Debating the President’s Portsmouth pitch (part 12)
13 August
We continue debating the President’s health care pitch at the Portsmouth town hall:
THE PRESIDENT: Another way of putting this is right now insurance companies are rationing care. They are basically telling you what’s covered and what’s not. They’re telling you: We’ll cover this drug, but we won’t cover that drug; you can have this procedure, or, you can’t have that procedure. So why is it that people would prefer having insurance companies make those decisions, rather than medical experts and doctors figuring out what are good deals for care and providing that information to you as a consumer and your doctor so you can make the decisions?
The quote takes on a whole new meaning if you insert a legislative detail that the President omitted. I’ll put it in brackets:
So why is it that people would prefer having insurance companies make those decisions, rather than medical experts and doctors [chosen by the government] figuring out what are good deals for care and providing that information to you as a consumer and your doctor so you can make the decisions?
In a world of limited resources, we cannot just make decisions about medical care based on whether an additional treatment provides a medical benefit. Someone must instead decide whether that benefit is worth the cost. The third MRI on the sprained wrist may provide more up-to-date and useful information, but the benefit is probably small compared to the additional cost. Someone must have authority to decide whether additional care is “worth it.” That person must control the dollars. Ultimately, the health policy debate comes down to the question: Who should make the cost/benefit decision? The pending legislation would move some of those decisions from insurers to the government.
I think it’s a mistake to have government make more cost-benefit decisions on our behalf in part because people are different. The President is talking about government policymakers (who would also happen to be medical professionals) making determinations about “what are good deals for care.” But cost-benefit tradeoffs depend on the particular medical conditions, situation, and preferences of the individual. I would like more of these decisions to be pushed away from insurers to individuals and families, rather than to people chosen by the government to make those tradeoffs for us.
Continue read the next post in this series…
Other posts in this series:
- The President’s overpromise that everyone can keep their health plan
- Putting the government in charge of your health insurance
- Waiting in line
- Government-mandated benefits
- Preventive care does not save money (in the aggregate)
- The House bill would increase short-term, 10th year, and long-term budget deficits
- The President was incorrect — AARP opposes the bill
- The bills would take Medicare savings needed for solvency and spend them on a new entitlement
- Medicare is not a good example of government-run health care because Medicare is fiscally unsustainable
- Even if the public option drops out of legislation, other parts of these bills would put private insurance under government control
- The President says the public option will keep private insurers honest at the same time he proposes cutting payments to private insurers competing with the Medicare public option
Related Posts
(best matches are listed first)- Debating the President’s Portsmouth pitch (part 14)
- Debating the President’s Portsmouth pitch (part 16)
- Debating the President’s Portsmouth pitch (part 17)
- Debating the President’s Portsmouth pitch (part 15)
- Debating the President’s Portsmouth pitch (part 19)
- Debating the President’s Portsmouth pitch (part 2)
- Debating the President’s Portsmouth pitch (part 13)
- Debating the President’s Portsmouth pitch (part 1)
Good Lord, am I confused.
On several series postings, I see the strike throughs, as is the points Keith made are now being retracted. Although on the latest post (no. `12) I see the strike throughs are removed.
Most importantly, would someone tell me about the deficit issue. I have heard it claimed that the CBO now says there is no deficit in the latest plans, and that is something Keith implies in an early posts – but then he says it barely meets nuetratlity.
Which is it?
The strikes, I believe, are just a glitch on the site. The different CBO scores I think are because the house has sumbitted a revised bill. You also have to keep in mind most people are refering when talking about the problems because it's the one most of us have sen for ourselves and read (You know the 1018 pg. on HR 3200 I think ) There are several bills out there we haven't seen. The senate also has one. The nuetraility that CBO is refering to is matching the debt that medicare would naturally incur on it's on if healthcare was left alone over the next 10 years. Let me see is I got this, Medicare is" unsustainable" and will be broke in 10 years anyway. Obama claims he can put 47million ( give or take because all 47 mil won't be covered) more people on a public option save money they would use in Medicare plus charge us premiums and taxes and remain deficeit neutral all while maintaining medicare with cuts to its program . So what he mean I believe is at the same cost medicare would cost over the next ten years according to what bill or plan he is refering to doing that I do not know and I don't think Obama knows either.
Don't the insurance compnaies have the same medical and actuarial experts making these cost benefit analysis? Becuase a test or procedure is not covered, does not mean the treatment can't be requested. It only means that your insurance (group of policy holders sharing the risk) will not pay for the cost.
I would not use the word "rationing" to describe what insurance companies do – it is not really comparable to how the Obama plan would work. Depending on what private plan you may have today, there are different levels of coverage and for the most part, most procedures and drugs are covered if they are prescribed or recommended by your doctor. And most plans encourage second opinions. I do not call that "rationing". It is the competition among the private carriers that allow us, or at least for most us, or employers, to choose what plan we want. And often employers will allow employees to choose between an HMO plan and PPO plan depending on how much the employee may want to pay. This is what I call CHOICE. Do I think the current system can be improved? Yes. But let's slow down and not ram another poorly crafted and expensive bill (Trillions) down our throats. There are dozens of ways to make the system better – let's work together to find the best solutions and keep the government out of our private lives. Some people may like the government taking care of them, but I don't, and many others do not either. Thank you.
A few years ago, my employer offered (as usual) a few different insurance plans from which to choose. Before long, the word was out that Insurance Co ABC (if I could remember the name of the company I'd use the real name) was not a good deal. People had all kinds of stories about ABC being difficult to work with, about them denying coverage, about them questioning treatments recommended by doctors…people were very unhappy with ABC. The following year, that company was no longer among the plans offered to us.
That's how it should work. If I am unhappy with my insurance company, I should be able to choose a different one.
I'd go further and suggest that insurance be divorced from employment. Let's flip the tax benefit for buying insurance from the employer to the individual. Give ME the tax benefit and let ME find my own insurance. We already do it that way for home insurance and car insurance–why not health, too? Even better, let me shop for health insurance anywhere in the country; don't limit me to a single state.