Daschle: Fixing Health Care "Top Priority" In Fixing Economy
This is kind of big. Health care advocates hoping that Barack Obama will fast-track health care reform had been waiting for a crucial sign: A public indication from the new Obama administration that they view health care reform as crucial to fixing the economy, a key talking point of reformers.
Today they got that sign.
In the Obama team's first public statements on health care since the election, top Obama health adviser Tom Daschle gave a speech today in which he hit exactly that note, describing health care reform as a "top priority" in rescuing the economy.
"There is no question that the economic health of this country is directly related to our ability to reform our health-care system," Daschle said.
Daschle cited the fact that high health care costs are preventing U.S. businesses from staying competitive and creating jobs. "That's what makes this so urgent and so much a part of the economic recovery process," Daschle said. "I believe that for the first time in American history, health-care reform will be done."
That last line is thrilling advocates and unions who are vowing a major push for reform. In a statement, SEIU hailed Daschle for "confirming the commitment of the new administration" to reform, which the union said was "great news."
To be sure, all the good feelings are easy to have right now, before the gristly business of agreeing on how to pull off reform gets under way. But for now, reform advocates have heard what they were hoping to hear.
"We're absolutely thrilled that Daschle took the opportunity to emphasize how important it is to fix health care in order to fix the economy," Jacki Schechner, a spokesperson for Health Care for America Now, a major umbrella group of reform advocates, unions, and providers, told us.
Of course the best way to make business more competitive is to ditch the employer-based health system altogether and go 100% public, single payer universal health care.
December 5, 2008 3:07 PM | Reply | Permalink
Yep. Businesses big and small, not to mention the self-employed and freelancers, will benefit greatly from universal health care.
December 5, 2008 3:23 PM | Reply | Permalink
Yes Yes Yes~~~ Universal single payer is by far the most economical way to get healthcare to everyone. The cost savings and freedom from changing jobs anxiety is the biggest help our economy could get. You could afford car payments instead of copayments. Bankruptcy for sick people must end. We must take ourselves into the civilized family of man and take care of everyone. It is economical thing to do and it is the right thing to do.
December 5, 2008 10:23 PM | Reply | Permalink
Amen.
December 6, 2008 6:40 PM | Reply | Permalink
OK, everybody, all together now:
It's not really reform unless it's single payer!
December 5, 2008 3:34 PM | Reply | Permalink
Dis country ain't ready for reform.
I wish it was, but I just don't see us getting there in one leap. It will take a series of steps. We'll wind up there eventually because every alternative will eventually fail.
December 5, 2008 3:38 PM | Reply | Permalink
You could be right about readiness. But this country spends between 15% and 20% of its entire annual income on healthcare. I believe France is next highest at around half that. We simply cannot cripple our employers that way and expect them not to try to escape by shipping jobs offshore. Our system is now hopelessly flawed and must go. The danger for reformers is that a series of baby steps will never get us there: as the economy improves the urgency and support for change will die down. Now, while the economy is reeling and people are desperate to cut spending, is exactly the time to roll the dice on massive reform. If we can free some of that high cost for allocation to more productive use within the economy then healthcare reform becomes part of the overall economic revival effort. And who doesn't want to revive the economy?
December 5, 2008 4:07 PM | Reply | Permalink
You're preaching to the choir. The forces of opposition are already lining up. Insurance companies, pharmaceuticals and the AMA are not going to go down without a fight, and they've got deep pockets. They can't win the argument on merits, so they'll spread fear. This is shaping up to be a titanic struggle.
In the end, I believe we'll wind up with a step in the right direction - maybe a big step. A major expansion of SCHIP, for sure. Many fewer uninsured, probably. An end or at least sharp curtailment to pre-existing condition exclusions, maybe. But universal, single-payer? I don't see it. Not yet.
December 5, 2008 4:19 PM | Reply | Permalink
The biggest reason this is the time is that we are going to be spending big wads of money trying to recover from the economic crash, so billions for universal health care doesn't seem so forbidding now. We just had 700 billion committed to the banking industry. Committing another 500 billion, or whatever it takes, isn't going to look nearly as bad to the public.
The lobby folks will be out in droves, but they are all Republicans now, so their influence will be watered down with the Democratic congress. And, the public isn't likely to sustain sympathy for insurance sales forces, who contribute nothing to health care, like they are to the automobile industry, which at least does make something to sell. I think most of us would consider the lost insurance industry jobs to be a small price to pay now.
December 5, 2008 9:43 PM | Reply | Permalink
Agree. I hope, and expect, that that is where it will wind up but to aim for it directly would be to repeat the chief problem with the Hillary-led health care effort when Clinton took office.
I always preferred Obama's proposal to Hillary's or Edwards' precisely because it was NOT universal, did NOT carry a mandate. The structure his proposal would put in place could easily convert to/be adjusted to a single-payer, 'mandated,' system, but that structure could be put in place without asking Congress or the American people to go to that length right away. Once the structure is in place and can be shown to be working, then it's a much smaller, more manageable step to go the rest of the way.
Like a lot of people of my generation, the overriding struggle that remains in the forefront of my mind, to which most else is compared, is the civil rights effort. It - quite literally - accomplished a miracle. It's hard to imagine any domestic issue that could ever be as high-voltage, or face so much resistance. There is a great deal to be learned from the patience of those in that movement and path they took.
When MLK came to prominence during the Montgomery bus boycott, the goal was, when you think about it, very small and simple: the right to sit anywhere on city buses. Big deal. They weren't saying "It's not really reform unless it's fully integrated schools, housing, work opportunities, chances for career advancement, respect in public, ability to be President, etc., etc." But look what was achieved, starting from that (and other) "small" victories.
Social change simply does not happen in great, giant steps. Fear & hesitation are natural reactions to something new and different. (That's why all the speeches and ads ALWAYS stress the "right to choose your own doctor," because that represents what people like about the current, badly flawed system.) The more flawed and threatening health care has become, the more emotional people have become about the whole issue.
That can be both good and bad: overplay your hand and they will recoil and listen to the 'vested interests' who want to scare them into recoiling .... but play it right, go toward the goal gradually enough and you have the makings of a strong grassroots movement that can, ultimately, force even those with vested interests to make, or at least accept, change.
So, I have to respectfully disagree with KYYellow Dog. I suspect that it's NOT going to be reform at all if we insist on nothing short of single-payer. On the other hand, what sometimes seems like a tiny step (such as having a single-payer-type option just for those "relatively few" people that won't get coverage from their employer .....) can make tremendous progress possible. If people get used to it, see that it works, realize it's not so frightening, the 'relatively few' could grow significantly and it would be a lot easier to win acceptance for a mandate.
December 5, 2008 4:17 PM | Reply | Permalink
The big argument against the gradual approach is that many of the biggest problems don't seem amenable to solving piecemeal. How can you require insurance companies to accept all applicants with no exclusion for pre-existing conditions without simultaneously mandating universal coverage? I just don't see a way.
December 5, 2008 4:28 PM | Reply | Permalink
This may be totally wrong, as I'm just now starting to pay serious attention to this issue, but my understanding from what Obama has described is that there *would* be the equivalent of a single-payer, no exclusions, etc. system operated by the government ("the same coverage we get in Congress") that would be an *option* to insurance company-based policies.
If you have coverage through your employer (i.e., via an insurance co), you can keep that, but if you don't have employer-provided insurance or if your employer stops providing it, then you can become part of this alternative, government-based coverage. (I think employers would have to pay in something if they don't want to provide coverage but, of course, they have to pay to provide coverage already... so not a huge change there .... *yet.*) I'm not quite sure what the gov't system is, but if it's the same coverage that members of the military get, then it's darn good coverage but, no, you don't get to always choose which doctor you see. Same thing with Medicaid, which a young relative was on for a short while - really very good coverage as far as I could tell. (Of course now they make to much money to qualify for medicaid but working only part-time, so no exams, no treatment, no nothing.)
Anyway, that's what I meant by setting up the 'structure' of a single-payer system but not mandating it. If it is indeed a better system, then there will logically be more and more people going over to the gov't-based coverage. Once it's well enough known and seen to be working, THEN the step from there to single-payer is a relatively small one. But to say, today, that everyone has to go into that radical new system ...... it just won't happen. At least I don't think so.
The odd quirk that is steeped into the public's consciousness but is really just an accident of history is the connection between employment and health insurance. As I understand it, that was something that started being done during the depression -- when there was no money for companies to PAY people much more in raises but, for a far smaller investment, they could offer them health ins. In other words, there is no "necessary" connection between employment and health coverage. Except in people's minds. So - again - it's going to take some time for people to learn to look at things differently.
As I understand Obama's proposal - we would as a general proposition still retain the employment-based coverage through insurance companies for most Americans, but provide this alternative gov't program for the "relatively few" who don't/can't get it that way. (people who aren't employed, those employed by small businesses that don't provide coverage, those employed part-time who don't qualify for coverage ...... and those employed by larger businesses that elect to pay into the system rather than purchase their own policies for workers). If the gov't based program really is better, then that last-mentioned group will grow, right?
And THEN is when you can raise the question of whether there should be any connection between employment and coverage at all. If folks who aren't getting it from their employer are doing fine, why impose that extra cost on the employer ... and therefore on their goods? If the - shudder - government-run coverage is as bad as folks on the right would have you believe, then we haven't dismantled the employer/ins co system of coverage.
To say, right now, that "there will no longer be coverage from insurance companies" or "there will no longer be coverage through your employment" .... that would just would trigger fears and, figuratively speaking, start a riot. Remember Harold and Martha or whoever it was around their kitchen table, worrying themselves into a frazzle.
Again, I may be wrong, but this does seem to fit with Obama's way. Instead of saying "my way is better!" - "no, mine!" - "no, mine!," you say
"Fine, fine -- keep your way - no prob. We'll just start this little experiment over here on the side for the few folks that slip through the cracks. Those folks don't matter to you, they aren't part of deal now anyway. Hey, you can even buy in if you want and get your coverage through this system. What? Okay, okay - I get it - your way is FAR superior and you'd NEVER want to subject yourself or your workers to a - shudder! - government run program. That's fine, that's fine ... just trying to be polite and friendly..... "
This also gives something to say to the ins. companies and pharmaceuticals, etc. "You think you provide better coverage, offer something people will prefer? Be my guest. Have at it. Employers, and individuals, are free to stay with you if you do, in fact, provide better coverage. Good old healthy competition and free market, and all that, you know. No need to fight - just make sure your product is the better one."
Again, I don't know that I have the right overview - have only listened to what he's said in speeches and debates and filled in between the lines myself. But IF what he's proposing is something like that, why wouldn't it work?
December 5, 2008 6:25 PM | Reply | Permalink
The problem is, if there's no mandated coverage, people can not pay for insurance until they get sick, then opt into the government program. Any insurance program necessarily requires lots of healthy people to pay for the fewer sick ones. It's pooled risk. There's also a perverse incentive for insurance companies to dump into the government program anyone who costs them money. Pretty soon the system is bankrupt. It's a pretty thorny problem.
December 5, 2008 6:54 PM | Reply | Permalink
Yeah, except children ARE mandated to be insured, and I don't think you can opt to become uninsured after joining the govt. program, which means in a generation it will transform into single payer.
December 6, 2008 1:52 AM | Reply | Permalink
We may be in leaping weather sooner than you think.
December 5, 2008 5:00 PM | Reply | Permalink
In Germany, BMW, Volkwagen, Porche, Mercedes all benefit from socialized medicine for their employees...it's not a cost that has to be factored into the price.
December 5, 2008 3:35 PM | Reply | Permalink
Hmph! They are thrilled, but will they be patient?
December 5, 2008 3:52 PM | Reply | Permalink
With all due respect to Greg and the rest, I seriously have heard this same blog about 4 times in the past week. Health Care is a priority, we know and we are excited about it.
Rant over.
December 5, 2008 4:08 PM | Reply | Permalink
Mr. Daschle--
All federal and state employees should be put on Medicare immediately, thus relieving their budgets and the taxpayer burden.
All students should have Medicare available to them.
All failing corporations should be able to enroll their employees in Medicare immediately.
Any corporation who wishes should be able to use Medicare for its insurance provider for its employees. (Walmart, in essence, already does this by relying on free government emergency care for its employees).
Any person who has no access to health care should be allowed to receive Medicare.
All this will boost employment for people in the healthcare field and will save millions for companies and local governments.
This is becoming obvious to all of us. The profit taking administrative middleman in health care must be eliminated. They are killing us, literally. This approach keeps the element of choice. If you can't see this, then your approach will ultimately fail.
December 6, 2008 12:05 PM | Reply | Permalink
I take exception to calling Health Care for all Now an umbrella group. It is not for single payer and is supporting a hybrid approach because they think that is all the is possible in the US. Many of the comments on this site support Single Payer. PNHP (physicians for national health care program) and state affiliates of Health Care for All support Single payer as the only universal, continuous, affordable for individuals and families, sustainable, effective, efficient, safe, timely, patient centered and equitable. This has been clearly recommended by the Institute of Medicine study and is currently in legislation before congress in H.R. 676 supported by over 90 congress members. We now have the momentum. Call your congress member and show your support while the issue is hot.
More is possible now than ever before in the US.
December 6, 2008 3:34 PM | Reply | Permalink
Single Payer. Why settle for more?
December 6, 2008 6:42 PM | Reply | Permalink