Healthcare has become the hot button issue of the day. Both sides of the political spectrum are crying out to be heard. The left is pointing to the 46.7 million Americans that are uninsured and the millions more who are underinsured and the right is expressing fears that the bill still has serious problems, provisions that would allow the government to mandate care, and no clear plan on how it will be paid for.
We believe in the importance of clear, public debate, especially around an issue that so obviously effects the entire population. As it stands, much of the discussion surrounding these issues has been mired in political grandstanding, stunts, simplifications and pandering to all of our basest hopes, fears and misgivings.
If we still believe in a system where people make choices based on understanding both sides of an issue, and policy decisions based on facts, we need to take some time to understand this situation and only then make up our minds about it.
This guide will provide you with some information about Healthcare, HR 3200, public sentiment around the bill and some thoughts on piecing it all together.
No matter what happens with Healthcare Reform, as the Baby Boomers grow older we will be spending more and more to continue to provide them with adequate Healthcare. As it stands, Medicare is not sustainable without serious restructuring.
As it stands, in the next three years Medicare and Medicaid will make up 50% of all national health spending, still 62% of all bankruptcies filed in 2007 were due to medical expenses that were not adequately covered. Small businesses are suffering as well, they will be paying out over $2.4 trillion in expenses health care expenses for their employees over the next ten years.
Despite the fact that it is extraordinarily clear the Healthcare needs reform it’s economically unsustainable, let’s not forget that there are many areas that we have been quite successful at maintaining high standards of care.
For common forms of Cancer, for instance, we have much higher survival rates than in European countries and Canada. We typically have “shorter lines” to see a specialist, we have greater access to high end medical equipment than many other countries in the developed world and a large portion of the innovations in Health care come out of the United States. Also, life insurance in your 80′s is much more available here compared to elsewhere in the world. This contributes to the longeivity experienced here.
To get a clearer view on how Health Care functions in the United States, Wikipedia offers a clear (albeit not concise) perspective.
Now that we have a slightly better understanding about Health Care itself, let’s look at the reform bill that has found its way into the news most often: HR 3200. Just what does this bill try to accomplish. Well, that depends on who you ask of course but if you are really interested I would suggest brewing yourself a cup of coffee and sitting down with the document.
What you should not do, however, is rely on sources like this one that have been floating around. Your political leanings notwithstanding, it should seem a little fishy to you how convenient a document like this is. Not only does it add a huge amount of fuel to the anti-reform fire but it does so without providing clear citations from the document that it “analyzed.” If you read the comments section on the post we linked to you’ll understand what we’re pointing out.
Since we don’t have the space or the hundreds of hours it would take to properly analyze every line of this document, instead we’ll touch on some key points.
Probably not. The party line is that the program will be paid for by removing inefficiencies from the current system. Much of the conversation has been, at best, theoretical. It is still unclear whether the bill can be paid for without significantly increasing the deficit. Though keep in mind that the increase would be a small fraction of the economic impact Health Care will have without reform.
President Obama has repeatedly said that a health care overhaul “will be paid for” and that he won’t sign a bill that isn’t deficit-neutral. But neither the House bill nor the Senate HELP Committee bill meets that criteria. According to the nonpartisan Congressional Budget Office and Joint Committee on Taxation, the House bill as introduced would add a net $239 billion over 10 years to the deficit, while the HELP Committee bill racks up more, $597 billion over 10 years.
No. This is an instance of selective quoting by Investor Business Daily. The bill will in no way outlaw private insurance. If you have insurance and you like it and your insurance provider continues to offer it you will be allowed to keep it.
Probably not. Obama promises mostly involve cutting the rate of growth of spending. As we saw in the statistics earlier, that is necessary in order for Health Care to remain solvent at all. If the growth of Health Care costs isn’t cut, the economy will not be able to sustain it in the long run. Achieving these kinds of savings would require a fundamental and politically unpopular shift in the way the Health Care is run in this country. The likelihood of that happening is slim to none.
CBO: [E]xperts generally agree that changes in government policy have the potential to significantly reduce health care spending—for the nation as a whole and for the federal government in particular—without harming people’s health. However, achieving large reductions in projected spending would require fundamental changes in the financing and delivery of health care.
As an example of the “fundamental” changes that might do the trick: CBO suggested moving away from the current system of paying doctors and hospitals for performing medical procedures and paying them instead a fixed fee per patient or some other payment based on “value.” Another CBO suggestion: “higher cost-sharing requirements.” So far we don’t see those ideas in the bills being considered.
No. From a 30,000 view that would be political suicide even if Medicare were running itself into the ground (which it is). Politicans don’t often commit Hari-Kari. More to the point, the bill proposes a series of savings and cuts but none of them are going to come from current or future medicare benefits. According to the AARP, “None of the health care reform proposals being considered by Congress would cut Medicare benefits or increase your out-of-pocket costs for Medicare services.”
The nonpartisan Congressional Budget Office has estimated that the House bill would result in “savings” of $219 billion after all increases and decreases are netted out. The House bill would trim projected increases in payments for hospitals, insurance companies, pharmaceutical companies and others, including home health care providers and suppliers of motor-driven wheelchairs. But it also proposes what CBO estimates is a $245 billion increase in spending for doctors, by canceling a scheduled 21 percent cut in physician payments. None of the “savings” or “cuts” (whichever you prefer) come from reducing current or future benefit levels for seniors.
No. This one comes straight from the bill itself,
H.R. 3200: Sec 246 — NO FEDERAL PAYMENT FOR UNDOCUMENTED ALIENS
Nothing in this subtitle shall allow Federal payments for affordability credits on behalf of individuals who are not lawfully present in the United States.
Certainly an argument can be made for what “lawfully present” means, but an argument can be made for just about anything if you choose to split hairs. This does not deny the fact that the bill states that undocumented aliens would not receive federal funds.
One of the biggest tangential arguments is that health adviser to President Obama, Dr. Ezekiel Emanual thinks that, “the elderly with dementia and the young who have neurological disorders should be sacrificed for the common good.”
This is another case of selective quoting by Betsy McCaughey (who also believes strongly in Death Panels). The truth is that Dr. Emanual wrote a paper 15 years ago discussing a philosophical and academic trend in how people think about organ transplants in a world where there is a limited supply. It had nothing to do with prescribing policy. Dr. Emanual has also gone on record as stating he in no way endorses anything remotely close to selective euthanasia.
McCaughey cites an article Emanuel wrote nearly 15 years ago in the Hastings Center Report, a journal devoted to discussion of ethical issues in medicine. There Emanuel discusses possible philosophical justifications to “distinguish basic from discretionary health care services.” Emanuel argued that thinkers on both the left and right were beginning to converge on a single answer when it comes to allocating medical resources. Here’s the quote in full context:
Emanuel, Hastings Center Report, 1996: Communitarians endorse civic republicanism and a growing number of liberals endorse some version of deliberative democracy. … This civic republican or deliberative democratic conception of the good provides both procedural and substantive insights for developing a just allocation of health care resources. … Substantively, it suggests services that promote the continuation of the polity – those that ensure healthy future generations, ensure development of practical reasoning skills, and ensure full and active participation by citizens in public deliberations – are to be socially guaranteed as basic. Conversely, services provided to individuals who are irreversibly prevented from being or becoming participating citizens are not basic and should not be guaranteed. An obvious example is not guaranteeing health services to patients with dementia. A less obvious example is guaranteeing neuropsychological services to ensure children with learning disabilities can read and learn to reason.
Emanuel conceded that the article is “pretty abstract” and may be difficult to follow for those who are not academics, but he said that one should not then “take two sentences out of context.”
“This is clearly not written in my own voice,” he said. “I am not advocating this.”
|The Daily Show With Jon Stewart||Mon – Thurs 11p / 10c|
|Exclusive – Betsy McCaughey Extended Interview Pt. 1|
We honestly had a hard time with this one because there is so much proof that Death Panels simply will not exist, and there doesn’t even seem to be a reason (based on fact and not politics) why this has spent so much time in the public consciousness.
This entire mess was started by Sarah Palin who coined the term on her Facebook page. She was afraid that government Health Care reform would mean rationed care for the elderly and her disabled child. She didn’t want the government deciding who was fit to live or die. All legitimate concerns based on her misinterpretation of the bill. This sentiment was wrapped in the term “death panels” and it took off from there,
Enter Betsy McCaughey, former Lt. Governor of New York and until recently member of the board of directors of the Cantel Medical Corporation. She claimed that the bill contained provisions for euthanasia of the elderly. In any reading of the sections cited (Section 1233 of H.R. 3200), what you will find is that it compensates people if they choose to have end-of-life counseling. If they then decide its a great idea to be maintained on life support for the next 100 years, they would still receive identical compensation.
The bill will neither requires nor endorse end-of-life counseling, all it does is modify Section 1861(s)2 of the Social Security Act to cover it. That is to say, nothing changes except that you can get reimbursed if you decide to go for counseling.
The public reaction to Health Care reform has been a mixed bag. Here are a few videos to give you some differing opinions on how we are reacting to reform.
Con: San Fransisco Protest of “Obamacare”
Pro: Does Obama Want To Kill Sarah Palin’s Baby?
Con: Is This the Right Kind of Change?
Pro: Guns At Townhall Meetings
Con: Obama On Health Care and Death Panels
Pro: A Touch of Satire
We’ve gone through a lot in this piece, so here is a brief summary of some of what we’ve learned.
Whether or not you will support or rebuke HR 3200 has a lot to do with your political leanings. That’s OK, to deny the fact that opinion is colored by politics would be a gross simplification for the human condition. What we wanted to present you with is information to help make your decision in a more informed, rational manner.
Understand that the job of media is as much to polarize as it is to inform. The reason that you typically agree with your news station of choice is because they “know you” and craft the news to fit neatly into your biases. The next time you hear something that seems a little off-the-wall, that doesn’t make sense, look into it. Trust that everyone has an agenda and that until you fully understand that agenda you can’t hope to make the sort of decisions that we pride ourselves on as a society.