Why We Will Win the Health Care Debate
I propose a metaphor:
Warship = US Congress
Lighthouse = The reality of runaway medical costs, looming Medicare/Medicaid deficits and other demographic considerations.
Now the video:
Robert Creamer at HuffPo also explains it well in his piece - Three Reasons Why a Strong Public Option is Likely to be Part of Health Insurance Reform
First, Creamer frames the issue:
Three basic models have been adopted by Western industrial nations to provide universal health care to their populations.
The government can directly employ doctors and hospitals to provide service. That is the system they have in Britain where they spend 40% less per person on health care than in the U.S. and get pretty good reviews from their citizens. It's the same system that we use to provide health care to veterans through the Veterans Administration.
The government can provide heath insurance for everyone as it does in Canada - or as we do in the U.S. with Medicare. Medical practices and hospitals are in private hands, but the health insurance fund is managed by the government. Again, that system seems to work quite well and also does a good job at controlling costs.
The third approach is to require individuals and businesses to purchase insurance and leave it to private insurance companies to provide that coverage. The problem with this approach is that requires some mechanism to control costs.
Suppose we turn to some sort of mandates -- to make sure we capture the premiums of people like this guy - Dear Medicare: I Want You To Have My $820 A Month
I am one of the lucky ones. I have a great job in local government where I get to help people in dire straits. I'm not quite 40. I'm quite healthy minus some pretty bad allergies, but who doesn't have allergies these days. I go to the Doctor every other year or so and call in when I need to update my allergy prescriptions. I have no dependents. I also have health insurance.
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In 3.5 years on the job I have paid approximately $34,440 into the private insurance system. That is more than my take home pay for a year. I figure I have cost the health care industry about $1000 (and I think I'm being generous here).
Without premium dollars collected to insure folks like this, we cannot insure folks with pre-existing or chronic conditions.
Okay, lets enact mandates (I remember arguing this to death during the Obama - Clinton primary fight) except MANDATES without a strong public option will be reverse Robin Hood write very large. As Creamer says (previous link):
Once everyone is required to buy insurance, the companies can have a field day raising prices and profits using the government to guarantee they are paid - either through subsidies or the imposition of fines. You can see why, from an insurance company perspective, this would be a great deal.
But from the point of view of the taxpayers - and the insurance ratepayers - it would be a disaster. It would be like giving the insurance companies a license to take your money - with no regulation - all enforced by government edict.
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What politician in his right mind would pass a law that requires individuals and businesses to buy products from companies who can then charge whatever the traffic will bear -- especially in an industry where premiums have increased three times faster than wages, and profits keep heading skyward even in the worst recession in 60 years? Once government requires you to purchase a product, it has to provide some means to guarantee that the price is fair.
Without a strong public option, mandates MUST also be off the table.
Take mandates off the table and universal coverage is no longer feasible.
Take universal coverage off the table and no health care reform.
No health care reform? Runaway medical costs remain a giant rock the US economy is slamming into.
Therefore, be calm and be strong.
We are the lighthouse and Senator Conrad (and friends) are the warship.
Hey Blue Dogs, it's your call. Mate.