Posts Tagged ‘single-payer system’
Health Care News
One common assertion among the left is that other industrialized nations, such as Canada, achieved great success in health care within their collectivist framework. This, then, begs the question: why is the head of an east coast Canadian province coming to the United States for medical treatment?
Newfoundland Premier Danny Williams is seeking heart surgery in the United States, drawing criticism from “local bloggers and people calling in to the province’s immensely popular open-line radio shows.” Yet his actions are hardly unusual for world leaders. Saudi Arabian King Abdullah bin Abdulaziz is known to have his checkups at the prestigious Mayo Clinic in Rochester, Minn. Italian Prime Minister Silvio Berlusconi had heart surgery at the Cleveland Clinic in 2006 . Even middle-class Canadians are utilizing their proximity to the United States to seek treatment here.
Health Care News
The United States health care system is not nearly as free market and consumer driven as it should be. And while government continues to slowly takeover our health care system, and Obamacare would fast-forward that development, the U.S. system is still more free than the Canadian “single-payer” system. And how is government run health care working for Canada? This past summer the Vancouver Coastal Health Authority considered cutting more than 6,000 surgeries to make up for a $200 million budget shortfall. British Columbia Medical Association president Dr. Brian Brodie called the proposed surgical cuts “a nightmare.” Access problems are not new to Canadian’s single payer system. Since 2003, Timely Medical Alternatives Inc. has helped Canadians “leave the queue” and get timely health care in the United States. Now The Globe and Mail reports: (more…)
The latest Senate leadership health care compromise is a “Bumper Sticker.” There are no details yet, but the Bumper Sticker tells us enough about where this compromise is heading: a massive concentration of political control over the health care system.
While the Senate leadership has decided to turn the outlines of their latest “breakthrough”- perhaps even the legislative text- to the Congressional Budget Office for a cost estimate, we know something about what they have in mind. The broad outlines tell taxpayers a great detail about where the congressional liberals are going with this scheme. Curiously, with the right tweaks, it could do something quite unusual: end up concentrating control over the nation’s health insurance markets, literally, in the West Wing of the White House.
Here’s how. Part One of this scheme would empower the United States Office of Personnel Management (OPM), the federal agency that runs the federal civil service, to enter into a contract with two large health insurers (probably the Blues and Kaiser) to sell health plans in the state- based health insurance exchanges set up in every state of the Union, under the Senate bill. According to the press reports, these giants will be “non-profits,” reflecting the Left’s ideological hostility to profit-making insurance, regardless of its performance or patient satisfaction. That probably means that the Blues or Kaiser will have the inside track on any contract and stipend from the government.
These two giants would then compete against private health plans everywhere in the country. Now the key issue is how the OPM will administer this process. (Precious details, details, details.) Presumably, OPM will determine the health benefits, medical treatments and procedures to be offered on the national scale – the federal government would set benefits in any case, whether the exact determination will be made by OPM or the Secretary of Health and Human Services. So, these two giant “private plans” will administer the federal government’s benefits package. Be sure of that. Even more important is how the OPM will set premiums. This again, is a crucial piece of the puzzle. Will the premiums simply reflect free market rates, or would the premiums reflect the White House’s policy agenda. Why the White House? Simple. The Director of OPM reports to one person: The President of the United States.
Free markets are not in vogue on Capitol Hill right now, and surely not in the West Wing. It’s a good guess that the premiums will reflect some form of administered pricing scheme, enabling OPM to secure below-market rates for its contractors and drive private sector competitors out of the markets, consolidating federal control over the insurance markets in the same way that a “robust” public option was designed to do at the beginning of this process. Same end, different means.
There is a third consideration. The health plans are to be “non-profits” and serve a public agenda, as defined by the Senate liberal leadership. But will these non-profits also be “non-loss” plans? Will they be eligible for federal bailouts if they lose money? Good question. It’s hard to imagine that the congressional liberals would allow their latest scheme of “non-profit” health plans to fail. When this is finally unveiled in the light of day, read that fine print closely. They hope you won’t do that. So annoy them.
A government sponsored oligopoly is not anything like real competition – real competition is open markets and a level playing field, anybody can play – and the so-called private plans are “private” in name only, and they are simply hired guns to serve as the vehicles of Washington’s political agenda.
Part II of the compromise consists of an expansion of Medicare (including people as young as 55). And it’s big entitlement expansion. (That’s how the Congressional liberals now define “reform.”) Not surprisingly, Rep Anthony Weiner (D-NY) has applauded this part of the compromise as a big step toward the single payer option, and told the Los Angeles Times: “Expanding Medicare is an unvarnished, complete victory for people like me. It’s the mother of all public options.” Not to be outdone, the editors of The Washington Post said this morning: “ The irony of this late breaking Medicare proposal is that it could be a bigger step toward a single payer system than the milquetoast public option plans rejected by Senate moderates as too disruptive of the private market.”
The prescription: Massive erosion of private coverage from “crowd-out,” as employers with a large number of older employees have new incentive to dump them; higher Medicare costs, and even more debt, as millions more are added to the Medicare program, which already has a long-term debt of $38 trillion. Of course, Medicare expansion means more people covered under Medicare rates and artificially lower rates for doctors and hospitals. Even the K street crowd, desperate to be in with Capitol Hill’s current “In Crowd,” and so eager to get a pat on the head and that coveted “Seat at the Table,” is having second thoughts about this latest compromise. The AMA, which is obsessed about Medicare payment above all else, doesn’t like it. The American Hospital Association and the Federation of American Hospitals have urged their members to oppose the bill, as it would cut reimbursement rates to hospitals, which are already heavily burdened.
Already, the Senate bill provides for an expansion of Medicaid, a welfare program, up the income scales. Together, entitlement expansions can be expected to accelerate the erosion of the private health insurance coverage for millions of Americans. There is no reform here. Few politicians stop to look at the poor quality of care provided under Medicaid; fewer doctors take Medicaid patients, which is why so many Medicaid patients crowd into the emergency rooms. The politicians on the Hill with their Medicaid expansion will guarantee even more hospital emergency room over-crowding.
So much for the Big Compromise – Senator Harry Reid’s latest Breakthrough Moment. The end is pretty much the same: More government dependency, more poor quality care, combined with a staggering deficit. There is one thing that one could say may be new – depending how the Senators write the crucial details – more power to the President, who can guide and direct the shape of the health insurance markets through his Director of the Office of Personnel Management. That, at least, is a fresh approach to government control.
Audrey Jones co-authored this post.
Today’s Washington Post editorial page takes a critical look at Majority Leader Harry Reid’s (D-NV) latest “compromise” health care bill, which it describes as 11th-hour “legislative sausage” that was “made on the fly” and includes ideas dating “at least to the Clinton administration.”
Most significantly, though, the Washington Post sees Sen. Reid’s bill as a “dramatic step” toward a single-payer health care system, even if the public option is not on the table:
“[T]he last-minute introduction of this idea within the broader context of health reform raises numerous questions — not least of which is whether this proposal is a far more dramatic step toward a single-payer system than lawmakers on either side realize.”
In a nutshell, Sen. Reid’s latest compromise allows uninsured individuals over 55 to buy into Medicare. As we wrote on The Foundry today, that policy brings with it numerous problems, the core of which are higher costs to taxpayers, squeezing individuals out of their private coverage (including retiree coverage from a former employer), and adding costs to an already-unsustainable Medicare system.
Why would costs skyrocket? As The Washington Post notes, sicker seniors “might flock to Medicare,” thinking that the government will be more likely to approve their treatments, which “would raise premium costs and, correspondingly, the pressure to dip into federal funds for extra help.” In other words, sicker seniors would move into the public pool, costs would go up, and so too would taxpayers’ bills.
There are more questions than answers, as The Washington Post points out, regarding reduced reimbursements to health care providers and further expansions of Medicare:
“Presumably, the expanded Medicare program would pay Medicare rates to providers, raising the question of the spillover effects on a health-care system already stressed by a dramatic expansion of Medicaid. Will providers cut costs — or will they shift them to private insurers, driving up premiums? Will they stop taking Medicare patients or go to Congress demanding higher rates? Once 55-year-olds are in, they are not likely to be kicked out, and the pressure will be on to expand the program to make more people eligible.”
“The irony of this late-breaking Medicare proposal is that it could be a bigger step toward a single-payer system than the milquetoast public option plans rejected by Senate moderates as too disruptive of the private market.”
This marks not the end of the public option, but the beginning of single-payer health care.
If you are one of the few Americans who still subscribes, your morning newspaper probably has a headline like this: Democrats Reach Deal on Health Plan. Don’t believe it. Majority Leader Harry Reid (D-NV) is still light years away from producing the 60 votes necessary to pass Obamacare out of the Senate. And the few details that have leaked out about this new “broad agreement” only reveal just how desperate Reid is to get any bill on to President Obama’s desk by the New Year.
Of course, there is no good policy reason why the Senate should be rushing the reorganization of one-sixth of our nation’s economy through their chamber. As leftist columnist E.J. Dionne has frankly admitted, the December deadline is a purely political invention, created for the sole purpose of enabling President Barack Obama to point to at least one accomplishment during his State of the Union speech in January. Details of the agreement have not been made public, and Senate Democrats are refusing to make them public until they hear back from the Congressional Budget Office (CBO). But judging from what little has been selectively leaked to the public, this idea deserves to die:
Doubling Down on Debt: Medicare is already bankrupting our country. In 2007 alone, Medicare was forced to draw $179 billion from the general revenues of the U.S. Treasury. According to the latest Medicare trustees report, the program already faces $36 trillion dollar long-term budget shortfall. Medicare’s annual drain on our resources is set to skyrocket in 2011 when the first wave of baby boomers retire. The new Senate deal would only make this problem worse by expanding Medicare eligibility to people without insurance between the ages of 55 and 64.
Death Sentence for Hospitals: The Reid Health Bill already delivers a huge blow to our nation’s hospitals by cutting Medicare reimbursements to hospitals by hundreds of billions of dollars. Moving millions of more Americans to Medicare would cut into hospital revenues even further. That is why both the American Hospital Association and the Federation of American Hospitals sent alerts yesterday urging their members to oppose the new Senate deal.
A Government Run Health Care Coup: You might think that leftists who have been dreaming about single payer, government run health care for years would be upset about the new Senate deal. They are not. The existing Medicaid expansions in the bill, and the new Senate deal Medicare expansions, are just a continuation of the left’s health care agenda since the defeat of Hillarycare: Slowly expand existing government programs so that all private health care is strangled out of existence. So instead of fighting to preserve the public option, leftist activist Chris Bowers urges readers to fight “to expand the Medicare buy-in to all Americans between the age of 55 and 64 (inclusive).” Progressive health care guru Ezra Klein says the new deal is better than the public option because “it seed[s] health-care reform with scalable experiments.”
When President Barack Obama gave one of his first national health care addresses in June, he instructed Congress: “As we move forward on health care reform, it is not sufficient for us simply to add more people to Medicare or Medicaid.” But after months of debate in Congress, that is all Obamacare has turned out to be.
Different versions of a “public plan” for health insurance have been proposed. In “Why a New Public Plan Will Not Improve American Health Care,” Walton J. Francis dissects the most prominent proposals and explains the pitfalls in each.
Two especially troubling elements of many proposals are government price controls—which are payment rates set by law rather than emerging from a competitive market—and mandatory provider participation requirements—which demand that doctors accept patients with public plan coverage. If a public plan included these regulations, it would not be on a level playing field with private plans.
A public plan proposal by Dr. Jacob Hacker of the University of California-Berkley includes these two elements, calling for “expanding a benefit-enriched variant of Original Medicare to Americans of all ages.” A similar plan from Dr. Karen Davis and colleagues of The Commonwealth Fund also preserves “government-dictated payment rates.”
Dr. John Holahan and Dr. Linda Blumberg of the Urban Institute have designed a public plan while remaining vague on whether it includes price controls and mandatory provider participation. However, “implicit in [Holahan and Blumberg’s] proposal is that the core requirements for a public plan are the ability of the government to compel provider participation and to dictate the prices of medical goods and services provided.”
Although these three plans are put forth with the goals of boosting choice and competition, they would actually undermine these important values. They would “displace most private sector health plan enrollment,” and their enactment would lead America towards a “single-payer system with private plans tolerated as second-rate alternatives.”
Arguments that these plans could contain costs or boost quality by modeling themselves on Medicare overlook the fraud and lack of managed care in traditional Medicare and the quality deficiencies in an existing public health insurance program— Medicaid.
Francis concluded, “No governmental entity in the United States actually administers a true health insurance plan,” so there is little preparation for this type of program. Finally, “Congress will not let the public plan fail,” so “competition and choice” in health care markets would become a memory.
Health Care News
President Obama’s comments at a townhall meeting yesterday about not supporting a single-payer system are drawing fire from all sides of the ideological spectrum. President Obama said, “I have not said that I was a single-payer supporter.”
The Foundry’s Conn Carroll notes:
“This is directly contradicted by candidate Barack Obama’s own websitewhich quotes Obama at a rally in Ames, Iowa form 2008: ‘If I were designing a system from scratch I would probably set up a single-payer system. … So what I believe is we should set up a series of choices….Over time it may be that we end up transitioning to such a system.’ So there you have in one paragraph the true purpose of Obama’s public option: a vehicle to slowly transition all Americans out of private coverage and into a government-run single payer health care system. This Trojan Horse view of the public option has been reaffirmed by Reps. Barney Frank (D-MA), Jan Schakowsky (D-IL), Washington Post blogger Ezra Klein, and New York Times columnist Paul Krugman.”
Meanwhile, David Sirota with the liberal blog Open Left had this to say of Obama’s claim in Portsmouth, New Hampshire yesterday:
“Obama has never really offered up an explanation for his about face on single payer, other than implying that it’s not politically realistic now – even though, again, back in 2003, he said it would be politically realistic when Democrats obtained the presidency and Congress.
Let me repeat: I’m really supportive of Obama’s health care efforts right now. But I’ll never – ever – be supportive of any president lying and/or not at least explaining their broken promises.”
Health Care News
CBS Evening News’ recent report on British patient Mary Brewis, who is currently battling colon cancer, shines the light on the dangers of a nationalized, single-payer health care system: Bureaucrats can deny patients access to experimental, but life-saving drugs by refusing to pay for them.
The article notes Britain’s National Health System refused to pay for an experimental drug for Brewis when she found out her cancer had spread to her lungs. Brewis, who lost two appeals so far, paid nearly $2,000 a week for the drug to shrink her tumors and a private nurse.
She told CBS Evening News, “I just feel I have a right to live as long as I can possibly live. Everybody does. Nobody should be allowed to say that somebody has lived long enough and they can’t live any longer.”
Health Care News
Bloomberg details today the frustration and confusion some Obama health care activists are feeling in trying to promote the president’s health care agenda. One problem is in-fighting among people who want a single-payer system. Another problem cited by an activist is “turning out the vote is far simpler than influencing legislation to remake an industry that accounts for 17 percent of the economy,” the article says.
Health Care News
“What are not legitimate concerns are those being put forward claiming a public option is somehow a Trojan horse for a single-payer system. I’ll be honest. There are countries where a single-payer system may be working. But I believe — and I’ve even taken some flak from members of my own party for this belief — that it is important for us to build on our traditions here in the United States. So, when you hear the naysayers claim that I’m trying to bring about government-run health care, know this — they are not telling the truth.” — excerpts from speech to American Medical Association conference in Chicago (June 15, 2009)
- April 2013
- March 2013
- February 2013
- January 2013
- December 2012
- November 2012
- October 2012
- September 2012
- August 2012
- July 2012
- June 2012
- May 2012
- April 2012
- March 2012
- February 2012
- January 2012
- December 2011
- November 2011
- October 2011
- September 2011
- August 2011
- July 2011
- June 2011
- May 2011
- April 2011
- March 2011
- February 2011
- January 2011
- December 2010
- November 2010
- October 2010
- September 2010
- August 2010
- July 2010
- June 2010
- May 2010
- April 2010
- March 2010
- February 2010
- January 2010
- December 2009
- November 2009
- October 2009
- September 2009
- August 2009
- July 2009
- June 2009
- May 2009