Monday, July 27, 2009

Following the Money

Not unsurprising that Time magazine's comprehensive review of the big obstacles health care must get over starts with those costs that were not a problem for the atrocities of the worst administration in history. The economy is in the toilet because of wars and unconstitutional, deregulated executive branch policies. Now that toilet status is being foisted off as the biggest obstacle to the public interest.

Before considering the plan itself, the review reminds us that we have to pay through the nose on our way to decent health care.

A lot of different avenues for cost cutting have been explored, including preventing fraudulent claims in Medicare and Medicaid and cutting programs and services that aren't deemed cost-effective. But one of the most recently touted potential methods, creating an independent board to take away from Congress the job of overseeing the rates of Medicare payments, took a hit late last week when the CBO estimated it would only save $2 billion over ten years. The CBO did acknowledge that the savings could turn out to be higher in the long run, but that qualifier only highlighted one of the biggest problems for health care backers; so much of the potential cost savings of overhauling the entire health care system is unknown and impossible to predict with any accuracy. The CBO, for instance, has no real way to determine how much investments in prevention might save down the line.
Hard to believe, but money is actually only half the problem. The flip side of cutting costs is adding coverage for the nearly 50 million uninsured Americans. To that end both the House and Senate HELP bills include a public plan that would compete with existing private plans - a highly controversial idea that Republicans say is tantamount to the socialization of health care, but which many Democrats (including Obama) say is essential for any overhaul of the system. The Senate Finance Committee's bill takes a middle-of-the-road approach, including a coop plan, essentially a non-profit version of a government plan that some critics say couldn't possibly compete effectively the way a public option could. The legislation does include provisions for a public plan, but such an approach would only be triggered if the coop plan doesn't prove to work in certain states or locales - a backup model based off of President George W. Bush's Medicare Prescription Drug Plan. But many wonder if that will garner enough votes in the Senate, since it will likely lose votes from both ends of the spectrum. (Emphasis added.)

Of course, there are reasons in the review that I am not covering in the excerpt, but the main arguments are in it. The twists and turns of the opposition combine the expense - which never bothered them while they pitched the country into economic disarray - and the mantra that government is the enemy, especially when it comes between the public and insurance adjusters, contain most of the heat in this arena.

While those of us who have seen the country's dive into the mess of having health too expensive for the public are hardly ignorant of the savings of making it accessible to all, CBO is charged with convincing those who would rather kick those on lower economic levels into the emergency room than let them in the doctor's office. This is a negation of common decency, and distressingly inhumane.

That view of society is one that this generation of unembarrassedly empathetic bloggers needs to return to concepts about the public and our standards that rise above those of antisocial wingers. When we leave out our humanity, profit becomes the overriding concern.

The worst administration in history fought for corporate welfare, free market for wage earners, and brought us to disaster. We are better than that, and to rejoin the civilized world we need to return our government to the role of protecting public interests.

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