Tuesday, July 21, 2009

Someone gets it right for a change

Jacob Weisberg of Slate explains why the mantra "If you like your current health care, you can keep it, period" -- a phrase President Obama repeats often and which might be the only thing Democrats and Republicans agree on in the health reform debate -- is exactly the wrong way to go.

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And here I was thinking I was all alone in the wilderness.

Weisberg argues correctly that "we're missing the boat most completely by sticking doggedly with a workplace-based system that no longer makes sense." Amen, brother. He argues, as I have, in favor of the bill known as the Wyden plan, and nicely explains how it works.

The president could explain all this to the American by saying something like this: "Sorry, folks, but you will have to change your health plan. That's the bad news. The good news is that you won't be forced into any particular plan (like you probably are now at work) but instead will have a range of options. You'll get government assistance to help pay for it (in lieu of your current employer subsidy), and because you'll be buying insurance in the individual market, you'll also get to decide what to buy. If you like your current plan, you'll be able to choose something very much like it, and you'll probably be able to keep your current doctor. If you want the Cadillac coverage, you'll have to pay more out of your own pocket. But it's your choice. You can also change your mind, so if you're not happy with the plan you pick, just fire 'em and pick a different plan, just like you could with your car insurance. Again, it's your choice."

Now that would be change I could believe in.


  1. But you don't get to keep your own doctor if that doctor drops your insurance plan because the insurer drops reimbursement in order to pay their CEO $5 million or if your local hospital no longer accepts the insurance due to reimbursement rates. We are all held hostage by insurance companies! The Slate author is right- our employer-based "marketplace" system of insurance is wrong.

  2. True, but if your doctor drops your insurance plan, you'd be able to fire your current insurance plan and hire one of the ones that your doctor still accepts. You may have to pay more for it. But life is choices. That's the beauty of an individual market: You get to pick the company that works best for you. Wouldn't it be nice, if you're feeling held hostage by your insurer, top be able to call them up and tell them to screw off, you're taking your business elsewhere? And be able to actually do it? The Wyden plan (which is what Jacob Weisberg is talking about) would allow that. The current House and Senate plans would not. You'd be stuck with your current insurance if you have insurance through work, and the "public option" wouldn't be available unless you became unemployed.
    Look, I'm not against reforming healthcare. It's a complete mess, the costs are skyrocketing, it's confusing, opaque, and it's killing business in the gloabl market. It must be fixed. But all the current plans do is raise taxes (massively) to create a new government insurance plan, while basically leaving the rest of the system alone. That is not reform.

  3. So a company currently $10,000 a month to Blue Cross for health insurance. They also pay payroll taxes of $6,000 that fund Medicare. (Ignore the numbers themselves- just an illustration) National Health Care is implemented and the company now pays $14,000 a month in payroll taxes to fund National Health Care. Oh My God! Taxes went up 130%!!!! It's awful! Oh wait. They are paying $2,000 a month less!!!! More money for the owners to pay bonuses, buy a used Bernie Madoff yacht or what ever they want to do with it. So take off your "taxes are bad" blinders and look at the whole picture. Read the details at www.pnhp.org

  4. Life is about choices, and this issue is fraught with vested interests and profit motivations on all sides.
    So in the interest of full disclosure the Primary Care Physician shortage can be ameliorated by deregulating the 35 remaining mandatory collaborative and supervisory practice Nurse Practitioner states. By allowing NPs to provide much of the needed primary care and practice to their full scope independently there would be an increase in providers which would spur competition for higher quality more affordable care. The research negates the bogus claims regarding unsafe care rendered by non-physician providers. Outcomes are comparable and patient satisfaction is higher among those cared for by Nurse Practitioners.

    Raymond Zakhari, NP
    Primary Care Provider