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McCain Proves Yet Again He Doesn't Get It On Healthcare
Submitted by nmaurice on Wed, 10/15/2008 - 10:14pm.
As someone who cares deeply about the issues facing our country, I found the first half hour of the debate deeply frustrating. I wanted to hear substantive debate on the key issues facing this country - the financial crisis, healthcare, energy, etc. While Obama gave measured and thoughtful responses to the questions, McCain repeatedly returned to canned attacks and games of guilt by association. When McCain finally started addressing the issues - beginning with healthcare - I went from frustrated to terrified.
McCain's healthcare plan is just, plain scary. He has based his approach on dismantling the traditional employer-based system of health care and pushing consumers into the individual insurance market, under the assumption that this will increase competition and save costs. In fact, this would likely raise premiums for many and reduce access for all but the healthiest people as insurers avoid people with pre-existing conditions and risk pools shrink.
McCain would further allow insurers to operate across state lines, which would have the effect of stripping states of their ability to protect their citizens as insurers seek domicile in the states that allow them to operate with the least oversight. Finally, he would not seek to address the issue of the uninsured.
Though the outcomes are stark, I do not believe McCain’s plan reveals some latent vindictiveness or hostility toward working people. He honestly believes this is the best alternative. What his plan does reveal, however, are two themes that resounds through many of his policies – a blind faith in unfettered private markets (didn’t seem to work so well for Bear, Lehman, Fannie and Freddie and AIG) and a basic lack of understanding of the challenges facing average Americans.
Obama offers a very different alternative. Recognizing the appalling inequity and unsustainable inefficiency of having a significant portion of the population without any health insurance, Obama wants to insure all Americans. Despite the alarmist rhetoric from the McCain camp this not an attempt to “socialize” healthcare through a government take-over. At its core, Obama’s plan seeks to retain the employer-based system while adding a public plan for people who do not have employment-based insurance. Additionally, he has proposed mandatory health insurance for children, along with premium subsidies related to income. Far from a government take-over, Obama’s plan seeks to facilitate the better aspects of market-based competition programs while allowing the government to step in and help those whom the markets fail – uninsured children for example.
What neither candidate has adequately addressed is cost The fiscal challenges facing employers as well as the federal government will require each candidate to go far beyond Obama’s pledge to reign in the worst corporate excesses and the candidates’ shared support of HCIT, chronic care management and pay per performance to seek cost savings. As a starting point, however, the Obama plan is clearly superior. By starting with the twin notions that the private sector alone cannot solve this problem and that we have an obligation to provide healthcare coverage to all of those in need, the Obama plan provides a strong edifice upon which to build the health care system for the next generation.
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What I find funny...
... is how so few of these so-called 'free marketeers' understand perhaps the only law of economics which can be consistently demonstrated to have a basis in reality: supply and demand.
Allow me to explain. Basic supply and demand says that, when an increasing number of people are demanding a given product, the cost for that product will increase. Hence, when more people want to buy a house in, say, Center City, the average cost for a house in Center City increases. We've seen this over the past 10 or so years in Philadelphia.
Apply it to health insurance. Let's say that McSame wins + enacts his entire health care plan. You'll then have more people than ever entering the market to buy a health care plan. Guess what happens... more people want to buy health care, more demand... the price *increases.*
Might there be competition between the insurers to lower the costs? Certainly. But will the effect of lowering the costs due to competition be greater than the effect of increased demand raising the costs? I rather doubt it.
Obama's plan is, in no way, perfect. I'd far prefer a true, single payer system a la Medicare for All. But Obama's plan is immeasurably preferable to McSame's.
-Z
McCain's private model won't work
And for whom will the private plans be competing? Clearly not the people who need health care - they cost too much.
The private plans will want to attract younger, healthier people who will pay small premiums without using much health care. They will design their benefits to pass larger costs on to people with chronic conditions who need healthcare.
To see how this is done, go on the Medicare Plan finder, www.medicare.gov, to see how HMOs and other Medicare private insurance plans in Philadelphia structure their cost sharing. They charger lower cost sharing than the traditional Medicare program for doctor's visits,(good for healthy people) but the cost-sharing goes way up if you need to use a hospital or a nursing home. Plans do it directly but charging more, or indirectly by making people by additional deductibles where Medicare wouldn't have another deductible.
Market place theories don't work for health care. McCain's plan won't increase, coverage, won't save money for individuals, and won't work to reduce health care costs.
Another basic capitalist fact
Whenever profit is the driving force in a system, everything else is a side effect. For example, if Mr. X wants to make money, he can do so by make widgets. To make widgets, Mr. X needs to hire people. To hire people, Mr. X needs to pay them and give them benefits. Therefore, as a side effect to Mr. X creating profit for himself, he creates both widgets and employees w/both decent pay + benefits. The widgets, decent pay, + benefits are *side effects* to the creation of profit for Mr. X.
Now, apply this same logic to our profit-driven health care system. Healthy people are the *side effect* to creating profit for the various owners of the system (insurers, providers, etc.). Healthy people are not the intended result of our health care system. Think about that: we have a health care system where HEALTHY PEOPLE ARE A SIDE EFFECT.
If that doesn't terrify you, then you must be a Republican. Or an idiot. Or both.
But I repeat myself,
-Z
Health care is a right
(Great post Zorro)
Health care is a right which is why hospitals deny care to no one based on ability to pay. We might as well have a president who reflects our national values and that candidate is Obama.