Some Get It, And Some Still Don't

In watching the debate over health care, I noticed that I was pretty much focusing only on the "major" national outlets: the NY Times, Los Angeles Times, Washington Post, and Boston Globe. I decided to nose around and see what some of the rest of the country was reading about on the issue, and I picked two Midwest papers, Minneapolis's Star Tribune and Milwaukee's Journal Sentinel. I'm from the Midwest, so the selection is biased in that direction.

First up is an opinion piece written by Kenneth Zapp, who is identified as "a professor and department chair in the College of Management at Metropolitan State University" and who identifies himself as an economist. Mr. Zapp took a pretty forceful and forthright stand on the issue.

The public plan (or a cooperative model) is essential because private firms have not served the public interest. One study found that 31 percent of our medical costs cover administrative expenses of the insurance companies. Another (reported in the New Yorker) found that a Texas city had double the national average health care costs because doctors were requiring twice the average number of expensive tests from private clinics they owned. Private drug companies charge significantly higher prices here than in Canada for the same products. ...

Health care is different from traditional market-based interactions for several reasons. First, when our citizens do not have access to needed services, the society suffers the consequences. Emergency room visits are more costly than regular clinic fees. Poor health impedes worker productivity and school children's learning.

Second, the theory of market economics assumes that buyer and seller have similar bargaining power so that they are equally satisfied from a freely entered transaction. This is obviously false in health care: The urgency of need casts the patient in a vulnerable position.

Most important, private firms seek maximized gain (realized in the short-term) while the customer seeks long-term health. We have not yet found a way to reward private firms for this long-term goal. Instead, each profit-seeking firm leverages its influence for the quarterly or annual bottom line regardless of the long-term effects. [Emphasis added]

Mr. Zapp has nailed the problem nicely. Health care should not be subject to the whims of the market place. We've seen what "free markets" have done to the health of our economy in general these past ten months, and they are not going to be of much help when it comes to the health of our people. All those "movers and shakers" are concerned about are profits for their company every three months, profits which determine the size of their bonuses. That's not what health care should be about, even though that has been what it's been all about for decades.

Now, moving southward to Wisconsin, here's what Senator Herb Kohl had to say in his op-ed piece (warning, Sen. Kohl is no Russ Feingold):

As we create a more efficient, higher quality health care system, we must expand coverage to all our citizens. And, again contrary to conventional wisdom, it will save us money to do so. When the uninsured cannot afford to pay the cost for the health care they desperately need, these costs are shifted to those who can pay. Doctors and hospitals do this by charging insurers more for the services provided for patients who have health insurance, and the insurers pass on these shifted costs in the form of higher premiums for consumers and businesses that purchase health insurance, resulting in a "hidden tax" at a cost of roughly $1,000 per family, per year. ...

While our goal is to reduce the growing costs of health care, we're going to make sure that those who like their current health coverage can keep it. Others who are in need of better coverage will have more choices. Ideally, I think health reform should include some type of a public option. After all, millions of seniors are happy with their government-sponsored Medicare coverage.

There are many proposals on the table, and I am confident that we will end up with one that won't undermine current health providers, will not rely on government subsidies and will garner bipartisan support. I believe we can reach consensus on this and all of the critical issues in health reform if we don't get caught up in ideological labels and work together for the good of the country. [Emphasis added]

I think the old adage needs to be updated: the United States Senate is the last refuge of scoundrels.

What Sen. Kohl is plumping is business as usual, with a little tweaking on the charges made by hospitals and other providers so that the insurance companies can continue to make their profits, only now they will be even bigger profits because doctors and hospitals will be reined in and people will be forced into insurance programs they couldn't afford in the past, and will be able to afford only because the government will pay part of the premiums to the private sector.

The mention of the public option is once again merely an add-on, a token nod to those of us who believe that the soundest and most equitable plan is a single payer system which takes our nation's health out of the clutches of the current market place's profit directive. Medicare, with its faults (and fraud is a problem) is still more efficient and cost effective than private plans.

To those who lament the loss of jobs and income within the private insurance sector I would suggest that the government will be hiring adjusters to handle the new claims and that insurance companies who provide personal injury, automobile, and workers compensation insurance will have a huge section of their payouts removed.

It's time.