When I studied the actual plans for health care reform in the Congressional pipeline I was disappointed. It is clear that the insurance industry is so firmly entrenched in Washington politics that any noises from the single-payer people are as unnoticed as sneezes at a football game. I came away resigned to the idea that single-payer (obviously the quickest, most cost-effective way to reduce costs) will have to wait until American health care gets so financially obese that even the most selfish of Washington politicians can no longer be in denial. Something like how the UAW, after driving two of their three cash cows into bankruptcy, finally "got it."
The only bright spot I found was something called the "public option," a government sponsored insurance alternative to private insurance. The insurance industry is terrified of any such plan, of course, because even at its most fiscally irresponsible, any government plan would easily undercut the private sector because there would be no need to pay executive bonuses, profits to share-holders or, of course, taxes.
And that's just a change in paperwork. Imagine how much could be saved if the government actually got into the business of DOING health care on a more widespread basis than the already vast network of military medical professionals and the Veterans Administration's hospitals and local private-sector affiliates.
This morning Maggie Mahar posted news of a hopeful signal from the White House. Her headline was President Obama: “I strongly believe that Americans should have the choice of a public health insurance option”.
In a letter to Senators Ted Kennedy and Max Baucus that the White House just released this afternoon, President Obama spelled out his vision for health care reform, making it clear that he wants a public sector alternative to private insurance: “operating alongside private plans. This will give them a better range of choices, make the health care market more competitive, and keep insurance companies honest.”
In his letter, the President also stressed that “reform cannot mean focusing on expanded coverage alone. Indeed, without a serious, sustained effort to reduce the growth rate of health care costs, affordable health care coverage will remain out of reach. So we must attack the root causes of the inflation in health care.” He then points to the large multi-specialty medical centers, where doctors work on salary, that HealthBeat has pointed to as models for learning how to provide more effective care at a lower cost: “ That means promoting the best practices, not simply the most expensive. We should ask why places like the Mayo Clinic in Minnesota, the Cleveland Clinic in Ohio, and other institutions can offer the highest quality care at costs well below the national norm. We need to learn from their successes and replicate those best practices across our country. That's how we can achieve reform that preserves and strengthens what's best about our health care system, while fixing what is broken.”
Go read the rest of her post. She will write a fuller commentary later.
Meantime, I was hit with a fantasy and left the following comment at her blog.
Addendum, a few minutes later...
Little did I know as all this was coming together that a similar discussion was already under way at The Health Care Blog.
Should We Open the VA to All Comers?
Perhaps the idea is not as far-fetched as I imagined.