Stanley Feld M.D.,FACP,MACE
President Bush made a weak proposal to reform the healthcare system in his State of the Union address. When his administration tried to reform the over inflated DRG system from hospital charges to hospital cost the lobbying groups force the administration to back off. Price transparency is another area the administration tried to get support. This too was not acted upon. The knee jerk reaction from his tax credit proposal resulted in the following cascade of response.
The three most prominent Democratic presidential candidates all have declared their intention to move the country toward universal health-care coverage.
The government can not presently deal with Medicare and cost overruns how are they going to deal with the cost overrun inevitable with Universal Health Care. Anyone ever think about what the words universal healthcare means in a free and affluent society? What form does it take? How is it funded? What does it mean?
Sen. Barack Obama (D-Ill.) committed on Thursday to providing health-care coverage for every American within six years.
”I am absolutely determined that by the end of the first term of the next president, we should have universal health care in this country. There’s no reason we shouldn’t have that,” Obama said in a speech to Families USA, a liberal health advocacy group.”
The meaningless sound bite “universal healthcare” is going to be a big issue in next Presidential campaign. I sense neither the politicians or the public knows what the term means or what the consequences will be to the healthcare system.
“Former Sen. John Edwards of North Carolina declared in announcing his presidential campaign in December that he would back universal health care, even if it required expanding the federal budget deficit.”
“And Sen. Hillary Rodham Clinton (D-N.Y.), who as first lady spearheaded the Clinton administration’s ill-fated plan, also has made health-care coverage for all a central theme—highlighting her commitment by appearing at a community health-care center last weekend, the day after announcing she was forming an exploratory committee.”
Has anyone asked practicing physician and patients what their needs are to make the healthcare system effective, functional and efficient? Not yet! I also do not expect it to happen anytime soon.
”One of the goals that I will be presenting . . . is health insurance for every child and universal health care for every American,” Clinton said on Sunday. “That’s a very major part of my campaign.”
This is a good sound bite in “our sound bite society”. However, it is a meaningless statement.
“We expect that it’s going to play a bigger role than it ever did,” said the Democratic adviser, who declined to be otherwise identified.
Republican Governors have jumped in and offered their plans to provide insurance for everyone. . The plans are a good try. The defects in their plans are causing reaction already. No one has addressed the real problems of distorted charges, distorted insurance premiums, and incentives for preventing the complications of chronic disease. No one has addressed the issue of putting the patient in control of their own healthcare dollar in a market that is priced correctly with equality for all.
“Several Republican governors also have recently embraced the goal of health-care coverage for all.
Former Massachusetts Gov. Mitt Romney, who is expected to be a GOP presidential candidate, signed legislation requiring all state residents to get health insurance by July 1 or face a tax penalty, with the state subsidizing insurance for lower-income residents.
The conditions of insurance are being fought over as we speak.
California Republican Gov. Arnold Schwarzenegger kicked off his second term this month with a call to assure health care for all state residents.
The Repair of the Healthcare System is really in the control of the state governments. Those governments issue licenses to practice medicine, insure patients, and open hospitals in their own states. They can set the conditions for these licenses. However, I have only seen conditions set for the benefit of the insurance industry and hospitals, and not for the patients benefit. Only the patient can create a competitive market place that will control prices.
The president, meanwhile, this week offered a health-care plan of his own, (hardly a health plan) aimed at helping more Americans obtain health insurance. Bush spoke Thursday about his proposal at a conference outside Kansas City, Mo.
“In Illinois, Democratic Gov. Rod Blagojevich’s All Kids program was the first in the nation to offer state-subsidized health insurance to all children. (No one has mention how they are going to fix the insurance plans) During his re-election campaign last year and since, Blagojevich has spoken of his interest in moving the state toward a broad universal health-care program.”
“In his speech Thursday, Obama argued that the political climate has shifted since 1994, opening an opportunity for universal health care.
“He noted that more employers have dropped private health-care coverage since then. Employees with coverage are paying higher premiums and co-payments. And, he said, American companies face greater competitive pressure from foreign businesses that are not burdened with health-care costs because their governments provide coverage.”
”We are not in 1992. We are not in 1993. We are not in 1994. We don’t have to be intimidated,” the senator said. (Another sound bite)
“Economist Henry Aaron of the Brookings Institution, a think tank with a liberal leaning, and health-care expert Stuart Butler of the Heritage Foundation, a conservative think tank, both said establishing universal health-care coverage would be enormously difficult.”
I agree. When are we going to learn that you can not enforce price controls? When are we going to learn that we can not control behavior or morality unless we have the correct rules and incentives? It sounds good but it does not work. Market forces and competition are the driving forces for reducing waste and inflated prices.
Is anyone listening to what has been proven a thousand times over? It does not sound like it to me.
Butler, who has studied America’s health-care system for 30 years, said he supports universal coverage, but that the current system would require a drastic overhaul and that the “costs would be staggering.” An estimated 47 million Americans have no health insurance.
Aaron, who has been working on reform of America’s health-care system for more than 25 years, said the climate for universal coverage has improved, but probably not enough to get very complex legislation passed in the next several years.
To adopt a universal plan is “technically enormously difficult,” Aaron said, and would have to take into account that the U.S. has a highly diverse population and a highly diverse health-care system. It would require passage of several pieces of legislation that could take years to get through Congress, he said.
”I am not sure that even a new president and a new Congress can work through those devilish details” in the next presidential term and pass a universal plan, he said. Still, he said, if the supporters of a national plan avoid the mistakes of the Clinton administration, “they’ve got a shot.”
Will any of the above proposed solutions by politicians work?
My answer in no!! If we can not control prices with Medicare, how are we going to control prices with universal health insurance?