A bioethicist and a health economist writing in the Washington Post sum up all the recent healthcare reform proposals in one word: band-aids. Elsewhere, we look at the top recipients of political contributions from insurance companies, Washington State picks a band-aid, Vermont picks a band-aid boss, and editorialists slam Bush’s proposal—while the American Medical Association smooches it.
Bioethicist Ezekiel Emanuel and Health Economist Victor Fuchs in today’s Washington Post urge our political leaders to think more freely about how to fix the healthcare problem. The problem with everyone’s plan—Romney, Edwards, Schwarzenegger and Bush:
They build on what everyone agrees is a broken system. Ultimately, they prop up the sagging employment-based insurance system, with all its inefficiencies and inequities, and preserve the second-class income-tested programs such as Medicaid.
Instead, they argue:
• Get businesses out of health care. Health care is not part of their core competencies but something they use as a part of labor relations. It creates job lock and distorts employers' hiring and firing decisions.
• Guarantee every American an essential benefits package. This package -- modeled on what members of Congress get -- should be provided by qualified plans that would receive a risk-adjusted payment for each enrollee. Americans could choose their health plans, with guaranteed enrollment and renewability; "cherry-picking" and "lemon-dropping" would be minimized.
• The universal basic package should be financed by a dedicated tax that everyone pays, such as a value-added tax.
This is a rough model for SinglePayer healthcare. And the arguments they make for it are based on a steely-eyed financial anslysis.
Reform based on these measures would eliminate job lock, increase workers' wages and make labor markets more efficient. It would also give Americans -- rather than their employers -- their choice of health plans, doctors and hospitals. And it would eliminate the $200 billion business tax deduction for providing health coverage.
I wish Washington Governor Christine Gregoire had read their article before making her recent health proposal. She didn’t even make it to the level of Schwrazenegger, Rendell and Romney. Instead, she proposes:
The package also proposes better use of technology, aiding businesses, finding ways to drive down costs, and expanding the state-subsidized health plan for the working poor…. coverage for unmarried young adults under 25, insurance plans that workers can carry from job to job, pooling of public and private markets to drive down premiums by negotiating en masse with insurers, reducing emergency room visits, and better management of chronic patients.
In this she displays a lack of imagination, courage, and leadership.
Or, perhaps, the head of the Wisconsin Council of Churches is more succinct in his criticism of bad health plans like this one:
But a more realistic interpretation of these plans' failure to move forward is a shortage of political will to overcome the resistance of entrenched interests that benefit from the current system.
Speaking of entrenched health care interests, I went to OpenSecrets.org to see who the top 5 recipients of political donations from insurance industries in 2006 were. Here’s the list:
1 Santorum, Rick (R-PA) Senate $454,706
2 Clinton, Hillary (D-NY) Senate $367,830
3 Lieberman, Joe (I-CT) Senate $357,544
4 McGavick, Michael (R-WA) Senate $352,897
5 DeWine, Mike (R-OH) Senate $330,486
Interestingly, three of them lost (Santorum, McGavick, DeWine), one lost his primary (Lieberman), and that leaves Hillary Clinton. She has a long history with the insurance industry, which will make her upcoming health care announcements even more interesting.
From the too-depressing-for-words category, Vermont has tapped the CEO of a healthcare corporation] to head their health board (although he says a SinglePayer healthcare system is on the table) and the American Medical Association sends a letter to the Wall St. Journal cheerleading George Bush’s recently-announced health proposal. It should be noted that AMA has stood in the way of many, many health reform plans over the years.