HEALTH CARE TOP PRIORITY FOR OBAMA- STILL
By Danae Jones Aicher | Thursday, December 11th, 2008 | PolicySo we know what Obama’s priorities are, don’t we? And it’s good to see that health care, still, is one of them despite (or especially because of, to hear him tell it) the downturn in the economy.
Today, President-elect Barack Obama announced former U.S. Senator and Minority and Majority Senate leader, Tom Daschle will head up the new administration’s efforts to reform health care (upon confirmation). As Secretary of the Department of Health and Human Services and Director of the White House office of health reform, Obama said Daschle would be not just responsible for implementing a new health care plan, but also be the lead architect of that plan.
I’m not particularly interested in a debate of Obama’s decision to choose Daschle. No doubt many Republicans will find something in that choice to criticize; many Democrats will be fine with it. The more interesting thing (in my opinion) is that this was among the first high profile set of appointments Obama has made; the third following his economic and foreign relations teams.
It’s encouraging that health care is among Obama’s top priorities, especially given our economic dire straits. Obama clearly recognizes that the rising cost of health care is a major component of our financial problems, as individual families and households, as well as collectively as a nation.
“If we want to overcome our economic challenges, we must also finally address our health care challenge,” he said during his press conference this morning.
And, to that end, Daschle is the perfect man for the job. His commitment to health care reform is no secret. And he echoed Obama’s thinking about the relationship between health care costs and our economy.
“At a time that there is so much at stake, there is no question that fixing health care is and has been for many years our largest domestic policy challenge,” Daschle said. “Addressing our health care challenges will not only mean healthier and longer lives for millions — it will also make American companies more competitive, address the cause of half of all of our personal bankruptcies and foreclosures, and help pull our economy out of its current tailspin.”
I hope he’s right.
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23 Responses to "HEALTH CARE TOP PRIORITY FOR OBAMA- STILL"
“Obama clearly recognizes that the rising cost of health care is a major component of our financial problems, as individual families and households, as well as collectively as a nation”
The problem is, any type of government system whether it be a tax subsidy, transfer payment, government controlled and managed… this does nothing to reduce healthcare costs. It just shifts the costs from the consumer of health insurance to the tax payer. If anything, giving more “free” health insurance to people increases the moral hazard of over consumption, ultimately driving up the costs of providing it. Unless something fundamentally changes the incentive structure on the supply and/or demand side of the healthcare system, costs have only one way to go – up. We will just go from bankrupting households to bankrupting the federal government instead. As of now, I have seen nothing in any of Obama’s healthcare proposals that do anything to actually alleviate costs in any significant manner… instead just transferring these costs to taxpayers.
So where does the balance point lie? Sure, over-insurance can create a moral hazard, insulating the consumer from the cost of wasteful choices. But on the flip side, under-insurance can cause neglect of potential preventative actions and result in unnecessary catastrophic illness, and its associated expenses. Expenses which get passed on to the consumers through increased rates and service costs.
If Daschle’s book “Critical” is any indication, he’s a pragmatist on health care, and an incrementalist of sorts. Significant is a relative term. The cumulative effect of many small changes in concert can be significant. What sort of changes would you like to see, EJ? Personally, I’m intrigued by this, though I don’t see a high likelihood, despite the authors brother being Obama’s Chief of Staff.
I may be indulging in idle fantasy, but I’m waiting to see Obama’s pick for AgSec. It’s possible that a real reformer there could start to unwind the damage done by our Nixon-era agribusiness perpetuating “farm subsidies”. And such a potential change to our food sources and nutrition could have major impacts on our health as a nation.
A single payer system could actually help control health care costs. The single payer could decide how much would be paid and the provider could then decide to either accept the payment or go into a new line of work.
Of course this could lead to a supply and demand type problem. However even in our current unlimited demand model there is rationed supply. This might not be true of those lower on the food chain like registered nurses but it is true of the number of Doctors that are churned out every year.
LD, unfortunately for you, that’s not the economy we have.
As I’ve said before, why stop at health care? Why not have government buy all food and then decide what the prices should be and sell it to us? Why not have government buy all the cars in the country, and then decide how much they should really cost and sell them to us?
Are we going to have a free market economy anymore or not?
one thing we could start with is shifting the credits from the employer to the individuals. as a business owner myself, I have over 500 options to choose from when purchasing healthcare for my company but my employees only get to pick from one of vetted two options. my business still being relatively small, I can generally accommodate the diversity in the company but the problem worsens as companies get larger. we hardly have “free market” healthcare in this country through the employer-based system. by giving the tax breaks to the individuals you allow them to choose from the over 500 options available to the business and get the plans better suited for them specifically.
also, many young people who go uninsured because of the high costs of healthcare and they think they are generally healthy but end up costing the system more money because they end up in the emergency room regardless. at least the insurance companies could then start providing plans that just include ER and yearly check-ups and other creative plans for different lifestyles.
healthcare isn’t a simple problem to solve but my inclination is to give the “free market” a chance first because once it is socialized we cannot reverse it no matter how bad it gets.
Brian,
Unfortunately for you the majority of voters can no longer afford health care.
Since the majority can’t afford it, they’re going to vote for change.
Ooops, I stated future tense when I should have stated past tense.
Amit,
I agree with you that health care costs should be born by those that live here and not by those that provide employment here.
Where I am probably going to fall into disagreement is that the wealthy should pay a larger share then the middle class.
David, throwing government money at health care doesn’t lower its cost.
Doesn’t work for higher education either.
Brian,
Well I would welcome government attempting to throw money at me while I put my kids through college. It ain’t been happening.
Sole provider can work on the health care issue with the evidence being that Canadian health care consumers can get state of the art medications at lower costs then we can get on our side of the border.
littleDavid, the wealthy will pay more because they can afford better healthcare and they essentially will subsidize the research and development for new drugs, techniques, treatments, etc. the middle and lower classes in turn get the benefit albeit not instantaneously of the wealthy paying more for healthcare with better medicine, treatments. etc. its sort of analogous to cars (sore subject I know) where the luxury cars are the first ones with air bags and other advanced features but then become standard even on basic cars.
also, the Obama administration could also help costs out a lot by limited frivolous lawsuits from the likes of trial lawyers such as John Edwards
David, I didn’t say government was throwing money at you. I said government was throwing money at higher education. It’s a big difference, and your comments about the cost of higher ed help me make my point.
and if your message is “make our health care system like Canada’s” you’ve already lost.
Amit,
Perhaps you need to understand that not everyone is an engineer. Some of us need capitatlization and paragraph breaks to completely understand you.
Brian,
I might be in the minority about single payer.
In fact I would point to Australia’s system before I pointed to Canada’s system.
I would not insist we adopt Australia’s system as our own. I’m just saying that America’s current system on health care is broken. I’m open to alternatives.
I’m not a fan of our employer based system. The increasing costs place an unneeded burden on our companies which makes them less competitive with foreign corporations that don’t have employer based insurance.
I don’t like the fully open market though either. With the ascendancy of the information age, and as insurers gain more and more knowledge of their potential customers, leaving the end consumer adrift without the benefit of collectivization will likely reduce coverage and increase costs. Look at car insurance. The worse your record (and the more likely their actuarial tables predict you are to cause a payout), the more your insurance. Which means the worst drivers will commonly forgo auto insurance, and risk the fines. The same would likely happen with health insurance. The poorer health of the individual, the higher their insurance, whether through individual pricing or required coverage options. Which would cause the sickest to forgo insurance and depend on the emergency system. And as treatment costs almost always exceed prevention costs, that will drive up costs for everyone.
I favor a public/private market hybrid. Use the govt to gain the benefits of collective pricing, but bring the market into the picture in the form of choices of coverage options. There’s lots of different systems that could be built around a hybrid approach.
LittleDavid, I wish everyone was an engineer. Also, I hate typing in these little boxes. Guess I should use MS Word to cut and past but feels like cheating.
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LittleDavid, the wealthy will pay more because they can afford better healthcare and they essentially will subsidize the research and development for new drugs, techniques, treatments, etc.
The middle and lower classes in turn get the benefit, albeit not instantaneously, of the wealthy paying more for healthcare with better medicine, treatments. etc.
Its sort of analogous to cars (sore subject I know) where the luxury cars are the first ones with air bags and other advanced features but then become standard even on basic cars.
Jeremy, what to do about people who do not care about their health? many folks simply rather smoke a cigarette, eat fatty foods, not exercise, etc. Does the rest of the public have an obligation to treat a smoker for lung cancer given all the proof of its causes? Personal responsibility needs to play a larger role in our healthcare system. I’m not talking about car accidents and gun shot wounds, but basic health problems due to everyday habits. I don’t think its rocket science on how to be healthy. It whether we want to be healthy or not which is the tough part.
Amit, i’m all for people bearing the burden of their choices. And i think that ideally such lifestyle choices should be taken into account, though the how of that is a thorny issue. Of course, its not like poor choices are without consequence. Regardless of coverage for treatment, you still live (or die) with the illness.
But you cannot build a system based on the idea that bad choices = bad health and good choices = good health. I could be diagnosed with cancer tomorrow, regardless of what i smoked, ate, or how often i exercised. I could also smoke daily, drink like a fish, and die peacefully in my sleep at 95. I am all too familiar with what chronic disease can do to a families budget, as my own family has been dealing with it for several years. We’ve tried HMOs, PPOs, and HDHP/HSAs. The last seems to be gaining the most traction lately among the business community, and is pretty good if you’re healthy and committed to making good choices. But if afflicted with a chronic disease… lets just say that we were quite happy when November and open enrollment arrived that year.
Many argue that our genes are inescapable, and can you legitimately punish someone for their genetic propensity for disease?
Of course, all that still avoids the issue of ER care. When an ambulance shows up with Tom in cardiac arrest, do you wait to do a lipid profile first? Look in the contents of his stomach for that double whopper with cheese? Did he bring it on himself through poor dieting? Or was it the supplements he took trying to keep in shape?
Jeremy, I agree those tragedies exist to well behaved people and I already made exclusions for ER care. But healthcare insurance is still a numbers game and it is undeniable that poor choices = poor health for 95+% of the population.
At what point does the insurance company continue to pay for heart attacks due to bad diet? (guess when they’re dead)
two questions we can ask ourselves:
1) is it the govt’s responsibility to maintain a healthy population?
2) is the govt the best entity to promote good health?
I would guess most people would say Yes to #1 and No to #2.
I better not say anything too sharp against engineers. My daughter is in college attempting to learn how to be one.
As for the wealthy subsidizing health care for the lower classes I wish that was true. But what happens is the wealthy get more then they need and the lower class gets little or nothing.
Smoking actually saves our medical system money. The smoker dies at an early age of one malady instead of lingering on into old age and burdening our health care system with treating him/her for all of the age related problems that come up.
There was actually a study done that proved this (smoking saves society money) but it was shouted down by people who claimed it was wrong to point out how it was beneficial for people to die at somewhat younger ages.
They paid into the medical system during their productive years and did not linger on “forever” draining the system as they grew old.
Amit, I doubt very seriously the Founding Fathers brought forth on this continent a new nation “with a responsibility to maintain a healthy population”
They actually wrote “conceived in liberty.”
kirwin, I would actually answer No to both of the questions I asked. I was just saying that most people would say Yes to the first one.
littleDavid, you also bring up the interesting scenario of what happens to Social Security if people live longer because of better healthcare. we’re screwed either way.
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