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the blog

Monday Jul 13, 2009

CNN's State of the Union - where is Congress on health care reform?

I get so frustrated listening to the health care debate that I can only listen to it in small bits. So, Republican Senator Lamar Alexander is talking about taxing something if you are ready have the "Cadillac" of health insurance plans. What the heck is that? Any health insurance plan is offered in 2009 is a fraction of what was offered in 1989. There are no Cadillac insurance plans anymore. Then, he talks about some plan in which the government gives Americans money (I guess in tax breaks or tax rebates) in which to buy health insurance. This is got to be a popular plan with the insurance companies.

Wolf Blitzer, who for the most part is clueless, states that in order to get coverage this will cost hundreds of billions of dollars. The statement is simply wrong. The statement should be in order to keep giving insurance companies are money we will need to spend hundreds of billions of dollars. If we exclude insurance companies universal coverage will not cost any more than we're paying now.

Senator Judd Gregg asked a good question but then has a stupid answer. Why are going to spend more money on healthcare? We are already spending enough (my answer not his). Senator Gregg is a 100% wrong when he states that there are good studies which suggest if you give patients incentives that will purchase better healthcare. This is simply wrong. It is wrong in a number of ways -- first, the majority of patients do not want to go through some complex permutation of healthcare plans to decide what's best for them. Secondly, Senator Gregg is asking patients to project into the future of what they're healthcare problems will be. As a trauma surgeon, I can tell you that most people do not plan on seeing me. Most people think of themselves as careful and thoughtful.

Senator Judd Gregg then launches into the fear tactics that Republicans have been using for nearly 18 years on healthcare reform. He suggests that they healthcare in Canada or England is awful. He suggests that a single-payer system would lead to rationing of health care. One of the things that he doesn't say is that currently insurance companies are rationing healthcare as we speak. They are deciding what to pay for and what not to pay for. So, the current system that we have not only rations but puts a for-profit company (insurance) between you and your doctor. The single-payer system puts nothing between you and your doctor. What could be simpler?

Update: Senator Judd Gregg also had some disturbing statistics about breast cancer in England and the United States and survival rates. Fortunately, there's something called the Internet. You can look up the survival rates in England and the survival rates here in the United States. The survival rates in England are actually better than they are here in the US. This really should not be a surprise to anyone. Everybody in England has insurance. A large number of Americans do not have insurance. These Americans present later, with more advanced disease and have poorer outcomes. This drives down the overall survival rate.

Senator Conrad is still pushing these co-ops as viable alternatives. It is clear that these co-ops are not viable alternatives and would be crushed by insurance companies. I talked about the utter stupidity of this co-op option. I haven't changed my mind.

The bottom line in this healthcare debate is obvious. Confused, obfuscate and dance around the issue. The issue is simply this -- do health insurance companies add value to healthcare? If the answer is yes then we need to spend time talking about healthcare co-ops in some sort of hybrid plan to get everyone covered. If the answer is no, then we need to quit wasting time talking about giving tax rebates to people so that they can afford insurance. Senator Stabenow understands the problem completely. She's the only one on the show that made any sense.

Posted by Errington Thompson on Jul 13, 2009 email post email Spotlight / / You are in Health Care