The Chance for Major Health Care Reform in Either 2009 or 2010 Is Now Zero
A couple of weeks ago I did a post, The Pretend Presidential Debate on Health Care--The Health Care Press Needs to Force the Presidential Candidates to Get Real on Health Care "Change".
In it I made the point that facing a $500 billion budget deficit next year, the sunset of the Bush tax cuts in 2010, fixing the alternative minimum tax problem once again, and the cost of the Freddie and Fannie bailout, the presidential candidates needed to get real about health care reform. Instead of giving us their rote health care talking points, I said they needed to start telling us how they were really going to deal with health care reform in the face of all of these challenges.
Just when you think things can't get any worse....
Two weeks later you can add the AIG bailout and as much as a $700 billion bailout of the financial system now being considered by the Congress to the reasons why the health care plans of both candidates are no longer relevant.
On top of that $500 billion deficit in 2009, the Congress is now being told it must take on a total of almost $1 trillion in government long-term costs to try to turn the financial system around.
I would suggest that lots of things have changed since each candidate offered their health care reform plan.
Obama's health plan will cost at least $100 billion a year. That's now a non-starter.
McCain's health plan counts on deregulation of the health insurance industry. Do I even need to explain to you why that is a political non-starter in this environment?
I don't know about you, but watching both Obama and McCain I feel like they are living in a parallel universe from the one the rest of us are in. We are living in the midst of the greatest financial crisis to face this country since the Great Depression--the outcome unknown and able to tip either way--and these guys are out there on the hustings as if this is all just another partisan reason to beat up on the other guy. I'm not seeing a lot of leadership here. Instead of making meaningless political speeches in the Heartland, why aren't they on the Hill this week leading their respective party--and the country--to a solution?
These guys have the greatest opportunity of any presidential candidate ever to demonstrate to voters why they should be President by taking their seats in the U.S. Senate and showing us their leadership skills.
On health care, they need to get just as real.
What are their plans to reform health care that actually make sense and can be implemented in the face of all of the things this crisis has changed?
12 comments:
It doesn't matter who wins this election because the cause of America's Health Care crisis begins and ends in the HOME! The government can not and will not fix this problem for us. We MUST fix it oursleves and we CAN do that.
What we can't do is continue to expect our government to bail us out every time we make a poor and/or greedy personal choice. We should all be held responsible for our own actions individually and some states are doing that by 'charging' obese workers $25 to help with the costs of their own health care which, by the way, is substantially more than the average weight person.
We are Americans. Our entire history is based on taking control of a bad situation and making it better so we can ALL benefit.
We better start Taking It On and quick!
Not getting more govt involvement in healthcare is the only good news of the Bailout giveaway.
The first rule when you find yourself in a hole is: STOP DIGGING!
The US is in a monstrous financial hole, and we keep digging faster and faster.
We should all watch the movie I.O.U.S.A.
Oh sure, Ronna, blame the fat people! This personal responsibility argument so misses the point. Yes, we DO need to take personal responsibility -- Americans generally lack a healthy lifestyle, and that is a critical piece to our overall health. But what will you do when your illusion of having total control over your body erodes and you get slapped with a major medical illness? When the SYSTEM is broken and more Americans simply cannot gain the access they need to healthcare services, and many more are forced to file bankruptcy to address outlandish medical expenses (many of whom thought they had great insurance, by the way) something more comprehensive than 'take the cupcake out of your mouth' is needed. Get real!
I think Ronna has a good point Iz. If we do run across unforseen conditions, there should be plenty of resources available if people start living healthier and lowering utilization. Another thing I would recommend is moving away from our moral hazard type system to a more traditional setup. Shoot, most people pay more for a haircut than a doctor's visit, but still complain about the cost of healthcare.
Once upon a time, health insurance paid for the 'major' things; surgeries, injuries, problems requiring hospitalization. Office visits, many times maternity and certainly prescription drugs weren't covered. The public needs to view health insurance as being for the 'big things' again. As more and more things were added, costs went up, along with advancing technology which isn't cheap.
Frivolous lawsuits harm the situation, and maybe physicians need to understand their incomes contribute to this crisis (I know that won't be popular). Caps need to be considered on upper executive compensation with health insurance carriers. But until we treat health care payment like homeowners or auto insurance, where many people opt to take care of smaller accidents and repairs, this won't be changing anytime soon. THIS is where we can take personal responsibility to help contain this fiasco.
I'm not blaming fat people lz, I'm simply stating the facts. The more overweight a person is, the higher the chances of becoming ill due to the weight problem.
As monkey said, the more fit we are as a nation the more equipped we will be to handle the 'crisis' illnesses due to the simple fact that funds will be more accessible.
If I offended in any way, I apologize.
Colleen,
I am a primary care physician working on providing appropriate primary care by taking time with my patients and taking a subsequent cut in pay by doing the right thing: providing my patients with quality as opposed to getting paid more by quantity (how many patients I see). I am curious. How much you feel a physician should make annually?
Thanks,
An FP in rural Colorado
Rural FPs, GPs and to some extent IMs are generally underpaid for what they are expected to do. Although it wasn't clear, I was referring more to specialists. I know their incomes have been dropping as well, relatively speaking. I knew an ENT physician many years ago who decided to leave our major metropolitan area because his income had dropped below $300k per year. He went to the rural south to be the only ENT for 80 miles. Not sure how that ended up working out, but he wasn't going 'cheap.' I certainly wouldn't want to bait you on this topic because I feel there are inequities in physician compensation often times. But when docs, specialists in particular, want to stop taking insurance because of what they are (or aren't) making, that adds to the problem of rising costs. As well as added expense for their patients who frequently aren't making 6 figure incomes.
I would love to claim to have the answer, but I don't. But we really have to watch where things are going, because many of the solutions being touted will really end up costing more eventually, without the quality of care Americans are used to.
I wish you all the success you can achieve!
Many in the political realm are jumping to the conclusion that the $ 700 billion Wall Street bailout and economic crisis preclude fixing the rest of our nation’s problems – including our broken healthcare system and our high gas prices.
If there is one thing we have learned from the Wall Street Financial crisis, it is that the worst thing we can do is ignore big problems. When we ignore problems they do not go away, they grow and grow until they become a disastrous crisis.
Our health care system is another economic time-bomb waiting to explode. Americas businesses – large and small – are becoming uncompetitive in our global economy with ever increasing health care costs. State and local governments strain to keep up with rising health care costs and underfund education, again undercutting our global competitiveness.
If we are willing to get serious and attack the cost issues that drive our health care problems, there are solutions that would level off or stop excessive health care cost inflation.
Incremental reform and leadership is what we need. One major event or episode of reform will only cause turmoil for all.
Having been involved in the last fight in the 90s I wouldn't put health care reform on a death watch yet. I seem to recall the last time the bankers got the country into a financial mess with the savings and loan problems, it also cost many billions to fix and yet all of it was kept off budget. So it is not an absolute $700 billion will show up anywhere on the Federal budget. In addition, there are also other avenues to tap for health care reform funding. Adjusting Medicare formulas can raise money easily, reducing certain Federal Health Programs in the budget can raise funding, especially a program that moves toward universal funding opens money. Finding a workable phase in of changes reduces the need for immediate funding. All of these ideas could be put to use to finance a health care reform proposal. I think a more important factor is if there is the political will to even try, or will the current financial crisis sap any will to move forward? Is there a champion in the House and Senate on the horizon willing to take on the task? I worked for Senator Chafee during the last effort and he was tireless in trying to find a responsible, reasonable, workable solution.
Doug: I think you miss the broader implication of the bailout.
The U.S. economy has been expanded on all of this easy credit. We are now going to see much less credit available after the bailout. The Ford dealer will sell fewer cars, fewer people will be eligible for loans--cars houses, refrigerators, credit card debt limits.
The bottom line will an economic contraction because of less demand in turn because of less credit. That means less in taxes at the state and federal level and a deficit bigger than the $500 billion we are already facing in DC.
Then there is the higher possibility of more taxes if all or some of the Bush tax cuts can't be extended and the impact on growth that will have.
Then there is the interest on $700 billion of debt--the debt may be offline but not the interest--at about $25 billion in annual cost.
Sort through this and tell me where you get the money for comprehensive health care reform???
I wish more people would have listened to you and Senator Chafee 15 years ago!
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