Health Care Monday: Stop the Madness

Written by: CorinneAM on Apr 21, 2009 10:12 AM EDT

I don't know about you, but I've quickly tired of the "health care Monday" posts on this blog.  Bringing in members of the Obama Tabernacle Choir to advocate for compromise on a bill that has not yet been debated, much less written, is premature and does nothing to advance the discussion.

Is single payer a worthwhile goal? Absolutely. Judging by the Obama Administration Traveling Healthcare Sideshow, though, one would never know it because the single payer option has not been on the agenda. The Administration has already decided that option is off the table.

Is single payer achievable this year? No. I say that not because I'm pragmatic; I say that because I'm a cynic.  I've been in DC for 25 years and no one has the intestinal fortitude to push for it because they have no easy answer to the inevitable accusations that it's "socialized medicine."  As Howard said on Morning Joe recently, we've had socialized medicine for 40 years--it's called Medicare.

What do I want in health care reform? Everyone in, nobody out.  Americans should be able to find a way to cover everyone and to rein in the exploding healthcare costs as well. 

Of the 30 OECD member countries, only 3 do not have some form of universal health care: Mexico, Turkey and the US.  How embarrassing.  The 27 other countries came to the same set of policy goals to make universal healthcare work even though they varied the ways they achieved these goals:

   1. Insurance companies were forced to accept everyone
   2. All individuals were mandated to contribute (through taxes or having to buy insurance)
   3. Doctors and hospitals (and drug companies) had to accept fixed payments for care negotiated upfront

That's why every time I hear a solo from the Obama Tabernacle Choir about "lines in the sand," "don't let the perfect be the enemy of the good," and "public plan or no plan?" or my favorite, "we can't put the insurance industry out of business in an time of already high unemployment," I know they've already conceded the debate.  Opening negotiations at the most you can logically argue for (for example, single payer) gives you room to negotiate. If your opening offer is too close to the lowest deal you're willing to accept, then you will not have enough bargaining range to concede to the other party as a way of giving satisfaction.

My concerns are not unfounded.  This story is on Page A01 of the Washington Post:

Health-Care Dialogue Alarms Obama's Allies

As Congress returns to begin an intense debate over reshaping the nation's $2.2 trillion health-care system, prominent left-leaning organizations and liberal House members are issuing a warning to their Democratic allies: Don't cave on us.

The early skirmishing -- essentially amounting to friendly fire -- is perhaps the clearest indication yet of the uphill battle President Obama faces in delivering on his promise to make affordable, high-quality care available to every American. [...]

Last week, two top administration officials suggested that Obama is open to compromise on the public plan, comments that set off alarm bells in some corners of his party.

"That's what got the left nervous. I took that as a signal to Senator Grassley" that Obama is willing to negotiate around an issue Grassley has vehemently opposed, said Len Nichols, health policy director at the New America Foundation, a nonprofit think tank, referring to Sen. Charles E. Grassley (R-Iowa). "It was the first time the president indicated he could live without it."

We should be alarmed. Candidate Obama promised offering a government-sponsored plan as a low-cost alternative for Americans who are having trouble purchasing insurance in the private market and now President Obama is reportedly "open to compromise" on a plan that has not yet been written. All of this talk of reform will be for naught unless pressure is brought to bear on the private market.  And there is no other entity to exert that pressure except for the government.

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