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Fiscal reality sometimes even hits Democrats
Posted by: McQ on Thursday, April 24, 2008

As the pander-fest known as the Democratic primary toddles drunkenly on toward North Carolina, Congressional Democrats are beginning to try to lessen expections about healthcare reform- an unusual move in a presidential election year:
For some senators, the promises made by Sens. Barack Obama (D-Ill.) and Hillary Rodham Clinton (D-N.Y.) outside of Washington may not match the political reality on Capitol Hill.

“We all know there is not enough money to do all this stuff,” said Sen. Jay Rockefeller (D-W.Va.), a Finance Committee member and an Obama supporter, referring to the presidential candidates’ healthcare plans. “What they are doing is … laying out their ambitions.”
And, as usual, their ambitions come at the cost of real money from real citizens. While the citizens may see health care costs as something of concern in their lives, that doesn't mean that they're at all crazy about the idea of that sector being taken over by government, as recent polls have shown.

There's also that little bump in the road known as the opposition party:
But veterans on Capitol Hill say that getting a sprawling piece of legislation requires broad compromise from both parties and outside groups.

Should the majority party rush the issue through, the minority may hunker down — as was the case with Bush’s Social Security proposal and President Bill Clinton’s attempt at addressing healthcare policy.
Call it a gut feeling, but my sense is that any healthcare reform that does take place in the near future will be of the incremental type. I doubt, especially if faced with an economic downturn, that voters are going to be in the mood for the cost of such a "sprawling piece of legislation" nor will the opposition party.

All the other side has to do, in fact, is point to the unfunded future obligations of Social Security and ask "do you want to add healthcare to that pile of debt as well?"

I think the answer will be a resounding "no" before ever getting to the probable efficiency of such a program.
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Previous Comments to this Post 

Let us not forget that the Dems in Congress realized what a boner ClintonCare was and hardly gave it approval. They were more afraid of the "Harry and Louise" ads than they were of the Clintons themselves.

Do you think things would be different with a President Hillary Clinton or a President Obama? Dems overreached once before, and they tend not to learn their lesson.
Written By: James Marsden
URL: http://
Umm isn’t healthcare already by far the biggest part of that pile with medicare and medicaid? Isn’t addressing healthcare genrerally the only way to effectively address that big giant part of the pile? You know the part that dwarfs Social Security.
Written By: Retief
URL: http://
Be careful about using "Clinton" and "boner" in the same sentence.
Written By: Diffus
URL: http://
All the other side has to do, in fact, is point to the unfunded future obligations of Social Security and ask "do you want to add healthcare to that pile of debt as well?"

They could also point to the future time-bomb that is Medicare:
Yet baby boomers will start retiring and signing up for Medicare in 2011 — during the next president’s first term. And the program faces double jeopardy from rapidly rising healthcare costs and an aging society. Indeed, the trustees’ report released Tuesday showed that Medicare spending will surpass Social Security in 2028, and grow to almost double the cost of the pension program in 2082.
Medicare may be an even more sobering case study than Social Security for those who want a "single-payer" healthcare system, since a huge percentage of every dollar paid out goes to fraud. It is a reminder of the way government programs that sound good on paper usually run in practice.

Written By: Aldo
URL: http://
I think that a single-payer health care system would be far cheaper than the wazr we are fighting in a libertarian I distrust centralized power, UNLESS a good Leftist is proposing it, generally in a European-approved manner, then I am pretty much in favour of it.
Written By: Joe
URL: http://
Umm isn’t healthcare already by far the biggest part of that pile with medicare and medicaid? Isn’t addressing healthcare genrerally the only way to effectively address that big giant part of the pile? You know the part that dwarfs Social Security.
Correct. The healthcare system has already been broken by Democrats. Now they want to break it more.
Written By: Don
URL: http://
I think you’re right here too, McQ. There simply is no money to do a lot of what is proposed, and if we are in a recession that is more than a short dip, things are going to get much worse. Moreover, a national single payer plan, or even a national insurance system would be a bureaucratic nightmare. The only possible way to address the issue without that is to do it at the state level. Even that becomes a bureaucratic mess, especially with state budgets in crisis too.

Moreover, both parties are in this together — blaming the Democrats for a broken system betrays a lack of knowledge about how we got to where we are, many of these were GOP initiatives over the past decades. The system benefits a number of corporate interests, thanks in large part to government policies that reflect the desires of lobbyists. Both parties have created a system that is dysfunctional and starting to crack. Add an aging population and unhealthy lifestyles to the mix, and things are likely to only get worse.

I don’t know the solution. I think, though, cutting the power of big corporations and pharmaceuticals on policy makers, emphasizing the needs of care providers is key. A major health care reform along the lines of what Obama and Clinton propose would probably get shaped to fit the needs of those big corporate players, and not the needs of patients and providers.
Written By: Scott Erb
the power of big corporations and pharmaceuticals on policy makers, emphasizing the needs of care providers is key
Uh as USUAL entirely wrong the problem is not with providers but with CONSUMERS....HSA’s are the answer.
Written By: Joe
URL: http://
Best fix is probably the exact opposite of what is being proposed by politicians. Instead of increasing government control, deregulate insurance. Allow insurance to *actually* be insurance instead of a mere cost-shifting mechanism. Let HSAs flourish. Everyone comes out on top. Patients have increased access and better choice of care. Physicians are able to structure payment to match costs and time —> patients get better care.

The "one size fits all" approach of single-payer is an exacerbation of the most pressing issues of health care right now. The only thing it "solves" is the issue of cost-shifting. Costs will no longer be shifted between patients, government, and insurance entities; rather it will all be shifted to the taxpayer. Meanwhile, physicians are still paid based on the number of procedures they perform rather than the quality of care. With the inevitable central cost-cutting measures comes a compensatory attempt to increase output (procedures) in a fixed amount of time —> substandard care.

Put the consumer (patient) back in control of the almighty health-care dollar:
1) Patients have choice — now a patient can go the doctor they want rather than the one who has room for another medicare patient or the one their HMO allows them to see.
2) Expertise is rewarded — top-notch physicians will be more likely to take on primary care roles if the financial opportunity is there. Currently, primary care pays the least and thus attracts the fewest top-notch physicians.
3) Overall health-care spending drops — clearing out all the middle-men saves a lot of administrative dollars (no coding clerks needed at the office, no cost-saving specialists needed at the insurer, no billing specialists needed to try and coordinate all parties involved).

There was some blog called the Happy Hospitalist that floated a similar idea.
Written By: ck
URL: http://
CK, that sounds like a reasonable starting point for discussion, but the biggies — big government, big medicine, big pharmaceuticals, even big insurance — probably will oppose that.
Written By: Scott Erb
big government,
You’re ineducable, Boris. Everyone here understands that now. But just in case you’re seized with some sort of fit and that crash-test dummy that is your inner self loosens his grip, I will point out to you, for perhaps the 100th time, that big government is the enabler and keeper of all the other "biggies."

They are not equivalents.
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