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Thursday, February 26, 2009

Obama Begins Health Care Push: First Find the Money

Less than 40 days into his administration, President Obama begins his push toward universal health coverage. He still hasn't endorsed Dennis Kucinich's single-payer plan (come on, Barack! you know you want to!), but the President is starting sensibly, asking Congress to figure out how to pay for the plan first. How's that for practical?

Among things to like about the first draft:
This first draft aims at building a $634B reserve over the next decade for health care reforms, and the administration characterizes that figure as a "down payment." As the President said Tuesday night, "None of this will come without cost, nor will it be easy. But this is America. We don't do what's easy. We do what's necessary to move this country forward."

Then again, health care reform may not be as hard a sell as the noise machine across the aisle will have you believe. A new Kaiser Family Foundation report finds 62% of respondents say, recession be darned, we need to reform health care now. 13% of respondents report burning up most or all of their savings on health expenses (KFF survey, page 2). President Obama has the confidence (a "fair amount" or a "great deal") of 72% of respondents to do health care reform right; Democratic Congressional leaders also enjoy such support from 57% of respondents (GOP leaders come in at 38% on that question; see KFF, p. 6).

One complication in winning support for increased spending is the majority of respondents who believe the right reforms can fix health care without spending more money (KFF, p. 5). We can make that happen, but only if we go real universal and transfer our money from the inefficient bureaucracy and profiteering of private insurers to the efficiency of a public single-payer system. Even Blue Dogs like Stephanie should be able to get behind fiscal savings like that!

17 comments:

  1. This is so funny. He wants Congress to figure out to pay for it first. We have no money now, we are begging China for money, and he is spending like a drunken sailor. You know what I think? O wants to actually bankrupt the country for real and then he can impose his socialistic agenda or one-world gov't without any opposition. I'm sorry, but there is no way in ____ that I trust that man, no matter how good he sounnds on TV.

    Just who did they interview for the percentage who want gov't funded health care? Illegals? People on welfare? People who manage to take care of themselves and pay for their insurance? Makes a difference, you know.

    There is no way that the gov't is going to do this in a responsible way. They have stolen the SS money and bankrupted that system. Anything they do has huge cost over-runs. They are spending us into oblivion and promising even more. It is ridiculous.

    What happens when the payees stop paying? That will happen if he completely ignores us. You can bet on that. What would we have to lose?

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  2. "just who[m] did they interview"? Well, if you'd actually read the links, you could find out:

    "The survey was conducted February 3 – 12, 2009, among a nationally representative sample of 1,204 adults ages 18 and older." [Kaiser Health Tracking Poll, Methodology, February 2009, p. 6].

    You keep making stuff up, Anon; I'll keep citing real information.

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  3. Anon 10:23,

    Seriously, get a grip. You obviously don't like reading so here is some TV that can explain to you how NOT for profit systems are far superior to our system:

    http://www.pbs.org/wgbh/pages/frontline/sickaroundtheworld/

    This isn't theory, this is reality. We need to suck it up, admit our error, and literally duplicate anyone of these systems.

    We simply need to copy.

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  4. I consider myself a Red Dog Republican. I'm about as far from an illegal alien or a welfare king as one can possibly get. And yet, I'm with Kucinich on this one. I suspect that I have a lot of company,too.

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  5. How do you pay for it????? I've seen how much O is spending and how much he plans to raise taxes and how much these programs will keep ballooning the national debt. It's nice to say let the gov't do it, but the gov't is us and our money, and there is not an unlimited supply even though O et al are spending like there is. What happens when our money runs out, our credit runs out, and our dollar is bankrupt? Fiscal responsibility seems to taken a hike in the last month and no one is noticing or caring.

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  6. Anon 12:28:

    Believe me, I share your concern. By the time the tax impact of the current spending spree is fully felt (or soon thereafter), I hope I'll be eligible for Medicare, so the whole private insurance racket will no longer be of concern to me.

    I hope.

    I believe Kucinich has proposed a 3-percent payroll tax hike to pay for his plan. As a self-employed person, that would mean a 6-percent hike in my case, making the overall self-employment payroll bite 20 or 21 percent -- on top of the income tax I already pay! Expensive, indeed, and no doubt it will be quite a burden.

    But the alternative, for people my age and younger, may well be worse than a heavy tax burden: an all-or-nothing gamble. Stay healthy, and you're all right. Get sick or injured, and everything you have, have acquired, or ever hope to have will be taken away from them.

    Therefore, even though I stand to feel some pain if universal health care (and I do mean socialized medicine here, let's not mince words) passes, I'm willing to bear it if, in exchange, I have the peace of mind that comes with the knowledge that I will not have to lie in a sick bed and wonder if I'll have a home waiting for me when I can get up and stagger out of the bloody hospital.

    Or -- I could just move on over to Europe where the people don't have to pay for huge war machines (that, ironically, can undo in a split second what the best doctor may take a lifetime to accomplish). Hanging out in a cafe in Amsterdam or Paris with fellow literati ... ranting and raving with my mouth just as I am doing here now with my keyboard ... life could be worse. Maybe I could even get Cory to translate my math books into Russian when St. Petersburg becomes the new intellectual capital of the world. Stranger things have happened. But none of it will come to pass if I am residing in an urn in St. Luke's Church in Rochester, Minnesota, reduced to ashes before the time God would otherwise have appointed.

    Yes, Anon 12:28, you raise valid points, and they ought to be part of the discussion every time our legislators come up with another spending idea. Barack Obama is staking his political career on the success of his plans, and for that, my hat is off to him. I know the feeling!

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  7. Stan, if by the time you are eligible for Medicare and the American dollar is worthless, your Medicare and anticipated worry-free medical care will also be worthless, and that is what I'm afraid will happen. Along with Social Security, gov't insured bank accounts, IRA's, etc etc.

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  8. "How do you pay for it?" I think Obama deserves credit for starting with that question.

    Stan's right, Kucinich's plan or anything like it would be expensive. But health care is already expensive. Look at your insurance premiums. We could pay for universal health care by telling every American, "Yes, we're raising your taxes. You can cover the increase by dropping your private insurance. Instead of you and your employer sending $1000 a month to Blue Cross Blue Shield (which will spend maybe $200 of that money on administration, advertising, executive bonuses, and other non-health overhead), you'll send Uncle Sam $950 each month. $920 of that will be spent on health care, $30 on overhead, and the other $50 stays in your pocket t help your local economy." Can't beat that!

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  9. Fiscal responsibility took a hike under Reagan. Bush couldn't even pronounce "fiscal responsibility." Obama has to spend to fix the problem, but he's proposing a budget that lists all the expenses as part of the deficit.

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  10. My laugh for the day: If we send $950 to the gov't for health care, $30 will be spent on overhead!!!!

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  11. You have to remember Cory, that when Regan proposed his tax cuts in the early 80s, they were to be coupled with reductions in government spending. Reductions that the Democrat-controlled Congress balked at.

    As for Star Wars... as my cousin Wade would say... Great movie, and a brilliant plan for bankrupting the Soviets.

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  12. If I had to spend $950 a month towards KucinichCare, and assuming his payroll tax proposal were adopted (6 percent of my adjusted gross income), then I'd be taking in $190,000 per year after taxes.

    God grant me the good fortune to end up paying so much to the government and, in return, getting peace of mind.

    Alas, I'm not optimistic. I fear we'll end up with the tax burden Kucinich would have us pay, but with few or none of the benefits he would have us receive.

    Let's not deceive ourselves. This country was ruled by large corporations before Obama became President, and I suspect that this country will be ruled by large corporations for some time to come.

    I doubt that our new President has many insurance company executives suffering from nightmares. More likely, they're having dreams of villas and yachts and store-bought citizenships in far-away places where it's summer all year round.

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  13. Anon 1:50 p.m.: My groan for the day: continuing to have to point you toward reality:

    "We have an American system that works. It’s Medicare. It’s not perfect, but Americans with Medicare are far happier than those with for-profit insurance. Doctors face fewer hassles in getting paid, and Medicare has been a leader in keeping costs down. And keep in mind that Medicare insures people with the greatest health care needs: people over 65 and the disabled. We should improve and expand Medicare to cover everyone. In contrast to the for-profit insurance companies, Medicare has a very low overhead - about 3 percent." [emphasis mine]

    Additionally:

    "A majority of physicians (59 percent) and an even higher proportion of Americans (at least 62 percent) support single payer national health insurance or “Medicare-for-All”. In spite of this, virtually all we are hearing about today are mandate plans that would require everyone to buy the same private for-profit insurance that is already failing us. The for-profit insurance companies and their plethora of plans make for a terribly complex, fragmented, costly and inefficient system. Administrative overhead consumes about 31 percent of health care dollars in the United States, and the for-profit insurance companies are responsible for half of this, or 15 percent of $2.4 trillion. This money, more than $350 billion per year, provides no health care: it is consumed by enormous administrative costs, profits for investors and shareholders, and large salaries for managers of these for-profit insurance companies."

    --Daniel P. Wirt, M.D., "'Medicare-for-All' Cure for Health Woes," Houston Chronicle, 2009.02.08, reprinted at http://www.pnhp.org/news/2009/february/medicareforall_c.php

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  14. Stan, it's harder for me to disprove your skepticism than Anon's mistaken-ness. Can I appeal to your sense of civic engagement and argue that at least under government care, we can demand more accountability than we can from private companies?

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  15. Well, Cory, I would demand more accountability from a government-funded system than from the current system, whether I could or not!

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  16. Here is a link and a quote from the linked article relating one reason that Medicare overhead is less than private companies. But this reason has cost millions in fraudulent claims, and many more never caught.

    http://online.wsj.com/article/SB121944730222565137.html?mod=rss_opinion_main

    “…draft report by the inspector general of Health and Human Services….determines that Medicare may have paid $2.8 billion in improper or fake claims for medical equipment in 2006. That's an error rate of 31.5%, in a single corner of this colossal entitlement. ...insurance companies spend money to screen their claims for fraud. Medicare automatically pays more than 95% of the bills it receives. This lack of scrutiny reduces overhead, but it makes the program highly vulnerable to abuse. …The real reason liberals… are outraged is because they want to claim one of Medicare's vices as a virtue, to help along their health-care ambitions. The inspector general's report makes their argument poorer politically.”

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  17. Aha! I forgot all about that. Nothing like a little dose of reality to get the old guts churning in the wee hours.

    Part of our new medical system ought to involve redistributing some of the wealth from crooks to honest people. That's not my original quote. It comes from Newt Gingrich.

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