‘I think the country wants health care fixed’

December 13, 2006

In a Democratic Congress, this might even get some much-needed attention.

A dozen years after Congress rejected a Clinton administration plan for universal health care, Oregon Sen. Ron Wyden is readying a proposal to provide health care coverage to all Americans through a pool of private insurance plans.

“Employer-based coverage is melting away like a Popsicle on the sidewalk in August,” said Wyden, a Democrat and member of the Senate Finance Committee’s subcommittee on health care.

Wyden’s proposal, which he planned to unveil on Wednesday, is an outgrowth of work by the Citizens’ Health Care Working Group, a 14-member panel that went to 50 communities around the country and heard from 28,000 people about how to reform health care.

The group, created in 2003 by legislation sponsored by Wyden and Sen. Orrin Hatch, R-Utah, recommended that the government take steps to guarantee all Americans have basic health insurance coverage by 2012.

If the Citizens’ Health Care Working Group sounds familiar, I mentioned the panel in September when the group found, after hearing from 6,650 people at 84 meetings around the country over 18 months, that “Americans clearly want a system that guarantees health care for everyone.”

Needless to say, the Bush White House will likely resist any and all attempts to reform the system, in large part because the president believes Americans already have too much health-care insurance

Nevertheless, Wyden’s “Healthy American Act” sounds like a step in the right direction and an important measure to help change the nature of the debate.

It is not, alas, a single-payer system. I don’t doubt that conservatives will reflexively call this “socialized medicine” — no matter the details, that’s what too many on the right call any attempt to reform the system — despite the fact that there’s nothing socialized about it. From Wyden’s press release:

Following 60 years of gridlock on a desperately-needed overhaul of the nation’s health care system, U.S. Senator Ron Wyden, a member of the Finance Committee, today unveiled a groundbreaking new proposal to provide affordable, high quality, private health coverage for everyone regardless of where they work or live.

The plan, known as the Healthy Americans Act:

* guarantees private health care coverage that cannot be taken away for all Americans;
* provides benefits for all Americans equal to those of Members of Congress;
* provides incentives for individuals and insurers to focus on prevention, wellness and disease management;
* provides tough cost containment and saves $1.48 trillion over 10 years; and
* is fully paid for by spending the $2.2 trillion currently spent on health care in America.

I haven’t even begun to look into many of the particulars of this proposal, and I’m confident that plenty of serious people will find elements to disagree with. But Wyden is right when he says it’s time to put the issue back on the front-burner.

“I think the country wants health care fixed,” he said, citing skyrocketing costs and an estimated 46 million people who are uninsured. “There’s been lots of rhetoric and position papers. It’s time for action.”

Action will, in all likelihood, be slow and incremental, but the more universal coverage plans are part of the policy dialog, the better.

“* is fully paid for by spending the $2.2 trillion currently spent on health care in America.”

The problem with that is the question of who’s paying for and who’s receiving the health care. Far too many Americans are willing to spend whatever it takes for their own health care (or worse, for their pets) and NOTHING on the health care of others.

Of course, failing to control the spread and mutation of infectous deseases it likely to kill us all, but the selfish Americans will go to their deaths (and likely consumption by rats because there will be no one to bury them) with the glow of knowing their money was not “wasted” on others.

  • It feels like the 110th Congress has already done more before it’s even started than its predecessor the 109th did by the time it was completed.

    Even if Wyden’s bill results in just talk, it will provide Americans with the first hopeful news about healthcare in a decade. What a refreshing change of pace to hear Congress actively promoting legislation that has nothing to do with limiting our freedoms, spying on us, flag burning or gay bashing

  • “citing skyrocketing costs” + “a proposal to provide health care coverage to all Americans through a pool of private insurance plans” = THUPPPPPPPTTTTHHHH!!!!!!

    Private insurance is the reason healthcare cost so much in the first place. If this plan is enacted these insurers cannot do what they normally do, cut loose the expensive poor who are sick and can’t pay. Don’t get me wrong, more access to healthcare is a good thing. I just don’t understand how giving monies over and above the actual costs associated with health care to UHC and KP and Bill Frist’s family business is going to make it more affordable or improve the system.

    Maybe it is a first step. Go Ron Wyden! At least you are doing something. Make Bush veto this and then Dems can use it as a bludgeon in 2008.

  • There is indeed a problem with healthcare spending, the third-party payor effect. With no one in control over expenditures (the patient, the payor, the government payor), there are few restraints on cost control. Medical savings account supporters recognize this issue, but MSAs have little practicable ability to restrain healthcare spending and consumption. MSAs sound nice to puerile conservatives, but when closely examined, they serve mainly as one more tax-avoidance scheme and an effective cherry-picking device to sell high deductible insurance policies to people with low healthcare needs.

    I would rephrase Lance’s paradox a bit.

    Far to many Americans are willing to spend whatever money (from any source) on their healthcare than any, even a little, of their own.

  • It’s one thing to have health care available to all people, it’s another to have AFFORDABLE health care available to all people. I didn’t see so much of the latter as the former in the proposal as it’s outlined above.

  • call this “socialized medicine” = Republicans don’t want black people to have their health care paid for.

    ‘Nuff said.

  • At the crux of this debate is a very simple mathmatical premise: The larger the pool of people insured, the lower the cost of insurance for each of them. Expand the pool to everyone and the overall cost will be brought to its lowest point. That’s from A to B. Duh. It’s so obvious. And if you don’t agree with me, you haven’t thought about it long enough. Not to mention letting anyone go uninsured is a big fat SIN.

  • This plan _sounds_ great, but that’s the problem…I think it’s overly ambitious. Now, don’t get me wrong…setting lofty goals is sometimes the best way to at least get _something_ done.

    But there’s no such thing as a free lunch. The way I see it, the point of health insurance (or any insurance, for that matter) is that everyone pays a little bit, so that if you are one of the unlucky few who face a crisis, you aren’t crushed as a result. If we want to cover the people who can’t even pay a little bit, then the people who can pay, need to pay a little bit more.

    Bottom line: the best we can realistically hope for is to cover the “uninsurable” poor against catastrophic health issues. Anything more would involve such an inflated tax burden on the middle class that there would be a revolt. And when has the government EVER been able to correctly assess the cost of a big program like this? Expect to pay a lot more, and receive much poorer service.

  • OK, once again, what is the root of all evil in American politics…?

    Ignorance.

    And since the media is the only effective weapon we have against ignorance, we have to ask ourselves, will this plan (or any really decent plan) be properly explained to the ignorant masses, or will it be bludgeoned to death by Harry and Louise? (who appear to be normal people, but are actually corporations with billions of dollars posing as real people)

    The key to fixing this issue (and most of the others) is to put the media genie back in the bottle. Once Harry and Louise have to debate real people on an equal footing, we’ll get health care and lots of other things that the big corporations don’t like.

    Right now the media makes BILLIONS from the waste that is designed into our health care “system” and they’re not going to let go of that without a fight.

  • Bottom line: the best we can realistically hope for is to cover the “uninsurable” poor against catastrophic health issues. Anything more would involve such an inflated tax burden on the middle class that there would be a revolt. And when has the government EVER been able to correctly assess the cost of a big program like this? Expect to pay a lot more, and receive much poorer service.

    Medicare A, B (but probably not D) operates very efficiently with about 2% administrative costs. Private insurers run 12 to 15%. Even at their best, private plans have trouble falling much below 10%.

    And estimating healthcosts is not quite rocket science. In fact actuaries are good at estimating future costs. (I again exclude Part D because its costs were intentionally underestimated to grease passage.)

    This country lacks the political will to seriously address healthcare costs and coverages. The healthcare stakeholders know this and with the use of effective lobbying and disinformation campaigns, effectively oppose anything that challenges their respective interests.

  • “#11 Because they pay a lot more in taxes.” – Addison

    And we pay more for health care and get worse outcomes.

  • Ciro Rodriguez, the Dem who just won TX-23 in a runoff yesterday, has affordable healthcare and war on pharma at the top of his agenda. If there’s the slightest doubt that Congress will take this on, then we know how to coalesce and apply serious, serious pressure.

    #11: “Why do they have free health care in other countries and we don’t?”

    Because they have citizens who know how to add and who’ve found the taxes are not as punitive as corporate-driven healthcare costs. For starters, the ratio of administration costs to actual medical care given is much “healthier” than in the US.

  • Why do they have free health care coverage in other countries and we don’t?

    Because there a whole lot of African Americans out in New Orleans that a whole lot of Evangelicals out in the west feel deserve what they got.

    And the rest of the Republicans aren’t any better. They smile at you and shake your hand if you’re a conservative black person but what they’d really like is to not have to talk with or work with any of you and if they do talk to you they probably think you’re one of the good ones they can stand. They’d like to not have your children going to school with their children anymore and that’s what this is about.

    That’s why when Democrats try to get us free health care coverage like other civilized countries the Republicans talk a lot of smack about it and try to prevent it from happening. What they give us instead is a war that they say was to save people, but it didn’t end up saving people, because they didn’t really want us to go there for that and they didn’t run it that way. They didn’t have the troops secure arms they found, which ended up getting stolen, and they let the people riot in the streets after Saddam’s deposal. So they wanted to just show the world how the Iraqis would act? They really wanted this war so they could profit off of producing the oil and reconstructing the country and have a strategic base in the region. But was it really worth it? They don’t seem to have though about it as a ‘saving people’ thing at all and that’s why they literally didn’t make any plans for occupation. They just wanted a conquest for money and ambition.

  • Swan, I don’t think it is only black people who are not getting insurance and health care, it is a lot of people: the self employed, those with ‘pre-existing conditions”, the unemployed, the “working poor”, the ‘seasonal worker”( I have a son who has been working for the State of California for seven or eight years as a “seasonal worker” and still has to go on unemployment part of the year and has no insurance), the underemployed who have to work three part time jobs to eek out a living, and the illegal immigrants.”

    Those of us who have insurance (which is often not fully paid for by our employers,) find that if we get sick, our policy doesn’t cover much. Health care in the US is a bummer and it is expensive, and we will never solve it if we don’t take the private profit out of it. We need to get insurance companies out of health care and decide that as a civilization we are going to provide for each other.

    The preamble of our constitution says government should “promote the general welfare.” I believe that ensuring that all residents have adequate and proper health care, is part of that mandate. What happens to this country if we have an epidemic of TB and we have 50 million uninsured? Germs and viruses do not check for a blue cross card.

  • Hey – thanks for this post. I’m helping Senator Wyden with his netroots site on this – Stand Tall for America.

    Obviously, there are going to be a lot of questions. Anything this big is going to be pretty complex.

    I’d encourage everyone to actually head on over to the site and read about the plan.

    As you can imagine, there’s definitely a lot of misunderstanding already appearing on the net… not to mention the usual trolls bad-mouthing everything in sight.

    I’m going to dig in now to everyone’s comments and try and answer questions as best as I can — given that I’m a netroots organizer, not a health policy guy.

  • The racists think that black people can’t survive without help, but white people probably can if they’re worth anything.

  • Something had better be done FAST otherwise many of the people now in their 30’s, 40’s and 50’s before they reach old age will be seeking to relocate into another country whose healthcare system is HUMANE while still being able to put a roof over ones head and food in the stomach. In this country one either is best to be filthy rich or dead poor – anything in between those are screwed.

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