ObamaCare: More of the Same Sicko Ideas

When Barack Obama convened a White House forum on health care reform last week, there was one ground rule: check fresh ideas at the door. Of course, you’d never know that from Obama’s opening remarks rife with the usual bipartisan Mad Libbery:

In this effort, every voice has to be heard. Every idea must be considered. Every option must be on the table. There should be no sacred cows. Each of us must accept that none of us will get everything that we want, and that no proposal for reform will be perfect. If that’s the measure, we will never get anything done. But when it comes to addressing our health care challenge, we can no longer let the perfect be the enemy of the essential. And I don’t think anybody would argue that we are on a sustainable path when it comes to health care.

Despite the inclusive rhetoric, invitees were carefully selected to ensure no contraband proposals made it past security checkpoints.  Among the attendees were the usual suspects:

The vast majority of the groups represented at the summit strongly support a federal health insurance plan, and some are even advocates of a single-payer system. The list of summit participants included no fewer than nine unions: SEIU, UFCW, USW, Teamsters, UAW, CWA, Change to Win, AFSCME, and AFL-CIO.

The attendance list also included Physicians for a National Health Program (“Our Mission: Single-Payer National Health Insurance“) and other liberal advocacy groups such as the Center for American Progress, Campaign for America’s Future, AARP, Planned Parenthood, Families USA, and Health Care for America Now.

Advocates of free market health care models were conspicuously absent.  Michael Cannon notes that the guest list excluded representatives from some of the top health policy think tanks in the world, including:

  • American Enterprise Institute (the #5 think tank in the world for health policy)
  • Cato Institute (ranked #7)
  • National Center for Policy Analysis (ranked #10)
  • Manhattan Institute
  • Pacific Research Institute
  • Galen Institute
  • The Heritage Foundation

What could analysts from these policy centers bring to the table?  Here’s just one example of an innovative approach to health care outlined by John Cochrane in a paper published by the Cato Institute.  He proposes a systemic reform that would separate health coverage into two products: medical insurance and what he calls health-status insurance.  “Medical insurance covers your medical expenses in the current year, minus deductibles and copayments. Health-status insurance covers the risk that your medical premiums will rise,” he explains.

John Cochrane’s free market solution would provide portability, preserve choice, and increase affordability. But as Reason Magazine’s Ronald Bailey points out in his excellent summary of the plan, Dr. Cochrane did not receive an invitation to the White House summit.

John Cochrane and other creative thinkers have been locked out of the debate, but the Teamsters and UAW have the president’s ear as he prepares to make a $634 billion down payment on health care reform. What happened to “every voice has to be heard”?


5 Responses to “ObamaCare: More of the Same Sicko Ideas”

  1. Eclectic Radical on March 17th, 2009 3:17 pm

    I’ve done some writing on health care myself, from time to time, and to be frank most of the ‘free market’ health care reform ideas I’ve seen thrown around would not make the current situation better. The problem with free market health care reform is that the free market, the practice of selling health care services as a commodity on which one makes money, has artificially inflated health care costs. Selling someone two sets of insurance instead of one is not going to solve that problem. Paying your insurance company twice, once to get insurance and once to keep it, hardly seems as if it is the most rational or logical solution to the problem. It sounds like a way for insurance companies to make more money.

    The most aggressively pushed free market solution is the McCain plan, which amounts to deregulation of the health care industry on a massive scale. It will do very little to help with the real problems of health care and could cause new problems by creating an environment in which the requirements of the least regulated states could apply in all fifty. Health care in California and New York might not meet necessary standards if Arkansas’s basic requirements are those met by the cheapest policy.

    A ‘free market’ solution could work, such as the universal coverage systems in France and Germany… but that would require a great deal of carefully written regulation, at the federal level, to make sure quality care is offered by all providers. That kind of regulation is hardly the ‘small government’ for which most conservatives will want to push. The Massachusetts plan, which some moderates are trumpeting and of which Mitt Romney is very proud, ‘covers’ everyone but falls short of the necessary regulation to guarantee everyone who is ‘covered’ can count on having ‘care.’

    Frankly, this is one area where the ‘socialist’ solution may be best for everyone. Business would lose the burden of subsidizing the health care of their employees, which could have a very beneficial effect on the economy. Employees with reliable health care would be healthier and less likely to lose working time or resign for health reasons. The greater sharing of costs across the entire tax-base, coupled with the fact that such a system would only need to meet its operating costs and would be freed from the need to make a profit or satisfy stockholders, would dramatically lower the individual cost per consumer and ensure the system was better funded than the current system of hundreds of programs each serving small percentages of the population. The government would be able to eliminate Medicare and Medicaid entirely, and one effective cradle-to-grave program would be more efficient than two systems competing for government money. Everyone (business, labor, and government) would save.

    I actually do agree with you that there should be more conservative voices included in the process. I am not willing to dismiss the idea that the opposition does not have something useful to add, and I strongly believe that conservative criticism is important in forming the best plan: the best plan will have to be able to address rational, constructive criticism from the center and right. A plan that cannot answer these questions will not be good enough. So people asking these questions must be involved, if only to be rebutted.

    The real failure, in my view, of President Obama’s thinking on health care is that he does not have a clear plan in mind and that is goal of ‘universal coverage’ is not the necessary goal of ‘universally available /care/.’ He is trying to tread a center road, using rather moderate ideas from the center-left and center-right, without addressing the deeper problem that the current system needs /radical/ change and simply cosmetic ‘reform’.

  2. Rob Taylor on March 17th, 2009 11:27 pm

    In every country that has tried your vision of what health care should be, the quality of care suffers. When the government is in charge of health decisions and is paying for all care rationing of that care based on the ideas of a Bureaucrat replaces your freedom to decide on what to do with your own health. For example England recently decided that certain cancer drugs will not be made available to patients because the drugs “merely” prolong cancer sufferers lives a year or so. If I had cancer I’d want that year, and not a technocrat basically telling me when I should die.

    Sans profit motive you also don’t get quality people coming in to the system. Using England again as an example many NHS workers are imported to the system. A few months ago the papers there reported on the story of how Muslims who worked for NHS were refusing to use alcohol based hand sanitizers. MRSA was spreading as a result.

    Wal-mart already provides an example of cheap affordable health care in the form of their walk-in clinics, and all medical care can be made cheaper wit Tort reform and limits on how much money Doctors can be sued for. Why don’t we try that before socialized medicine? After all when we socialize medicine, where will Canadians go for quality health care?

  3. Jenn Q. Public on March 17th, 2009 11:56 pm

    Eclectic, I appreciate your agreement that the opposition should have a voice in the health care debate. From your lips to Obama’s ears.

    However, your contention that “this is one area where the ‘socialist’ solution may be best for everyone” is an idea on which we will never see eye to eye. I am unwilling to accept restrictions on choice, access, and quality as a way to guarantee “equality” (read: equally rotten care for everyone.)

    Terminal breast cancer patients in the UK are being denied life-extending medications so the NHS can contain costs. NHS hospital staff shortages have resulted in hundreds of women being denied epidurals during labor. Pap smears are not given to British women under 25 because the risk of cervical cancer is considered negligible – try explaining that to the women in their late teens and early 20s who end up having radical hysterectomies or worse when their diagnosis comes too late.

    These are just a scant selection of the major systemic failures of socialized medicine that people have paid for with their lives. Even President Obama included choice and patient safety as two of the principles that must guide American health care reform. Unless we have fierce defenders of those principles involved in the process, I fear we will end up with universal access to long lines, substandard care, and dangerous rationing based on cost effectiveness ratios calculated by bureaucrats.

  4. Eclectic Radical on March 18th, 2009 3:53 am

    I originally typed out a very long rebuttal to the statements made about the British system and a few nightmare stories about our own health care system and the hospitals in my own area. That really isn’t the point, though. The point is not not to duplicate the British or Canadian system, nor the French or German systems (which attempt to guarantee universal care within a more privatized framework, with strict regulation to guarantee both access and quality), nor the Swedish system. This about fixing our system, which is broken.

    I have exactly the same concerns about access, choice, and quality that you do, and I would not be satisfied with any policy that did not meet your concerns. I may be assuming too much, but I think you would be less than satisfied with any program that did not seriously improve the baseline cost for consumers across the board.

    The administration is currently focused on system costs, with the idea that helping the industry spend less money will lower consumer costs. I’m not certain this is true. We don’t pay less for a Buick because GM moved its manufacturing to Mexico, however much they may be saving on labor costs. I think system costs will be naturally corrected by real reform.

    I am as skeptical of free market solutions as you are of socialist solutions, because free market health care is already failing us. I am not dismissing the possibility of a solution that includes a market health care industry. Germany and France have such systems and still provide universal care. However, such a system might actually require more regulation and big government than a more socialized solution, in order to enforce quality standards and police business practices.

    I am an economic Hamiltonian, but I am highly skeptical of the track record of corporate America in my lifetime. It’s the free market that is currently screwing health care up so badly.

  5. ObamaCare: More of the Same Sicko Ideas - Smart Girl Nation on April 12th, 2009 7:05 pm

    […] following article by Jenn Q. Public originally appeared on JennQPublic.com. Barack Obama at a Health Care Forum in 2007 (photo credit: americanprogressaction on […]

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