Is There Anything In This Health Reform That?

5 Responses to Is There Anything In This Health Reform That?

1. Chillax Mayng says:

   October 20, 2009 at 11:07 am

   Thirty years ago, one of us questioned the retiring CEO of one of the largest drug companies what was the worst mistake he had made as CEO. Without faltering he said, “Opposing Medicare. We were so ideologically hostile to a huge new government curriculum that we lost sight of our own self-interest. All the foremost drug companies except Syntex different it. Luckily we lost. We have made billions of dollars because of Medicare.”
   The Colorless House “summit” on shape care reform was a nice start but as the as the reform debate unfolds, broadcast and congressional opinion and the positions of the powerful interests involved – pharmaceuticals, insurers, device manufacturers, physicians, large and small employers, and technology companies – will be swayed by their ideology, perceptions of self-interest and the rhetoric used in the debate.
   At one level, there is a broad consensus in America that we need to reform healthcare to expand coverage, improve quality, and make healthcare affordable. Broadcast opinion polls show broad agreement and large majorities in favor of fundamental change. Even amongst specific stakeholder groups, from employers to hospitals and doctors, there seems to be widespread agreement that healthcare needs to change. But, the combination of a deep ideological divide, self-interests that are mutually exclusive, and rhetoric that is capable of turning broadcast opinion against change may end up making an environment of inaction.
   The ideological debate is about the roles of government and the market. Most Conservatives, Republicans and business leaders strongly oppose new government programs (especially if they involve substantial tax increases) and believe the market is the solution. Many believe the individual insurance market, tax incentives (read targeted tax cuts), higher out-of-pocket costs (“skin in the game”) and competition can fix the system. Most Liberals and Independents believe that only government can ensure that the healthy majority pays most of the cost of caring for the unhealthy underground and that markets cannot do this. The left despises for-profit shape care. The right despises huge government programs and mandates. A poll by Harris Interactive and the Harvard Teach of Broadcast Shape shows that two thirds of Republicans reckon we have the best healthcare system in the world but only one-third of Democrats do.
   And what about self-interest? Doctors and hospitals don’t want Medicare cuts or huge, powerful insurers. Pharmaceutical companies don’t want the government to negotiate their prices or to allow drug import. Doctors, hospitals and medical device companies would all benefit from a huge extension of coverage – if the prices are right. Small employers despise mandates to provide shape coverage to their workers. Unions despise mandates that individuals have to buy shape insurance. Large employers despise paying excess shape insurance premiums because of the “under-payment” to providers by government programs. And so on. Policy is usually made by the sum of the self-interests, weighted by the political clout of each interest: who has the power and what do they want?
   Each powerful stakeholder in healthcare has a “line in the sand” issue that they will not give on. The problem is that in a $2 trillion healthcare system there are many powerful stakeholders, there are very clear “lines in the sand”, and many of these self-interests are in conflict or are mutually exclusive.
   One of the lessons from the demise of the Clintons’ proposals in 1994 is that rhetoric matters. If people reckon reform means expanded coverage, better cost-containment, more value for cash and increased personal security in the future, they support it. If they believe reform means higher taxes, higher out-of-pocket costs, less scale, reduced quality, fewer jobs and rationing, they oppose it. Words and slogans have been misused and abused in shape care policy for many years. Most shape maintenance organizations (HMOs) focused on cost containment, not maintaining shape. Managed care firms, it appeared, “didn’t manage and didn’t care.” “Personal responsibility” and “empowerment” really meant “patients pay more.” “Consumer-driven shape care” was driven by insurers, employers and consultants and never by consumers. A “preferred provider” was anyone with a colorless coat, a stethoscope and a pulse. Nearly any curriculum to expand coverage was attacked as “socialized medicine” even when
   the insurance and the care would be provided by the private sector.
   Policies that would constrain costs were either “rationing” or would reduce “quality” or “scale.
   Ideology, self-interest, and rhetoric will shape the shape reform debate. A sneak preview of this process was embedded in the contemporary stimulus package. $1.1 billion was added for comparative effectiveness research. Many policy wonks agree that we need better information on what works and what doesn’t in shape care, but disagree on the details of
2. Native American Guy says:

   October 20, 2009 at 11:10 am

   Both House and Council versions really eliminate that pre existing conditions can disqualify you. Neither the broadcast option, or private option can no longer disqualify or payment higher rates for pre existing conditions of any type. If that’s what you were wondering.
3. gosam777 says:

   October 20, 2009 at 11:19 am

   Probably nothing. If you are thinking the government is going to place your loved one in some nice care facility, reckon again. Get in your car today and go to any VA Hospital. Look around. That is the future of Obama care. Horrible.
4. kisses&l says:

   October 20, 2009 at 11:50 am

   most likely 6 months to a year on foremost treatment
   just like in canada
5. Michelle M says:

   October 20, 2009 at 12:03 pm

   sedation therapy
   Really. In the plot, older people and those with life threatening diseases will be the last to get care.