Current Events Public Policy

President Obama’s Healthcare Summit

How did Obama’s Healthcare Summit go?  It was basically a pile of bad ideas.  Senator Harkin gave the best explanation of what’s truly needed, but I’ll save that for last.

Examples of BAD IDEAS include

Starting over.  John McCain asked to “Go back to the beginning” and Republican Senator Lamar Alexander said “If we can start over, we can write a healthcare bill.”  The whole start over rhetoric is dumb.  If you don’t like the current proposals, say what you don’t like about them.  If you have suggestions on how to do it better, say them.  Suggesting a “do over” is not helpful.  Even if you think health care in the U.S. is perfect and prefer the status quo, you should stand up and say that rather than asking for a clean slate.

Health Reform will lower the deficit. Expanding federal entitlement programs will NOT lower the deficit.  In the short-run, additional tax revenue and cuts to other programs may decrease the deficit in the very short run, but adding or expanding big government programs never lowers the deficit.

Reforming medical malpractice.  I have documented that the medical malpractice system does not work well (see here and here).  However, malpractice costs are a small share of the overall health care dollars.  If physicians prescribe too many tests and treatments because they wish to avoid being sued, than tort reform could decrease costs more drastically.  However, this issue is more of a partisan one where Republicans can pander to their physician supporters and Democrats can pander to their attorney supporters.

End Waste and Abuse.  This is a laudable goal, but determining what is waste and abuse is difficult.  If you get an MRI for an injury, you may not need the MRI, but it will provide the doctor with some helpful information.  This is certainly not fraud, but it may be waste.  Having Medicare administrators who are far from the hospital floor determine what is wasteful is not as easy as political rhetoric makes it sound.  Further, although there is much waste in the Medicare system, there is much waste when doctors are paid by private insurers as well.  Every President promises to reduce Medicare fraud and waste, but few succeed.

We actually create more diabetes through the food stamp program and the school lunch program.”  – Senator Coburn.  Do poor people buy more unhealthy food?  Yes.  Is it because of these programs?  No.  The poor have less money and fast food is cheap.  Fresh fruits and vegetables are expensive.  Increasing redistribution would allow the poor to eat healthier, but if Senator Coburn wants to mandate that poor people eat healthy, I think that is going too far.  People on food stamps aren’t all of a sudden start shopping at Whole Foods.  The food police are not the solution to health reform.

Here’s where the GOOD IDEAS were:

Incremental Reform doesn’t work.  Senator Wyden said, “The evidence says incremental reform not only does less, it costs more.”

The most sensible comments came from Senator Harkin.  In order to reduce health insurance premiums and Medicare expenses, we need cost control (i.e., rationing).  We need to limit the medical care we make available to ourselves.  Every person should not be able to receive every medical treatment they think will improve their lives.  Determining which treatments to exclude form Medicare or private insurance is full of tough decisions, but they must be made, otherwise health insurance premiums will gobble up more and more of our wages.

Of course, no senator could support rationing care, but that is what Senator Harkin is essence supporting.   Here is a quotation:

Well, quite frankly, if we want insurance reforms you can only do that if everybody is in the pool. You can only get everybody in the pool if you make it affordable for middle class families and others. You can only make it affordable for middle class families and others if you have cost controls.

The full transcript of the summit can be found in three parts (1, 2, 3).  NPR also has some good analysis here.


  1. I think the med-mal reform is more effective than just reducing med-mal insurance premiums. It might reduce the CYA tests and procedures and I don’t think that number is insignificant.

    I do think trashing the current bill is a good idea, although a non-starter, given this Congress. Nothing in the current bill actually works to reduce the cost of services, which is the cause of high health insurance premiums.

  2. I agree that providing incentives for healthier eating habits in the food stamp program probably have little bearing on the overall cost of the US health-care, but I don’t think any such change would necessarily be particularly costly.

    Interest group politics aside, one simple way to incentive people on food stamps to purchase healthier food is to make the coupons worth variable amounts, depending on how “healthy” a food is. For example, if a $1 coupon could be redeemable for $2 when used to purchase fresh fruits and vegetables, but only worth $0.50 when redeemed for fast food.

  3. I respectfully disagree with whoever wrote this article. Incremental reform is better than NO reform, which is exactly what is going to happen if the Democrats keep trying to push this massive, comprehensive bill through that the Republicans will never vote on. You say “If you don’t like the current proposals, say what you don’t like about them.” The Republicans did!! They said they don’t like the philosophies upon which the bill is based — giving more control to the Government. Do you really think that can be fixed by incorporating a few Republican amendments?

    Furthermore, you said “If you have suggestions on how to do it better, say them.” It’s logistically impossible to go through every disagreement the Republicans will have with 2,000-page legislation that is prominently Democratic in a forum such as that one. No matter what gets changed or amended, it will still be largely Democratic and thus the Republicans will still disagree with it. This is why the GOP pushes to start over. Without starting over, there’s no possible way to achieve anything bipartisan.

  4. Great points in the article – I’m not so sure cost of services is solely responsible for high health insurance premiums though. Medical malpractice premiums have gone out of sight – I’m not sure why doctors even want to practice today! Stephanie, RN, MBA

  5. The Senate Democrats put in the ideas that Minority Boehner wanted in their healthcare proposal:
    1. “Let families and businesses buy health insurance across state lines.”
    2. “Allow individuals, small businesses, and trade associations to pool together and acquire health insurance at lower prices, the same way large corporations and labor unions do.”
    3. “Give states the tools to create their own innovative reforms that lower health care costs.”
    4. “End junk lawsuits.”
    The Republicans still said no to it. The Republicans don’t want to deal with healthcare reform. They had a chance to do it during the Bush Administration, but nothing was done.

    Almost every industrialized nation has some type of government intervention in their healthcare system, which allows its citizens to have affordable healthcare. Governments negotiate prices to what doctors, hospitals, drug companies, and medical device companies are allowed to charge.

    Frontline did a show on five different healthcare systems around the world: the UK, Switzerland, Germany, Japan, and Taiwan.

    Switzerland and Germany have private insurance companies, which negotiate with providers to set standard prices for services. The Swiss government sets drug prices. Swiss insurance companies aren’t allowed to make a profit on basic care. They can make money on supplemental insurance. German insurance companies can only make a profit for those who want private insurance, which is about 10 percent of the population.

    In every industrialized nation, its citizens have the right to healthcare. No one system is perfect, but only in America does its citizens not have the right to healthcare. Only in America does its citizens go bankrupt.

    If you want to reduce the cost of healthcare in the US, there has to be some sort of government presence in the system, whether it be a single payer system or where the government relegates the costs of services provided by the healthcare industry.

  6. “Almost every industrialized nation has some type of government intervention in their healthcare system”

    Do you know what else every other industrialized nation has? A worse economy than the US. Also, less freedom.

  7. ” People on food stamps aren’t all of a sudden start shopping at Whole Foods. The food police are not the solution to health reform.”

    I am disabled and trying to get healthy. I do shop t Whole Foods occassionally when I have extra money. What an ignorant stereotypical. comment. Being poor does not mean you don’t try to eat right. being poor does not mean you are nutrition ignorant.

    Being wealthy does not mean you eat right either. Your comment is very elitist and ivory tower.

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