US Health Crisis » Obama

Where’s Health Care Reform Now?

francine — Tue, 26 Jan 2010 19:12:51 +0000

Looks like the Massachusetts election sent everybody scurrying for cover. Congressional Democrats and Republicans are retiring in droves, lest they lose an election and forego those pension benefits. Try to imagine how I feel about that cowardly behavior. First, Congress sabotages true reform, and then it heads for the hills.

The only one speaking out even a little is President Obama, who told Diane Sawyer that he’d rather be a one-term president who did the right thing than a two-term president who did nothing (exact words are mine, not his). However, today he said something about a “discretionary spending freeze” to attack the budget deficit, and that also means he has turned from wanting to be transformational to resigning himself to the usual battle about what’s discretionary, what’s necessary, and what’s pork. All of these, of course, are in the eye of the beholder.

And what of health care reform now? As evidenced by the performance of health care stocks, no one knows. As near as I can tell, Nancy Pelosi, who might have been the root cause of all our problems because she represents a very progressive district that doesn’t reflect the country, is wildly looking around for eighteen votes so she can pass the Senate bill and we will have something rather than nothing.

Go back to sleep. Nothing will happen today. Pre-existing conditions may end up being outlawed only for people under the age of nineteen. That will be hard to swallow. Formerly big issues like the right of a poor woman to an abortion (rather than being forced to have a child she can’t afford and will probably not be able to support in any sense of the word) have completely vanished. And the public option? Out the window, or under the bus, or both.

Ugh. We are not going to have real reform even though it is an economic necessity.

And the quality of our care isn’t even being addressed, even though my son-in-law’s dad had a stent put in last week and he got a hematoma from a supposedly routine procedure that was supposed to be performed by a surgeon and was instead performed by a resident. There are countless anecdotal data points about what happens in American hospitals, even though people in Haiti can be operated on in the open air with pen knives and still recover. The operative word isn’t money. It’s care. The doctors in Haiti are there because they care. In America, does anyone in health care still know why they are there?

How Can You Ignore Something that’s 18% of Our GDP?

francine — Tue, 19 Jan 2010 20:46:08 +0000

The pundit are saying the election today is a referendum on Obama’s health care reform plan. Massachusetts voters, they say, don’t care about health care reform. That’s too easy.

People in Massachusetts already have universal health care. If they vote down Ted Kennedy’s legacy, it will be for many other reasons: either they don’t care about anyone else in the nation getting insurance, or because it isn’t working and is breaking their state. Or maybe they think the big issue is elsewhere — the banks, the economy, or Afghanistan, and Washington is misguided. Or they have ceased to believe in government at all. Or it’s snowing, and it’s a pain in the ass to go vote. Any of those could be true.

I’m no expert in Massachusetts politics, but I worry about the outcome of today’s Senate election for an entirely different reason. I’ve become an expert in the law of unintended consequences. You get that way if you live long enough.

The pundits are calling the election over on Morning Joe. TV programs like that have a way of setting the agenda, so it probably is, indeed, over. The “fix” is in. The health care lobbyists have done their work.

Now what, though? Health care is 18% of our GDP and growing. How do we fix the economy, or create jobs, without doings SOMETHING to control health care costs. Here are some interesting, if probably unpopular, alternatives that could emerge:

1)Cut Medicaid and Medicare sharply. Let the poor and the elderly fend for themselves. The poor don’t vote anyway, and the elderly will soon die.

2)Allow the re-importation of drugs, which wasn’t part of the original bill. Let people get their drugs in Canada and Mexico. This will create that NAFTA Bill Clinton wanted anyway.

3)Put all the jobless to work in the healthcare industry; if we’re going to spend so much of our tax money on health care, let’s create “white coat” jobs rather than green job.

4)Cut the military budget, and use the money for health care.

5) Do nothing, and let the country rot.

6) Raise taxes

You see where I’m going with this. There are no good alternatives. Something must happen.

File this away somewhere and haul it out in four years: my prediction is that the Republicans will sweep into power in 2010 and 2012, running on the change Obama just ran on. They will then, Obama having prepared the public for it, enact some sort of health care reform and get the credit for it.

Things are changing. Republicans aren’t rich anymore. They are the middle class. Democrates are limousine liberal elites. This would be hilarious if I didn’t pay taxes for it.

(cross-posted from my posterous.)

If you doubt President Obama’s commitment to health care reform…

Karoli — Wed, 08 Apr 2009 21:11:14 +0000

Don’t. He is fully committed to it, and put some muscle into the words today with an executive order establishing the White House Office of Health Reform. Here’s some of the text:

Policy. Reforming the health care system is a key goal of my Administration. The health care system suffers from serious and pervasive problems; access to health care is constrained by high and rising costs; and the quality of care is not consistent and must be improved, in order to improve the health of our citizens and our economic security.

Beyond the fact of the establishment of this office, the most encouraging part of this policy statement is the acknowledgement that health care reform is not just a health issue, but also an economic issue.

President Obama Signs SCHIP Bill

Karoli — Thu, 05 Feb 2009 00:45:19 +0000

…and shoots across the bow of obstructionists in Congress. Expanded SCHIP benefits were widely supported on a bipartisan basis and sailed to President Obama’s desk where he signed it into law with a flourish and a warning.

The flourish:

This is not who we are. We are not a nation that leaves struggling families to fend for themselves. No child in America should be receiving her primary care in the emergency room in the middle of the night. No child should be falling behind at school because he can’t hear the teacher or see the blackboard. I refuse to accept that millions of our kids fail to reach their full potential because we fail to meet their basic needs. In a decent society, there are certain obligations that are not subject to tradeoffs or negotiation – health care for our children is one of those obligations.

The Warning

President Obama made it clear that he views his Economic Recovery and Reinvestment Plan as a key first step toward comprehensive health care reform.

Think about this – if Congress passes this recovery plan, in just one month, we’ll have done more to modernize our health care system than we’ve done in the past decade.

We’ll be on our way to computerizing all of America’s medical records, which won’t just eliminate inefficiencies, save billions of dollars and create tens of thousands of jobs – but will save lives by reducing deadly medical errors. We’ll have made the single largest investment in prevention and wellness in history – tackling problems like smoking and obesity, and helping people live longer, healthier lives. And we’ll have extended health insurance for the unemployed, so that workers who lose their jobs don’t lose their health care too.

He also made it clear that he was committed to getting this work done, and that he was not going to tolerate politics as usual with regard to Americans’ futures:

Now, in the past few days I’ve heard criticisms of this plan that echo the very same failed theories that helped lead us into this crisis – the notion that tax cuts alone will solve all our problems; that we can address this enormous crisis with half-steps and piecemeal measures; that we can ignore fundamental challenges like the high cost of health care and still expect our economy and our country to thrive.

I reject these theories, and so did the American people when they went to the polls in November and voted resoundingly for change. So I urge members of Congress to act without delay. No plan is perfect, and we should work to make it stronger. But let’s not make the perfect the enemy of the essential. Let’s show people all over our country who are looking for leadership in this difficult time that we are equal to the task. Let’s give America’s families the support they need to weather this crisis.

Bankruptcy Relief May Be On the Horizon

Karoli — Wed, 07 Jan 2009 19:27:14 +0000

From the WSJ Health Blog:

A bullet point within his economic agenda says:

Obama and Biden will create an exemption in bankruptcy
law for individuals who can prove they filed for bankruptcy because of
medical expenses. This exemption will create a process that forgives
the debt and lets the individuals get back on their feet.

This is great news for those who are facing bankruptcy or have already declared bankruptcy because they simply couldn’t pay the bills.

What isn’t clear is how debt forgiveness will work. Right now, declaring bankruptcy does not release individuals from the obligation to pay the bills. Discharging debt will leave hospitals and providers with a need to write off assets, which will certainly cause a tilt on their balance sheets.

Still, it’s a step in the right direction, no question.