So now that the primaries are actually underway and we're not just talking about them anymore, I want to share my real disappointment with the health care reform proposals of the major Democratic candidates. I wrote an essay on the plans of Obama, Edwards and Clinton and while my first thought was, "Cool! I really get this stuff now!" my next thought was, "Wow. This is a bunch of the same old crap that doesn't actually get us anywhere. Sigh."
In many ways, the proposed reforms of all three are strikingly similar. They all focus on reforms to the current system of public and private insurance and embrace the “play or pay” mentality of mandating employers to provide health insurance for workers or pay taxes for failing to do so. Concurrently, they propose varying methods of increased insurer regulation, creation of public insurance programs and maintenance and expansion of current public insurance programs. Clinton and Edwards also include individual insurance coverage mandates in their proposals, much like the recently implemented system in Massachusetts. Finally, cost controls that are centralized to the federal government are generally lacking from all three proposals.
I find all of this really depressing. None of these proposals actually address the root causes of the health care crisis and by focusing on getting everyone covered we'll probably miss the boat in terms of getting everyone care. The individual mandates experiment in MA is very young and it seems insane to me to try something on a national scale that has no evidence of success. Most distressing is the fact that none of the candidates really address controlling costs in meaningful ways, and individual and employer mandates will really only mean a lot more of the same and even more astronomical health costs. Why doesn't anyone have the gall to address the clinical and administrative wastes that arise from the dysfunctional relationship between doctors that charge fees that are too high and insurance companies and the government (Medicare being, by far, the worst offender in my opinion) that reimburse at rates so low it's almost comical. And the fact that pharmaceutical companies make the majority of their worldwide profits in the U.S. because we have no way (or desire, it would sometimes seem) to set and negotiate drug prices on a national scale. Grrr!
I think the thing that is most frustrating for me is that if one of these candidates is elected president there is going to be a lot self-congratulation in terms of health care reform. But in order to give every American a little card that says "I'm insured!" we'll end up passing out policies with huge premiums and high co-pays and many will still be unable to actually access care! I guess I don't have to worry that my degree will be useless when I graduate. There seems to be no exhaustion of opportunities to fight for care for all in the near future.
In many ways, the proposed reforms of all three are strikingly similar. They all focus on reforms to the current system of public and private insurance and embrace the “play or pay” mentality of mandating employers to provide health insurance for workers or pay taxes for failing to do so. Concurrently, they propose varying methods of increased insurer regulation, creation of public insurance programs and maintenance and expansion of current public insurance programs. Clinton and Edwards also include individual insurance coverage mandates in their proposals, much like the recently implemented system in Massachusetts. Finally, cost controls that are centralized to the federal government are generally lacking from all three proposals.
I find all of this really depressing. None of these proposals actually address the root causes of the health care crisis and by focusing on getting everyone covered we'll probably miss the boat in terms of getting everyone care. The individual mandates experiment in MA is very young and it seems insane to me to try something on a national scale that has no evidence of success. Most distressing is the fact that none of the candidates really address controlling costs in meaningful ways, and individual and employer mandates will really only mean a lot more of the same and even more astronomical health costs. Why doesn't anyone have the gall to address the clinical and administrative wastes that arise from the dysfunctional relationship between doctors that charge fees that are too high and insurance companies and the government (Medicare being, by far, the worst offender in my opinion) that reimburse at rates so low it's almost comical. And the fact that pharmaceutical companies make the majority of their worldwide profits in the U.S. because we have no way (or desire, it would sometimes seem) to set and negotiate drug prices on a national scale. Grrr!
I think the thing that is most frustrating for me is that if one of these candidates is elected president there is going to be a lot self-congratulation in terms of health care reform. But in order to give every American a little card that says "I'm insured!" we'll end up passing out policies with huge premiums and high co-pays and many will still be unable to actually access care! I guess I don't have to worry that my degree will be useless when I graduate. There seems to be no exhaustion of opportunities to fight for care for all in the near future.
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