The debate over President Obama's health care plan continues to grow, and it looks like the government plan provision will be the point of greatest contention:
The impasse is rooted in ideological divisions that doomed former President Bill Clinton's health care plan in the 1990s. "The public option discussion is a mirror of the debate we've been having for 60 years about the government's role in health care," said Sen. Ron Wyden, D-Ore.
Part of the problem seems to be that Obama hasn't spelled out what he wants in a public plan, even as he expresses strong support for the idea. His health secretary, Kathleen Sebelius, said Friday that Americans need a new government-sponsored insurance plan to guarantee choice and competition -- especially in rural areas. "What the president feels is important is to have some competition and to have a choice," Sebelius said at a round-table discussion in Omaha, Neb.The government already has a public plan for the elderly -- Medicare. And there's Medicaid for the poor.
But a government plan for middle-class workers and their families would be new.
Under some scenarios, a government plan could undermine one of Obama's central health care promises: that people can keep the coverage they have if they like it.
A recent analysis by the Lewin Group consulting firm found that if the new government plan was modeled on Medicare and open to all employers and individuals, it would swamp the private insurance industry. Employers and individuals would flock to the public plan because of its lower premiums. Private insurance enrollment would plummet by about two-thirds.
It seems that the divide among Americans about the government's role in health care is as wide as ever. Democrats want a public plan, and they appear to want to go farther than President Obama's campaign idea to limit a public plan to individuals and small businesses. Republicans want Americans to continue to have the private insurance option--but a public plan that all employers could use would effectively end that for the vast majority of American workers, as corporations ended their relationships with insurance companies in favor of the government plan option for their employees.
Doing nothing, the president said recently, is not an option; but as both sides of the debate dig themselves back into their longstanding ideological trenches, it's hard to see what, if anything, will actually be done.
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Unless there is an unlimited supply of something, there will be rationing of some sort. (Supply & Demand 101) In a market economy rationing is usually by price. Consequently, for those who are able and willing to afford the price, the current system is preferable to any rationing that does not recognize their willingness and ability to pay more. Bill Gates probably doesn't worry about the availability of health care, though he almost certainly would if he had to stand in line behind a homeless guy to get treatment.
This attitude toward health care availability is the Achilles' Heel for any Democratic plan to provide affordable, universal access to health care. As expensive as it might be for the middle class, the idea - perhaps not the reality, but that's another rant - that any universal health care plan will take away whatever discretion remains to pay the current price for care is simply not acceptable.
There is almost no limit to the amount of money that will be spent by insurance companies and certain health care providers (e.g. hospitals, big pharma, etc.) to reduce the choices to just two: "socialized medicine" or "the best medical system the world has ever known." Once again, actors will read scripts about the horrors of the medical care in Europe and Canada. Few will explain why it is that these democratic countries all refuse the opportunity to adopt our superior health care system. Once again, the threat of "rationing" by "government bureaucrats" will be thrown down as the clinching argument without any mention of how insurance company bureaucrats already ration the health care of their policy holders, policy holders already cherry-picked for being less likely to make claims than those who might likely need health care. And once again, I'll bet, our "representatives" will be bought and paid for by the highest bidders.
It has never made sense to me that corporate America--which pays to keep the GOP running--stands by and willing accepts responsibility for paying for U.S. healthcare by providing it to employees. We are the only country in the world that expects employers to bear the burden of health care costs. How is our international competitiveness hurt when U.S. based companies must pay for U.S. health care, while companies in the rest of the world are freed from those costs.
News flash, Michael! There is no mandate for employers to provide health care plans, and fewer than half do. Your are correct in noting that those companies that do provide plans put themselves at a competitive disadvantage that employee productivity might not make up.
JLF
Unless there is an unlimited supply of something, there will be rationing of some sort. (Supply & Demand 101) In a market economy rationing is usually by price.
Indeed. Rationing already exist, in fact, it's happened so much the health care industry is suffering from it. (There are fixed costs in providing health care, and if health insurance reductions mean less people are visiting, than per person cost goes up.)
It amazes me how many people don't understand that 'rationing' is perfectly normal, and is entirely predicated on how much supply is available. The only way there would be more rationing is if supply went down. (OTOH, people who fail to understand basic economics are sadly common.)
Now, people opposed to government involvement like to imagine that would happen, that supply would go down, but considering the state of the health care industry and how much the health insurance industry is robbing them blind, I suspect that government health care could not help but result in more money in the system, which results in more supply, which obviously results in less rationing.
The real joke is that people assert this and that hospitals would fail to compete and become inefficient with government payouts. Being efficient is almost the definition of rationing. Inefficient hospitals are ones that have doctors standing around waiting for patients! An efficient hospital is a full one!
The difference is that the rich and the healthy might have their health care rationed, as opposed to now, where it's the poor saps who have insurance and are sick, or who don't have insurance and are sick, who are rationed out of health care.
"the best medical system the world has ever known." ?????
Americans are among the unhealthiest people in the developed world, have one of the highest infant mortality rates and die sooner than Europeans and Asians in developed nations. Hardly the picture of the best medical system in the world.
We are trying to get government sponsored insurance, but not asking ourselves a better way to run our healthcare system. Insurance is a huge disaster. Why does it have to be either socialized or this mess we have right now. Is insurance the only option? Let's be creative and come up with a third way that will actually help us to be healthier people.
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