Subscribe via RSS Feed

Tag: "health care"

The Wonders of Free Market Health Insurance

[ 0 ] August 3, 2009 | Scott Lemieux

Sarah Wildman on the glories of the individual insurance market:

Our six-month-old daughter cost over $22,000.

You’d think, with a number like that, we must have used fertility treatments—but she was conceived naturally. You’d think we went through an adoption agency—but she is a biological child. So surely, we were uninsured.

Nope. Birthing our daughter was so expensive precisely because we were insured, on the individual market. Our insurer, CareFirst BlueCross BlueShield, sold us exactly the type of flawed policy—riddled with holes and exceptions—that the health care reform bills in Congress should try to do away with.

[...]

Last fall, the National Women’s Law Center issued a report detailing exactly how women who want to bear children are derailed when searching for out-of-pocket health care. Only 14 states require maternity coverage to be included in insurance sold on the individual market, according to the Kaiser Family Foundation. In contrast, the Pregnancy Discrimination Act of 1978 requires employers with more than 15 employees to include maternity benefits in their health insurance packages. “We looked at 3,500 individual insurance policies and only 12 percent included comprehensive maternity coverage,” said Lisa Codispoti, Senior Advisor at the National Women’s Law Center. Another 20 percent offered a rider that was astronomically expensive or skimpy or both. One charged $1,100 a month; others required a two-year waiting period.

It’s definitely worth clicking through and reading in full. (Or, for those who prefer things in podcast form, she talks about it here.) This is one of the many things that an incremental reform package that keeps the private insurance system in place is going to have to regulate very, very carefully.

The Core

[ 0 ] July 29, 2009 | Scott Lemieux

Ezra objects to my post arguing that it might be better to reject a bill that sells out too much to the Blue Dogs:

But it’s also worth offering a more general reality check here: The public option is not now, and has not ever, been the core of the argument for heath-care reform. It is the core of the fight in Washington, D.C. It is an important policy experiment. But it was not in Howard Dean or John Kerry or Dick Gephardt’s plans, and reformers supported those. It was not in Bill Clinton’s proposal, and most lament the death of that. It is not what politicians were using in their speeches five years ago. It is a recent addition to the debate, and a good one. But it is not the reason were are having this debate.

Rather, what has kept health-care reform at the forefront of liberal politics for decades is moral outrage that 47 million of our friends and neighbors are uninsured.

I certainly agree with this, as far as it goes. Obviously, the core of the argument for health care reform is universal coverage. And, indeed, there are better ways of achieving this than a public option and employer mandates, although they’re not on the table. My concern is whether or not a compromise bill will, in fact, provide politically sustainable universal coverage, or anything close to it. If Ezra (and Kevin) are right that even compromise legislation will, in fact accomplish a lot, then I agree that it’s worth supporting, and I guess we won’t know until we have actual legislation on the table, and I’m willing to keep an open mind.

Ezra also outlines a criteria we should use to evaluate whether a bill is worth passing:

If reformers cannot pass a strong health-care reform bill now, there is no reason to believe they will be able to do it later. The question is whether the knowledge that the system will not let you solve this problem should prevent you from doing what you can to improve it. Put more sharply, the question should be whether this bill is better or worse than another 19.5 years of the deteriorating status quo.

I agree with this, to a point. Anybody who’s read the many nasty things I’ve had to say about late-period Ralph Nader knows I’m not a heighten-the-contradictions guy. If the proposed bill represents a substantial improvement and is constructed in a way that it will be politically sustainable, I agree that it merits support. However, there also has to be a point in which the two premises start to contradict each other. It’s true that there may not be many more opportunities to pass a good health care reform bill. It is likely, however, that there will be plenty of chances to pass incremental reform that is far too expensive because of the need to buy off vested stakeholders. (The 2003 Medicare expansion, after all, passed with the Democrats holding none of the elected branches, and pretty much fits this description to a T.) If the bill gets bad enough, it’s not clear how much is being risked by trying again, perhaps after mid-term elections likely to be favorable to Senate Dems.

…and, yes, progressives are going to have to use threats if there’s any chance that the bill will be worth supporting. If only conservatives (in both party caucuses) are threatening to torpedo the bill it’s going to be bad.

[X-Posted at TAPPED.]

A Health Care Bill Is Not Necessarily Health Care "Reform"

[ 0 ] July 28, 2009 | Scott Lemieux

I think it’s pretty obvious that a health care bill with no public option and no employer mandate is worse than no bill at all.

Not the Onion

[ 0 ] July 28, 2009 | Paul Campos

Math is hard!

Health Care Reform Prospects

[ 0 ] July 20, 2009 | Scott Lemieux

This is certainly right on the merits:

For Gingrich and his allies, the health care debate wasn’t really about health care: it was about destroying the power of a Democratic President.

It’s not surprising that the Republicans have remembered that lesson, but it’s disappointing that the “centrist” Democrats have forgotten it. This bill is make or break for the Democratic Party, and Harry Reid ought to enforce party discipline on the cloture vote. No on cloture should mean no subcommittee chair, no pork, and no money from the DSCC.


Alas, I’m also inclined to think that Benen is right on the politics:

It occurs to me, then, that there’s at least a possibility that “centrist” Democrats — Blue Dogs, New Democrats, Lieberman, et al — might not see failure as such a horrible option here. In other words, they may realize that coming up short on health care, letting this opportunity slip away, and hurting millions of Americans in the process may be devastating for the Democratic majority, but these same “centrist” Democrats may prefer a smaller majority, or perhaps even a GOP majority to “balance” the Democratic president. They may very well disagree with the party’s leadership on most issues, and think the best course of action is taking away their power by undermining the party’s agenda.

It seems odd that these “centrist” Democrats would forget the lessons of 1993 and 1994. But alternatively, are we sure they have forgotten those lessons, or have they learned those lessons all too well?

Alas, I think this is right. It’s not that Blue Dogs don’t know that defeating health care would be a major blow to the Democratic Party, it’s that they don’t care. And while I’d like to think that Reid would apply enough pressure to alter the incentives a little, well, I’d like to think that the Mets could remain competitive while fielding 6 or 7 replacement level players and 1 proven starter, but they’re about equally likely.

B-Day Addendum

[ 0 ] July 17, 2009 | Robert Farley

So, as some of you knew and others surmised, today was supposed to be the day in which the wife and I enjoyed a Blessed Event, and introduced spawn into our happy home. For a variety of reasons too complicated to go into, we and our doctors had agreed four months ago to schedule a C-section for this morning at 7am. Thus, when I started my “D-8″ series, I was aware of the possibility that the spawn might arrive early, but had psychologically excluded the possibility of a late arrival.

So…. it turns out this morning that, in the midst of preparation to engage in the aforementioned C-section (IV was in), our doctors noticed that the procedure ran afoul of a previously unknown hospital policy. Bureaucrats arrayed themselves for battle, and in the end it was determined that the birth would be delayed for an additional six days. Spawn remain healthy, but still trapped in the wife. Wife remains uncomfortable, grouchy, irritable, and litigation-prone. I have seen July 17, 2009 change from Momentous Life Changing Moment Day to Day that Something Remarkably Irritating Happens, which doesn’t really distinguish it from any other day.

DJW has the last word:

With an evil, government bureaucrat-run health care system like they have in Europe, you’d just be put on a waiting list and they probably wouldn’t be born until November.

The Idiocy of Beltway "Centrism"

[ 0 ] July 16, 2009 | Scott Lemieux

Yep:

In other words, [red-state Blue Dog Democrats are] concerned that the bill (a) costs too much overall and (b) will increase the deficit. And their proposed solutions to this are to (a) increase the cost of the bill by neutering the public plan and (b) decrease the quantity of revenue by fiddling with the employer mandate. Under the circumstances, it’s no wonder that Ross didn’t want to go into detail with CNN about how he’d propose changing the bill. Maybe Harry Potter knows a spell that could untie this mess of contradictions.

I think it’s time for another Michael Lind column about how urban liberals are preventing the Democrats from supporting economically progressive policies…

Against Health Co-Ops

[ 0 ] June 17, 2009 | Scott Lemieux

Hacker makes the definitive case.

More on the Meetup

[ 0 ] June 17, 2009 | Scott Lemieux


I’m the one with the tight sweater…

More on what was discussed at TAPPED, and from Samhita, Emily Douglas, Chris Bowers, and Lindsay. Amanda Terkel has a transcript.

Clinton: Be Bold On Health Care

[ 0 ] June 15, 2009 | Scott Lemieux


I was fortunate enough to be part of a group of journalists and bloggers invited to meet with President Clinton at his offices in Harlem this afternoon. The main subject was the Clinton Foundation, but as one would expect the conversation ended up being quite wide-ranging. There was lots of interesting stuff, but perhaps best was Clinton’s argument for being very bold on health care. Clinton identified four major ways in which the current context differs from the one he faced in 1993:

  • A different psychological and political landscape. Because, as Clinton noted, Democrats in Congress had stopped Reagan’s strongest anti-government from being enacted, stated Republican retained a popularity that, after 8 years of Bush (much of it under unified government) they no longer do. Knee-jerk anti-government opposition won’t be nearly as effective. And, of course, Obama has larger and more liberal majorities to work with.
  • Obama doesn’t have the same budget restraints. Clinton, having barely gotten a minor tax increase through Congress, wasn’t in the position to raise taxes. Obama will have more options, along with a political context much more receptive to spending increases (although of course this window will close shortly, making quick action on health care essential.)
  • Obama doesn’t have to deal with a Republican Senate leader running for President. The famous letter from Bill Kristol to Dole played a significant role in killing Clinton’s proposed reforms, although Dole might have been willing to cut a deal in different circumstances.
  • Health Care has gotten even worse. Since the GOP killed reform, American health care has continued to get more expensive while failing to even come close to universal coverage and failing to produce outcomes any better than countries that provide care to more people for less money.

I might quibble with #3 — while of course this precise factor shouldn’t be an issue, it looks like most Republicans in Congress plan on being just as obstructionist. The other 3 points are certainly valid, and for this reason Obama needs to be aggressive rather than living in fear of the failure of reform that happened under Clinton.

From a strategic perspective, Clinton said that it was smart for Obama to try to get 60 votes rather than using reconciliation, to preserve his relationship with Congress for other issues. However, that doesn’t mean “giving away the store”; if the only way to get a good bill — i.e. universal coverage combined with policies that will contain spending — is a 50%+1 vote, then that’s what Obama should do. I think that this is right (and if Obama attempts to get a more bipartisan bill, this would also contain the political damage if he needs to do it with a simple majority.)

AMA: Maximizing Profits More Important Than The Health of American Citizens

[ 0 ] June 11, 2009 | Scott Lemieux

Well, this isn’t surprising. Hopefully, this time parochial interests won’t trump the compelling public interest, although given the extent to which American political institutions favor the former I’m still not inclined to bet on it.

Paying for health care and "healthy choices"

[ 0 ] May 2, 2009 | Paul Campos

Matt Yglesias points out he doesn’t really think that raising sin taxes will reduce health care costs. And he doesn’t make that argument in the post in which I attributed it to him, although he does link approvingly to people who do.

As Matt Weiner notes in the comments to my post, I over-interpreted what Yglesias was saying — he was arguing that “sin taxes” are a desirable way to raise revenue to pay for health care, and may well improve public health in the bargain. I’m more skeptical than he is about the latter point, for reasons I reference in my original post.

But my real concern is an argument that shows up all over the comments to Matt’s post, and, somewhat more significantly, is implicit in such pronouncements as Obama’s preposterous claim during the presidential campaign that rolling back obesity rates to 1980 levels would save Medicare a trillion dollars.

That argument is that people get sick because of lifestyle choices, which means that being sick is your own fault, which in turn means that “forcing” me to pay for your health care means I’m being forced to subsidize your bad lifestyle. This argument isn’t completely false, but it wildly exaggerates the extent to which “bad” lifestyle choices are responsible for health care costs. (As I pointed out in the context of cigarette smoking, it’s not even clear that a healthy lifestyle produces a net health care savings to society in comparison to a less healthy one). And it’s fueling such dubious innovations as quasi-mandatory “wellness programs” for employees

In other words, the really invidious effect of this argument is that it provides yet another handy excuse for not socializing the cost of health care, since needing health care at all, in the most extreme version, becomes a “choice.” And it’s disturbing how many people buy into some version of that claim.

Page 10 of 12« First...89101112

    • Switch to our mobile site