Monday, June 01, 2009

Find The Flaw

I'm at the conference organized by the Campaign For America's Future. (Many thanks to you for paying for the hotel room which is charming and old-fashioned and fits me to a t.)

One of today's sessions was called "Affordable Health Care For All". We heard what U.S. Secretary of Labor, Hilda Solis, had to say on that topic. We also heard Governor Howard Dean, Dr. Salomeh Keyhani and William McNary, and all four agreed that the public insurance option should at least remain on the table.

A single-payer system appears to be ruled out on political grounds, went the consensus of this panel. Instead, we should aim at --oh, let's say -- affordable high quality insurance for all Americans!

And pigs would float if they were born with parachutes. I'm getting tired of a list of desires when combined with a plan which will do nothing to fulfill them. Sure, we need affordable insurance. But how are we going to get that?

Note that the reason other countries have lower health care costs is largely because they have one dominant source of public health care funding, perhaps combined with a small private insurance market. It is this which keeps the costs low. One large buyer can negotiate low prices and take advantage of huge quantity discounts and the public sector has the power to make new rules and regulations to limit the high rate of price increases in health care.

But we are not going to have that. We might not even get a public insurance option! So what is it exactly that we would get in the most recent Obama plan?

I guess there would be extra emphasis on preventive medicine and cost-savings through information technology, with the hope that these would lead to cost savings. But those savings are unlikely to be very large. They certainly won't balance out the enormous cost increases which will come about when all those previously uninsured people suddenly get medical insurance (remember the goal of having universal coverage).

All that suggests a further nasty thought in my tired head: If there are unexploited ways of achieving cost-savings, how come didn't all those health care firms already take advantage of them? Hmh? Especially given the great advantages those firms are supposed to have over a governmental delivery system? You know, the brisk competition in price we see all over the place?

Without the public insurance option the Obama plan will contain very little that would slow down the rate of increase in health care costs. That's the flaw I see in the plan and that's the flaw which would ultimately make it fail. This means that we really must fight for the inclusion of the public insurance option.