Someone named M.B. McLaughlin just posted a very good point-by-point analysis of health care reform options in today's Washington Post online. This was in response to Louisiana governor Bobby Jindahl's op-ed piece, in which he basically says the Democrats are full of poo, then offers his own plan, which basically mimics what the Democrats have been saying all along on some points, and mixes in a few Republican articles of faith (e.g., tort reform) so he doesn't look too blue-state, and makes a couple of claims about what Americans want that don't seem to be backed up by any facts whatsoever. Jindahl is like someone who shows up to a meeting two hours late, takes the floor, and proceeds to blather on about things that were already discussed before he showed up.
Here's Jindahl's op-ed: http://www.washingtonpost.com/wp-dyn/content/article/2009/10/04/AR2009100402003.html
McLaughlin's response is below, just so you don't have to slog through pages and pages of online comments.
mbmclaughlin wrote:
This is a point by point response to Gov. Jindal's ideas (which, incidentally, would have better served everyone if they had been presented six or sevent months ago when we first started talking about health care reform).
-- Voluntary purchasing pools: This is one of Obama's ideas and is already in the Democratic health proposals in the form of insurance exchanges.
-- Portability: Allowing policies to cross state lines would ensure a "race to the bottom" that would gut all of the useful regulations that insurers are currently forced to comply with... things like covering mammograms, insulin, and smoking cessation materials and programs. If insurers cared about getting their policy holder's healthier, they would already "make more investments in prevention and in managing chronic conditions." The fact is that it's cheaper to drop people for misspelling something on a form than it is to cover them and it's easier to raise their rates so high they can't afford it than it is to treat chronic conditions.
-- Lawsuit reform: Every study I've seen says that lawsuits add no more than 1-2% to the cost of health care. Small price to pay when you consider that there are doctors out there who amputate the wrong limbs, leave sponges and surgical tools in people, and do all sort of other horribly incompetent things that maim and kill people. A better plan would be to develop basic, standard practices that doctors should follow for certain common procedures. Things like always have patients who require non-emergency surgery shower and scrub with antibacterial soap before the procedure, always wash your hands, and do a simple blood sugar test on patients with a family history of diabetes at least once a year.
-- Require coverage of preexisting conditions: Good, excellent, and it's already in the Democratic health proposals.
-- Transparency and payment reform: A majority of consumers get health coverage through their employer and thus only care about their copays. Most consumers are so busy with finding jobs, keeping jobs, making meals, getting the car fixed, paying bills, going to school, keeping an eye on the kids, and the myriad of other things that occupy modern daily life that even if the prospect of reviewing hundreds and hundreds of pages of efficiency studies and billing detail minutiae were exciting they wouldn't have time for it. Insurers should be making sure that the system works. But again, it's cheaper to just drop expensive patients than it is to question the details and try to save money.
-- Electronic medical records: Sounds good, as long as the system used is a secure one like the ATM network and not some insecure thing like most "online" systems. Also, how will you pay for it? Will our taxes go up or will it be another unfunded mandate that gets watered down due to lobbyists?
-- Tax-free health savings accounts: These are fine provided that you're well-to-do and can afford one. But the amount of record-keeping they entail makes them almost not worth it. Have you ever tried finding receipts for aspirin you bought a month ago? And what about the large amount of pointless medical care and purchases that happen at the end of each year as people who have these HSAs rush to try to spend the leftover money that disappears on Jan. 1? These are actually one of those nice ideas that work out rather terribly. We'd be better off giving everyone an extra $2,500 on their standard deduction. It wouldn't force people to buy care they don't need and penalize them if they lose some old, grease-stained receipt.
-- Reward healthy lifestyle choices: Sounds good. Why aren't insurers doing this already? Of course the only way to make them do it would be to mandate that they do it. Which I personally have no problem with but I expect many Republicans might.
-- Cover young adults: This seems like a good idea though young adults whose parents don't have health insurance won't benefit from it. Nor will many young adults who are in college. College's like to force really cheap, horrible "gulag" plans on students. Many insurers will refuse to cover children who have other insurance. Why not give young adults the option to buy in to Medicare?
-- Refundable tax credits (for the uninsured and those who would benefit from greater flexibility of coverage): Why is it OK to force people to buy insurance from private companies and anathema to allow them the option of buying it from the government? Why can't American families be given the choice of getting health insurance protection from our gov't? We get protection against invasion, crime, and fire from the government and those all seem to work just fine. How is it that we continue to support a for-profit health insurance system? The profits come from denying care to people. Every time they have to provide treatment, they lose money and their profits go down. Isn't it immoral to profit off of making people sicker and refusing treatment to sick people?
10/5/2009 1:26:38 AM
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