A question to an Obamacare critic


Here’s a good review of the impact of the 2010 healthcare law. I don’t think its going to be a be all end all for American healthcare at all. I’m skeptical of the claims of singe-payer as well. But in its passage, I hope that a national discussion that will last year will produce improvement over the status quo.

The most disappointing thing about the discussion isn’t I don’t see many really comprehensive alternative to the 2010 bill that address the failings of the status quo, and yet the failings of the status quo seem evident. Check out this graphic:

image

The high cost of health care would be easier to understand if we clearly had the best access and the best health results.  Overall we do well in treatment of some conditions, but we don’t have even close to the best life expectancy in world, and many people lack insurance if not access to healthcare.

image

Setting all that aside, I visited a blog of a severe critic of “Obamacare”, the term of choice of the law’s critics.  He has a pretty good chronicle of the numerous criticism of the law:  how it was railroaded into law, will ration care, cost to much (I think this emphasized the most), will redistribute wealth, end the development of new treatments, and provide care for conditions that people may have brought on themselves.  But in all that criticism, I didn’t really get a feel for any good alternative, especially one that would improve access to care for those who don’t have it.  I put this question to the blog author.  I’m curious to see what answer I get.

Question

Doesn’t this really boil down to:

Do you think the current health system is in need of a major changes?

Are you in favor of increased access to healthcare for those who don’t have it , even at the cost of higher premiums and taxes for yourself?

You pretty clearly would answer no to these questions.

I think I’d answer yes to both questions (for what its worth I have pretty good medical benefits and I pay taxes). I’m not sure the ACA is what we need, because we need a better way to control costs. I just don’t want to end up like we did after the 1993 health debate which was with basically the status quo. You and most of your citations clearly argue for no “Obamacare” to mostly people who don’t like Barack Obama for a variety of reasons, but I don’t know what you suggest instead.

Can you clarify?

There may be no way to reach anything close to a consensus, because those on different sides of the health debate basically want a different end state as the good society.   They make different value judgments.

I’d like to move even if more slowly may than the current law to better access to health care for those who don’t have it, even if some of them are drug addicts, or illegal aliens, or arguably don’t “deserve” it.  I don’t think healthcare is a beach house as Rush Limbaugh recently asserted

The strongest critics of “Obamacare” seem to see health care as just another good you get if you work hard and earn it.  This a value judgment that can’t be shown to be wrong or right with facts, but it bothers me that this is usually not explicitly stated.  Its hard however to not draw this conclusion from the lack of policy suggestions that address the access issue for those of modest means.

Ultimately we as a society will make its value judgment about who should get access to healthcare.  I hope we try to improve on the status quo and not treat health care as a beach house.  Unless conservatives can actually suggest a way to improve health care access, one has to assume they think of health care as a beach house.

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8 responses to “A question to an Obamacare critic

  1. I’ll be curious to see what response you get. But meanwhile, one of the things I find annoying in this debate is this: the failings of the private insurance system are many but are rarely spoken of. Rationed care? They do that. Denial of care? Of course they do that. OVercharge? All the time. Prices going up every year by as much as 30% – my last employer, like many, had to devote days and sometimes weeks every year to repricing health care for the company. It was nuts.

  2. It is very interesting that the top three most expensive healthcare countries (the United States, Germany, and Switzerland) are also the ones that likely have the most vibrant and innovative biotech and medical equipment industries.

    My worry is that because other countries subsidize healthcare, they are in a sense getting a free ride from the medical innovation of these three countries, while Americans, at least, are bearing the cost.

    If Amgen, for instance, cannot charge a fair market price for its drug in Canada, then it will have to offset its price upward in the United States accordingly.

    I know it is not this simple, but seeing those three countries at the top of the list sparked my curiosity.

    • A big difference though Sean, is that in Germany and Switzerland, everyone is covered by insurance. So it’s universal.

      I dont know about Germany, but I think in Switzerland they require private insurance companies who want to see health insurance to those divisions as non profits and cover everyone. The gov’t set up the plan, which seems to be working well. The insuracne companies still run their other product lines as for profit businesses. Or something like that.

      But again, the critical diff between them and us is they cover everyone and we don’t.

      • Moe,

        I was just pointing it out. I am the last person one would expect to be an expert on healthcare. All I know is that it consumes a huge amount of the federal budget and its costs need to be reined in. Confronting the problem now is important. I am just naturally suspicous of any government solutions. And I just don’t think the healthcare bill focused on reducing cost. It focused more on insuring the uninsured. A noble cause, but something that will likely raise costs in the long-run, which defeats what I think was the whole reason for having a healthcare debate. Massachussetts is learning this painful lesson now.

        I spent 5 years in the military’s tricare system and it wasn’t the greatest medical care. For instance, Army witch doctors wanted to cut into my wife’s 23-old breast because they said she might have breast cancer. We said “no” and spent money out of pocket to have a private consultation. The doctor rolled his eyes and said she was fine.

        I know the government wouldn’t necessarily be involved in actually providing the healthcare, but in reining in insurance. Still, any government solution just makes me nervous, especially given my personal experience.

        I think the U.S. healthcare system is structurally unsound both on the public and private side. I just have no clue how one would fix it.

      • I think you nailed in pointing out that supporters of reform really were most interested in greater access, not cost.

        Many of the critics seem to me to be focused on the preserving the status quo, or only reducing costs.

        Balancing those is the rub. I’d lean toward better access (I think universal is beyond our means at least right now), and would be willing to control costs by limiting the use of some of the most expensive treatment that produce only marginal results.

      • Sean, I think we all three agree that what we have is failing and what’s been proposed (ACA) is not the answer. Covering everyone is non negotiable as far as I’m concerned. I really like the Swiss model because it seems to take the best from both private and public plans and they created something that works very well.

        Unlike you though Sean, I’m no more suspicious of gov’t than I am of a company that just wants my money. I spent my working life under private insurance of course and now have Medicare. Far and away, Medicare is easier to use and hasn’t the restrictions I was accustomed to – out of network doctors etc. But of course we can’t fund it – but that’s also about to be true for private insurance companies. There’s a limit to how high they can raisie their rates.

        By the way, your story about your wife (glad she’s okay!) – my best friend had the exact same situation about ten years ago. Two doctors told her she had to have a full mastectomy. The third dr said it was absolutely not necessary – she had a partial, so partial in fact that one could hardly tell. And she’s just fine today.

      • Moe,

        I’m glad your friend is OK, too. 😉

  3. I agree with Sean’s concerns, but I think that might be a cost worth paying.

    In any case though I think we can learn something valuable from other nation’s systems. Too many American’s start with this idea that our healthcare is the best in the world in every possible way. When I think even a slight review of the evidence shows that simply not true.

    Excessive hubris is not a sign that we’re a great nation.

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