. Let's focus first on those things where we can all find common ground.
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Hello,
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Why should the government be allowed to tell a private company, "You must insure this customer?" I think the market should be the driving force, not government.
If insurance companies want to accept people with preexisting conditions, they will and they should charge higher premiums. IF the consumer does not want to pay these higher premiums, then that is their choice.
Insurance companies are FOR-Profit businesses. Whether they make $10 a year or $10Billion a year is not relavant, so don't bring up insurance companies profits.
Leaving the market to be the driving force without an oversight historically led to:
toxic and tainted food being sold to Union soldiers, in cans that were improperly cleaned and sealed with lead solder
The slaughterhouses as written of in "The Jungle" where diseased meat and occasionally a human limb or digit were processed and included in the food eaten every day.
Factory owners locking their workers in, and refusing to let them leave for any reason. It took a few deaths by fire and exhaustion to change that.
Children working in factories in the most dangerous positions "because they were small enough to reach."
Would you like more recent examples?
The sub-prime mortgage fiasco and consequent financial meltdown.
The refusal of pharmaceutical companies to manufacture drugs necessary to cure certain disease because "the market wasn't profitable enough."
The Gremlin, Pinto, and Pacer.
The failure of GM and Chrysler.
The dumping of chemicals into drinking water by companies.
The illegal dumping or sub-standard dumping of toxic chemicals. The worst being the Marion School district built on TOP of a waste dump.
The whole market as the driving force argument is a joke. Without smart government oversight and law enforcement, the market forces would seek maximum profit at the expense of everything. There is no mercy or justice in the market. As evidenced by our shared horror stories of student debt.
If those insurance companies weren't legally held accountable and/or told to insure those persons, they never would. In fact, we'd lose coverage the first time we got sick, if some of these companies could have their way.
#1 and #5 are good. #3 while noble, isn't going to occur with the requirement of #4.
And #2 is a bad idea. Look at other industries that have been deregulated (namely the power and utility companies), prices didn't drop they actually went up. The competition didn't materialize because the original companies were already established with majority market shares.
Lastly, it's not that people don't have coverage, it's that they can't afford it. We need to reign in costs, invest in more preventative care, and better regulate the health care industry.
The reason the current bill wasn't going to pass (even with the 60 seat super majority) was because it wasn't a good bill. Costs weren't adequately addressed, and what people wanted/needed wasn't in the bill.
We don't need a "public option" we need lower costs, and affordable care.
I think you make a valid point, but costs will only lower if competition of the smaller and start-up kinds appear. Under the current settings, those companies could appear as well, and would have the benefit of needing to only compete with a limited number of companies.
The only competition that I see occurring would be from other large insurance providers. And there's no guarantee they won't operate within agreed upon price parameters (whether that's legal or not is another matter, whether companies care or not about legality is also another matter).
And with these large companies competing from stable and secure bases, it would seem that the market would be much more difficult for smaller companies to get in.
It's hard to find common ground on #3 and #4 because those are not simple principles that most people agree on (there may be a little contradiction in your essay).
#1, #2, and #5 are good principles - we should go with those and pass those.
So you believe that a person who cannot afford health insurance deserves lesser care than someone who can afford it? That's not the America I know and love.
Whether you know and love it or not. That's the sad state of America right now. In theory we're a classess society, but reality is something akin to a two class society: Those with money, and everyone else.
That is precisely why I'm using my voice to convince others that I am right on this issue. We are ALL Americans. We are ALL our brothers' keepers. A modern, enlightened civilization can only be judged by how we treat those who need a helping hand the most.
Totally agree with this option plan. I would like to share, that as a former Health Information Manager with 25 years experience in Health Care, I can assure you of the following: a) There is a significant amount of waste in the system, and redundant work processes, that cost us money and also impede effective care from practitoners. Much of the redundant and wasteful paperwork is required by the US Government, for Medicare and Medicaid reimbursement. It would take me hours to explain the dynamics in the hospital setting alone with the paper and computer processes. b) So long as their are lobbyists, and the bulk of our elected officials are bought and paid for by them, they are controlled by them, and the insurance companies will continue their strangle hold, just as the Dept. of Education, and the big banks and WallStreet do with our student loans and credit cards and stocks. It is really pretty sad. The system is just so corrupted at this point that we are in a tangled webb, and a maze of complexity that it is impossible for me to even think of a real solution to the mess. Robert is right, we have to focus on this cause, and if everyone works hard at fighting for their cause, we can have some clout -- maybe. It does pay to try. It doesn't pay to give up. I am backing Robert on this alternative option, which is better than nothing, and will help most people in some way. I continue to write President Obama, my Congresspersons, too. It's the only hope we have. Keep writing your Congresspersons, call, keep up the blogs, and don't ever give up. Even some attention to the problems we are facing is helpful. For those burdened with student loans, affordable healthcare is even more important.
I agree and you are correct a society should be judged on how it treats the defenseless.
But I think the reforms have stalled because people don't like what's being offered on the table. Just like many didn't like the bailouts, or the wall street (lack of) reforms.
It isn't that people don't want universal healthcare. It's that they want universal, low cost, high quality health care. Which the current reforms weren't necessarily offering.
I respectfully disagree with your characterization that elimination of the anti-trust exemptions would be akin to deregulation of utilities. Insurance companies can easily, and would gladly compete across state lines if they were allowed to do so - there isn't a need for infrastructure as in the utilities industries. The status quo allows some insurance companies to control upwards of 90% of the market share in certain markets, resulting in absolutely no incentive to keep costs down as they have a captive clientelle. Allowing smaller and start-up insurance companies to compete with the giants of the industry would force the giants to reduce their costs. There are many areas where cost savings can be achieved: overhead, including executive compensation, taxing excess profits, etc.
The resulting drop in costs should make health care affordable to millions more people than at present and the remainder of the uninsured should be able to participate in some kind of insurance pool, whether public or private - I don't care.