June 10, 2009
The United States Congress finally puts “single payer”–improved and expanded Medicare-for-All–health reform on the table at the HELP Subcommitee (Health, Education, Labor and Pensions) hearing. Click link to view hearing on C-SPAN http://www.c-span.org/Watch/Me…
The House HELP Subcmte. held a hearing examining the merits of a single-payer health care plan, which calls for a single insurance plan to pay for medical costs nationwide. A panel of health care experts, physicians and medical scholars testified in favor and opposition of the legislation. View at http://www.c-span.org/Watch/Me…
It should be up to the American people and NOT the lobbyists, not the big-money campaign contributors and not the advertisers as to what happens next on health reform; what do you think should happen?
Single payer is not ‘government health care’. It’s ‘government insurance’. “Government health care” would be the VA, not medicare.
“if not outright”, i.e. “although not outright”. I’ll fix.
I know it’s incredibly important that our health care system be fixed, and I would be first in line to kick the insurance industry to the next galaxy.
My concern is the red tape involved with a medicare type system. I have watched elderly friends driven to tears trying to reach Medicare customer service to resolve problems such as having another insurance company listed as their primary payer when they were no longer covered by that company. It takes months or longer to go through the process to take the old coverage off of your plan so Medicare will pay. In the meantime, claims are rejected, hours are spent on the phone talking to one representative after another, all of which don’t have a clue what your talking about even though you just spoke to them last week. I can’t even bear the thought of going through that, but then, the current system we have is pretty unbearable as well.
Perhaps if there were no other coverages available to be secondary to, then that would cure one huge difficulty in dealing with a medicare type system.
Should be “all of whom” not “all of which”.
Geez, does it really matter.
I recently started collecting Social Security retirement benefits. It was easy to apply for (on-line) and has worked like a charm, starting on time, coming via direct deposit like clockwork. I even changed banks, and the switch in direct deposit was handled by me in minutes on-line, and went into effect immediately. A dream.
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p>In contrast, I have a former employer (I left there in 1980), from whom I am trying to collect my pension. I have been trying for at least 6 months, and I’m not much closer than nowhere. I finally, by writing an indignant letter to a senior executive, got someone to actually call me, instead of referring me to yet another 800 number to be ignored. The woman was very nice, but said I would have to be patient since my records were not computerized, and she would have to authorize a search of their physical archives. “It’s so old,” she said somewhere along the way. Duh. People who retire and want to collect pensions are usually young? This comes as a surprise to them? Were they hoping I wouldn’t ask?
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p>Sorry, but all my experiences with government agencies (not just SS) have been far superior to their private equivalents.
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p>When I have time, I’ll post a letter from a friend, who complains of the amount of useless paperwork required by the insurance companies that provide MassHealth. She says she has to do about an hour of paperwork for every hour of treatment she provides. Talk about inefficiency!
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p>More anon.
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p>Meanwhile, sign me up for a government-run insurance plan!
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p>Any day!
than the grief people endure through private insurance — something much more than anecdotal.
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p>And when you get that insurance and everything straightened away, a public option or single payer won’t throw you overboard as soon as you have the audacity to actually get sick!
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p>All these complaints are very silly when you factor in just how bad HMOs are in this country. They do everything much worse than single payer ever would — and at least single payer (or public option) is accountable to the public. If there are improvements to be made, voters can demand them. They could never, in a million years, do the same for an HMO. Single payer exists in most of the developed world; most of the developed world has vastly better health care than us. We’re not even remotely near the top 10. Our private system, which leaves 40-50 million uninsured a year, with another 100+ million having bad insurance, is a complete clusterfuck/FUBAR/failure.
Such as if I had to choose between a government bureaucrat and an insurance bureaucrat, I’d take the former in a heartbeat. They are more accountable because if someone is having a problem they can complain to their congressman who will get on the horn and slap some people around. The insurance industry would not be responsive to that; in fact influence works in the opposite direction with private insurance.
I’ve always been a proponent of single-payer health care. There’s little reasonable argument that it would be a better solution for the 40+ million people with no insurance at all than a new patchwork of partially subsidized private insurance. I used to think the obvious merits of this reform would eventually overcome self-interested opposition from the insurance, drug and medical industries.
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p>However, over 15 years removed from the Hillary Care debacle, I think it is pretty clear that I was wrong.
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p>It seems clear to me now that will never be able to transition directly to single-payer. We may be able to get a larger “public plan option” (Medicare Part B-2?) that is available to everyone. This would be a great start that could lead to single-payer if done right.
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p>But (in addition to opposition from powerful corporate interests) I’ve come to realize that inertia plays a more important role than I would have thought. There are simply too many people with real employer-sponsored insurance (low premium sharing) that the person is happy to keep. Indeed, a recent Rasmussen poll showed that 70% of insured people rate their own health insurance coverage as good or excellent. Only 25% would support any reform proposal that required a change in their own coverage.
(http://www.rasmussenreports.com/public_content/business/healthcare/june_2009/congressional_consensus_on_health_care_gets_mixed_reviews_from_public )
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p>Most folks want the government to help cover almost everyone but they don’t want to replace the private insurance system that serves them reasonably well at relatively low direct cost to the employee.
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p>It’s time, Anne, for you to aknowledge these realities too and consider an alternative approach to reform like a robust, highly-subsidized public plan option.
There have been some good articles in The New Yorker lately about how government plans in other countries have evolved slowly, and how that’s a good thing.
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p>Medicare Part B is the poster child for the dangers of making a sudden switch to an all-new plan. Chaos and worse!
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p>Let the government plan compete with private plans. If the efficiencies are there, as I expect they will be, people will gradually switch over. Employers will see the light of day (why pay for insurance when you don’t have to?), and the government plan will become the vehicle of choice. No need to foist it on people. And, probably dangerous to do so.
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p>The Massachusetts experience shows that a patchwork quilt can work, however awkwardly at times. Despire numerous problems, I think nearly everyone agrees we’re better off than we were, even though there is lots of room for improvement.
is if the insurance industry can’t outright stop the public option, they’re going to do everything possible to make it terrible. They’ve already pushed successfully to ensure that the public option pays doctors more than medicare — and thus costs more than medicare. Why should that be written in? What else will be written in? That they can’t charge less than private care? That it, unlike any other government program, must come in at or under budget every year? If the public plan isn’t a good plan and far more affordable than private options, it’ll be a massive failure — and a costly one at that. We’ve got to ensure that it reigns in costs, gives excellent care and that the private markets are the ones forced to compete on an even playing field — no longer allowed to refuse care or charge different rates based on preexisting conditions, etc.
there are public options and there are public options. The question is where exactly did the progressive caucus draw the line in the sand. These are the folks we need to keep the pressure on. The other Dems will have to fall in line, because the public demands reform.
I have experience with Medicare from the doctors billing perspective. Medicare does not reimburse doctors for their services 100%. Recently a patient received a drug called avastin that cost the doctor 4K to procure. Medicare reimbursed the doctor 3K. The doctor makes up that loss form private insured patients.
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p>In many cases Medicare denies doctors bills or claims automatically. Then the doctor must start the appeals process to receive payment ( payment again could be less than the services provided) and spend a lot of time and money trying to get a bill paid.
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p>How is that reasonable? How could a system like that work? Medicare is a mess, be careful when touting a system like medicare, it is not working.
To learn more about how and why Medicare is not working as well as it could be, I suggest these posts from Maggie Mahar’s Health Beat blog for starters
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p>Apparently, so does President Obama…
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p>And to add to the beauty of this proposal is to fund it by “…rooting out fraud, waste and abuse in both the Medicare & Medicaid system”… and by “….scaling back on how much the highest income American’s can deduct on their taxes”.
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p>This is terrific!
We’re actually on the same page, I believe! You see, AnnEM long ago “acknowledged these realities…” that you refer to and she set to work alongside other activists seeking to build a broader progressive movement for health reform. Case in point, see comments page on BMG including this post http://vps28478.inmotionhosting.com/~bluema24/s…
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p>For an update on the national reform scene, below are 2 items from EQUAL, a national listserve run by a PhD MPH in health policy out in California. BMG readers might find it a useful resource; EQUAL=Equitable, Quality, Universal, Affordable health care and can join the EQUAL listserve by sending a blank email to: join-equal@list.equalhealth.info
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I had not seen these or the other BMG post where you rightly argue that “finding a way to come together in solidarity united against our common opponents is essential.”
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p>We are mostly on the same page, for sure.
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p>Our remaining difference, it seems, is on the wisdom of vigourous advocacy for single-payer given the admittedly “short window of opportunity.” I do think now is the time (for political reasons and in the interest of national reform that includes a public plan option) to call a temporary halt in advocacy for single-payer and go “all in” on backing the Obama/Kennedy approach to reform.
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p>But that’s a pretty small tactical difference given that we seem to agree that now it is essential to “forge links of human and political solidarity across coalitions” abd, most importantly, that “Without a groundswell reform movement that is largely united we will not be broad, deep nor strong enough to defeat the Insurance Co’s, big PhARMA, medical supply Co’s and their lackeys.”
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p>Together we struggle…
I do believe that educating and advocating for “SP” creates the political space for a stronger Medicare-like public insurance option to be included in final the national reform bill of 2009
It’s clear that Obama and the liberals in Congress and everyone at BMG want Medicare to be the ONLY health care system available. You crave centralized control of the supply and delivery of health care in US.
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p>Is this preferable to having CHOICE? Why not have just one brand of toothpaste? Or one type of PC? Or one car manufacturer? Or one TV channel?
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p>Want lower prices? Competitive choices will lower prices. When in the history of man has a government monopoly delivered the best product at the lowest price?
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p>Has anyone read gp2b3a’s comment? How is a 75% Medicare reimbursement feasible in the long run? In an effort to reduce cost, the government will begin to restrict medical care. Is this what we want?
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p>Not me. I’m happy with my Harvard plan.