If You're Just Tuning In...
If you're just tuning in to this week's book club, a quick summary of what you've missed.
Jonathan Cohn started things off urging universal health care supporters to "think big" and not preemptively take single-payer off the table because of an artificial concept of "what's posssible." Also offering starting thoughts, Don McCanne offered numbers to put things in perspective, Roger Hickey argued that voters are sick of tinkering, and Joe Paduda pointed out that traditional lines are being crossed by making the business case for single-payer.
But Jacob Hacker, himself the author of a plan, argued that while Cohn's "thinking big" is good, political and fiscal realities can't be ignored.
Robin Podolsky agreed with Cohn and Paduda and reports on the steady progress of her efforts toward single-payer in California. Matthew Holt, on the other hand, deemed the argument miscast if it's over the type of system rather than simply the number of people covered. Diane Archer disagreed, noting that there is "a world of difference" between privately and publicly run insurance system.
Our own Mark Schmitt warned that good policy doesn't make good politics (often just the opposite) and advises that we should focus on building the political coalition. A last, but far from least, Maggie Mahar made an amazingly comprehensive case for the necessity and political possibility of fundamental reform.
Coming today, Cohn's case against single-payer.
(Note: A very special thanks to Andrew Cleary for the research help!)
Andrew Golis
Cross-posted from my comment to Jonathan Cohn's post today.
I hate to spoil the fun but in this whole set of blog-posts and comments there is almost nothing discussed on the grandaddy problem of them all ahead-Compassionate and Ethical Cost Reduction.
A treatment based disease care system is NOT economically sustainable
Please prove me wrong on that latter statement?
Thanks,
Dr.Rick Lippin
Southampton,Pa
http://medicalcrises.blogspot.com
April 12, 2007 2:23 PM | Reply | Permalink
As Rick says "A treatment based disease care system is NOT economically sustainable".
Nor is it ethically acceptable. It makes econoic sense and is the ethical approach to prevent illness and promote health. The human sufferring directly caused by our very dysfunctional system is doing unimaginable harm on tens of thousands of people.
In a very real sense this is our fault, isn't it? As a nurse I know I feel a terrible burden of the preventable illness and suffering that is wrought on people as a direct result of our U.S. HC system. Where's the outrage and action?
We can do SO MUCH better. Single payer universal coverage should be our goal. Thanks for this TPMCafe book club topic; I hope it will contirbute concretely to creating the grassroots political movement we'll need to win.
In MA visit http://www.DefendHealth.org and http://www.MassCare.org/about to learn more and to get involved on the local level.
April 12, 2007 7:53 PM | Reply | Permalink
Re: . It makes econoic sense and is the ethical approach to prevent illness and promote health.
Well, yes, but not very realistic. People get sick and suffer injuries. That's life. Even the healthiest person will eventually grow old and suffer from the debilitations of that state, unless "lucky" enough to die from sudden truama.
April 13, 2007 5:59 PM | Reply | Permalink
JPF you seem to have missed the word "preventable" in my comment. I suggest you re-read it.
Then if you're serious about understanding this national disgrace you might want to take a look at the Institute of Medicine Report "Consequences of Uninsurance" in the U.S.. It identifies that over 18,000 Americans die prematurely directly as a result of being uninsured. "That's life"? Not where I come from.
April 13, 2007 11:46 PM | Reply | Permalink
You have twisted my words. I was not saying "that's life" in response to the outrage of our healthcare system's lack of universal coverage. But it is a fact that illness and injury are a natural and normal (albeit undesirable) part of life and there's no way we are going to prevent our way out of them. Nor do I think there are huge savings to be had in prevention.
April 15, 2007 4:50 AM | Reply | Permalink
I appreciate your thoughtful and reasoned reply. I am positive that there are HUGE SAVINGS IN PREVENTION if we would create a system that allows us to pursue them.
Maybe we see things differently in how to define prevention. I see preventing obesity (and helping obese people lose wt) as an area of prevention.
Obesity directly contributes to the development of Diabetes, Arthritis, COPD, and on and on - these are all very costly in terms of disease burden (symptoms affecting ability to function, to work, etc) and have high costs associated with treating those diseases.
There are huge savings to be had in both preventing physical pain, sufferring, and disability and HUGE economic savings for all of us (the disabled more often than not end up covered by publicly financed insurance).
Medical economist Ken Thorpe has done tons of studies on this topic and I'm sure much of his work is available online (see www.HealthCareForMass.org upper Rt-corner for one such link).
Actually, Ken is likely making quite a bundle $$ off of this work; I hope he's donating a generous chunk of it to groups that are trying to build a winning health reform movement!! :)
April 17, 2007 8:26 AM | Reply | Permalink