The Right Prescription
Patriotism and the Public Plan
As a sign of good faith, those politicians in favor of a public option should enroll themselves and their families in one now.
On this Fourth of July weekend I was moved to tears by the blog I read written by Karen Davis, President of the Commonwealth Fund, the multi-billion left-wing health care foundation. Ms. Davis invoked the words of Abraham Lincoln in discussing health care reform:
As President Lincoln emphasized in his Gettysburg Address, the U.S. is guided by the philosophy of “government of the people, by the people, and for the people.” What is needed in health care is a similar philosophy: a health system that is truly for the people. Redesigning health care so that it puts people front and center and ensures that care is patient-centered, accessible, and coordinated should be the fundamental goals of health reform.
Yes indeed. Except that in the previous paragraph, Davis who fancies herself dedicated to the “unfinished work” of “great task” had this in mind when discussing a “health system that is truly for the people”:
A national organization, such as a Health Value Authority…could be given the authority to negotiate provider payment rates and methods on behalf of all insurers — public and private — and eliminate the administrative waste now generated by thousands of individual-provider price negotiations. In addition, it could institute new methods of payment, changing the marketplace from one that competes on providing greater volume of services to one that rewards better outcomes for patients and more prudent use of resources.
Not exactly a new birth of freedom but hey, the enemy today is not whether that nation, or any nation so conceived, and so dedicated, can long endure. It’s the failure of private insurance plans to offer premiums “15 to 25 percent lower than premiums now offered in the individual and small business market, depending upon whether providers are paid at Medicare levels or at some midpoint between commercial and Medicare levels.” Not exactly Lincolnesque but you get the idea.
The signers of the Declaration of Independence came together “with a firm reliance on the protection of Divine Providence, [to] mutually pledge to each other our Lives, our Fortunes and our Sacred Honor.” Lincoln urged the assembled at Gettysburg to take increased devotion to that cause for which they here gave the last full measure of devotion.
Can’t we at least — those of us stirred to action by Dr. Davis and the billions lavished by Commonwealth in the pursuit of a public option — to resolve to join a public plan now, to enlist and abide by those stirring principles even when the law does not require it.
I would submit that we cannot wait for Congress to act to establish a people centered value-enhancing system. Rather, given the resources of organizations such as Commonwealth and the American spirit it embodies, people who support a public plan should enroll themselves and their families in one now. Further, any legislation that includes a public option such require members of Congress to give up their current health care and participate in one form of public health care.
Patriotism demands no less.
Specifically, Commonwealth Fund employees and executives, along with members of Congress, their families, staff should enroll in Medicaid or a public option that includes the following elements:
1. A Health Value Authority that would set prices for drugs and medical treatments, reduce “rates for overpriced services” and limit use of services identified by the authority as being “overused.”
2. Cut what doctors and hospitals are paid to payment to Medicare levels and limit future increases to the rate of inflation.
3. Limiting the choice and use of doctors and hospitals to those participating in plans that are part of the “public option.”
4. Forgoing any out of pocket expenditures for services or care not covered by the public plan to insure as a nation we achieve the true goal of health care reform: “$3 trillion in health system savings between 2010 and 2020.”
Indeed, enrolling in Medicaid or some variant now would give a public option the leadership and head start it needs to give the private plans a run for their money. If healthcare under a public option is so “patient-centered, accessible, and coordinated” and delivers high-quality, high-value care, why shouldn’t Karen Davis, Henry Waxman, President Obama and others enroll or at least take the pledge to “go public?”
To paraphrase Lincoln, those who support a public plan should dedicate their health insurance portion as the starting point place for those who here gave their lobbying efforts that that public plan might live. It is altogether fitting and proper that they should do this. Unlikely, but in America anything is possible.
About the Author
Robert M. Goldberg is vice president of the Center for Medicine in the Public Interest and founder of Hands Off My H ealth, a grass roots health care empowerment network. His is new book, Tabloid Medicine: How the Internet is Being Used To Hijack Medical Science For Fear and Profit, was published last month by Kaplan.
Letter to the Editor View all comments (35) | Leave a comment
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Rocco| 7.7.09 @ 6:48AM
Will never happen. It's the best for the politico elite, and the dregs for us plebeians.
Darin| 7.7.09 @ 7:27AM
In the minds of our elitist "rulers," the rest of us serfs should grovel and appreciate their largesse. And then get back to tending the upkeep of the castle.
Big J| 7.7.09 @ 8:02AM
While we are fantasizing, force the "gentlemen" to retire on Social Security, as opposed to their current retirement plan.
Kill two birds with one stone. Fix Medicare and Social Security all at the same time.
Nah, never happen.
TJK| 7.7.09 @ 8:54AM
I just heard a news story that Obama wants to name a "health czar." This is probably the same as the "Health Value Authority" mentioned in the article above. Just one question- how are either of these constitutional? For a president who supposedly taught constitutional law, did he not ever read the 1oth amendment? I will not stand by and watch this administration destroy what our founding fathers created. In the words of another great American, "Give me liberty or give me death."
James Pawlak | 7.7.09 @ 8:58AM
We should require all Members of the Congress, the Cabinet and such critters to be provided medical care by the VA on a non-priority basis and forbidden from having any other medical services.
FeralCat| 7.7.09 @ 11:37AM
Please Mr. Obama, I don’t wanna go
Hey, Mr. Obama, please don’t make me go
I had a dream last night about my comin’ medical care
Somebody said “What you’ll get is Dashle Kennedy Care!’”
And there I stood with a rag in my mouth upon which to bite.
Look at them waiting lines there, they’re hardly even movin’
And there’s a bureaucrat at every one
Hey, Mr. Obama, you mind if I be excused the rest of the afternoon?
HEY MISTER, DUCK YER HEAD!!
(Sound of bureaucrat’s clipboard whizzing by)
Hmm, you’re a little bit late on that one
Whooh, I bet that smarts!
Please Mr. Obama, I don’t wanna go
Listen, Mr. Obama, please don’t make me go
There’s a bureaucrat a’waitin’ out there, just fixin to decide my fate
A complainer I’ve been called cuz I don’t wanna wind up screamin’ or dead
I wonder what the Kenyan word for friend is
Let’s see-friend– kemo sabe, that’s it
KEMO SABE!, HEY OUT THERE-KEMO SABE!
Nope, that itn’t it
Look at them durned fascists
They’re runnin’ around like a bunch of wild Mengeles and Kevorkians-heh, heh, heh
Tim| 7.7.09 @ 12:43PM
We can all look forward to the day when, in addition to IRS audits, the politically troublesome will find their medication canceled or their surgery postponed.
When a future Clinton has to explain how all those confidential health records made their way into the White house...
Joe Redfield| 7.7.09 @ 5:03PM
Dr. Davis mentions an interesting concept -"rewards better outcomes for patients"; I wonder if the Left would consider that idea for public education?
Gary Gaston| 7.7.09 @ 5:08PM
I would suggest an even more draconian (to the pro pols that is) idea than the health care issue - upon election to the house or senate, their children must, as soon as possible, be, if not already, immediately enrolled in the appropriate level public secondary school nearest their home residence. This enrollment would last at least two years and I'd give the buffoons in the senate and additional year. A thought, of course, that will never happen.
John II| 7.7.09 @ 9:48PM
Someone should start cataloging the KINDS of articles in TAS that attract no comment from the liberal trolls. This is one of them, apparently. Does that mean that the trolls have run up against something they can't handle with their airy sound bytes?
Seriously, what draws them like flies to a broken honey pot, and what leaves them indifferent and unengaged? I have a theory, but I'm keeping it to myself, for now.
Marcell| 7.7.09 @ 11:34PM
Physicians' Proposal Intro:
http://www.pnhp.org/single_payer_resources/physicians_proposal_intro.php
The Physicians’ Proposal for National Health Insurance establishes the vision and principles of a single-payer health system for the United States. The document was composed by a distinguished group of physician leaders*, and secured the endorsement of 8,000 physicians by the time of its publication in the August 13, 2003 JAMA.
The text outlines the general structure of the single-payer plan: eligibility and coverage, physician and outpatient care payment, global budgeting of hospitals, the establishment of a national long-term care program, planned capital investment and single-payer financing.
Marcell| 7.7.09 @ 11:43PM
My services don't come free.
**************
Health care industry resistant to reform?
www.msnbc.msn.com/id/22425001/vp/31768616#31768616
Paige Freeman| 7.8.09 @ 11:06AM
Yes, the President, Vice President, and all members of Congress should enroll in the type public health care many are mandating, while their children should all attend primary and secondary public school. This is fair and honorable, and as it should be....and this will also greatly influence their legislatives actions, more than the will of those they represent.
Easy Solutions| 7.8.09 @ 11:16AM
All these solutions are picking out which group of people to send to unemployment. A national exchange will kill off insurance salesman, single payer kills insurance companies, Health Value authority kills networks and doctors.
Here's two easy investments to save those jobs, create more, and cut costs which no one talks about:
1- Eliminate the 100-500 billion in fraud. (FBI estimates)
2- Cheap schooling for Dr.s & Nurses. Flood the supply side to lower costs. Excess supply can go help out failing single payor systems in other countries.
3- Agree with political elite either switching to existing government plan... or pay P of their health benefits like the rest of us.
Cato| 7.8.09 @ 1:53PM
Each of us pays $3000/year (pre-tax) into a personal account that goes with us from employer to employer. $1500 of that goes into a Medical Savings Account at an institution of our choosing. The money is there strictly for medical bills for yourself or your loved ones. Penalties for early withdrawal, money can be withdrawn tax-free starting on your 63 birthday or it can be willed to your survivors.
The other $1500 goes into a Catastophic Illness coverage plan which covers the individual for all major diseases or major accidents. Individuals can shop all 50 states for the best rates and coverage. Any individual can put more money into their system, either in the MSA or for more coverage as they see fit.
People go back to paying doctors what the visit costs - costs go down.
This absolutely has to be coupled with tort reform - caps on damages and an uncoupling of the FDA and its conjoined twin, the pharmaceutical companies. The fed allows generic drugs to be sold at their Free Market price, not the ridiculously high markups the FDA/pharma lobby enjoys now.
The poor are provided with $3000 vouchers to participate in the same plan. Anyone can opt out of the system whenever they feel like, provide they sign an agreement indicating they're cognent of what they're doing and hospitals/doctors will provide 'best effort' to serve them when they have the time or money to do so.
Crazy? Not as crazy as bankrupting the greatest country in the world just to provide medical services to the subset of folks who really need help now.
Being sick in the US is better than being healthy in Haiti. Let's not turn our country into Haiti, shall we?
Scott A Joseph, MD| 7.8.09 @ 3:13PM
I asked Jim Oberstar of MN, my vermin rep, if he would enroll in a public option. He has refused to answer me.
Scott A Joseph, MD| 7.8.09 @ 3:29PM
I was a senior consultant in an NHS in New Zealand. Compared to Minnesota, it was a nightmare of rationing and waiting lists (1-6 months wait for a back MRI, 2 year wait for back surgery (my wife needed these, I know---and this is for the wife of a senior consultant). Any dimits who support a public plan that will slide inevitably into single payer need to review this---it is INFINITELY worse than insurance companies in the US. I am an expert in both, I KNOW---I don't guess or surmise.
I have never seen an article on this by a clinician who has practiced in both who would prefer a single payer program for anything that would require an high tech intervention (surgery, for instance). If you guys want to draw your own conclusions, go to the NZ Herald website (quite leftist) and put in the search term "District Health Board." Bon Appetit!
Marie| 7.8.09 @ 6:46PM
I think the telerprompter lied when he said he taught constitutional law. THERE'S NOTHING constitutional of anything that he's doing. Ever read the communist manifesto? Please do..you'll find it rather "familiar" but NOT because you've been to china...
Pingback| 7.10.09 @ 4:25AM
The Reform Effort Is Fraying at The Edges | TAKEbackMEDICINE.org links to this page. Here’s an excerpt:
Pingback| 7.14.09 @ 7:30AM
Questions for Robert Goldberg « DUNCAN CROSS links to this page. Here’s an excerpt:
migrainemaven| 7.24.09 @ 10:18PM
Say...could we make that inflation-adjustment to Medicare reimbursement retroactive to the last time it actually matched up with the Consumer Price Index? That would rock!
Don| 8.13.09 @ 5:30PM
@John II:
*huff* *huff* sorry I'm late, I had to run out and murder some babies with my satanic homosexual orgy cult.
Congress already is enrolled in a form of public option. Medicaire, Medicaid, Tricare (Military), and the Congressional health care are all run by the government.
I'm not sure what the article is disagreeing with. You say that those who support a public option should sign up for one. Well, that is a tiny bit hard since there isn't a public option open to the public yet. All the government health care systems are very limited in who they take.
What is so wrong with wanting to take care of our citizens. What I don't understand is how we can look at a system that does everything in its power to kill of the sick and say that we are okay with it. I am not okay with the health care system. I am not okay with having companies decide how much my life is worth. I am not okay with a health care system that has a business model of denying health coverage to those that actually need it.
Until we have health care run by an organization whose goal is to keep people healthy rather than an organization whose goal is to make money; we will continue to be the sickest first world country.