Sunday, July 8, 2012
Here I go Again
I thought I could turn the page and move on, but this health care issue is still at center stage, and my side doesn't want to defend the Affordable Care Act as much as the opposition wants to destroy it.
It's almost like defending the indefensible because most Americans have health care, and they worry about how we are going to insure 30 million more people, without jacking up their premiums. It's a legitimate worry and the government, regardless of the party, doesn't have a stellar record that instills trust.
The basic idea of consumers paying more for their own coverage to control costs is fundamental in both parties but the Republican plan doesn't expand coverage, so it leaves the market open for free loaders.
Fareed Zakaria, one of my favorite journalists and authors, said what I've been saying all along, “the markets work imperfectly in this realm." He quoted some studies conducted by the pharmaceutical company Novartis and McKinsey and Company showing a difference among countries with regard to a health- care efficiency.
For example: Smoking rates in France are much higher so the French population has a higher rate of lung disease. The French system is able to treat the disease a lot more efficiently and spends eight times less on treatments per person than we do. Another example is Britain, which handles diabetes far more effectively than the United States while spending less than half of what we do. The British System is five times more productive in managing diabetes than the United States.
The United States does better, battling breast cancer because of early screening and easy access to advance treatment, making us one of the most effective places to treat this disease.
What is common in the three examples? You guessed it, a systematic approach that gives all health -care provider's providers incentive to focus on early detection and cost effective treatments, and that makes wellness the goal.
Name me one politician or political party who would tell their constituents the absolute truth? By the truth, I mean, that they must accept the fact that these consumers will never be expert enough to know what product is best. Choosing between hundreds of policies may be a great free market idea, but it's unrealistic. Imagine any politician telling their constituents that they can lower their healthcare premiums by eating less, quit smoking and eating less junk food and seeking preventive care. For more you can read Fareed's article.
I read another interesting article by Donna Dubinsky, businesswoman who played an integral role in the development of personal digital assistants (PDAs) serving as CEO of Palm, Inc. and co-founding Handspring with Jeff Hawkins in 1995. I wish that she would have given the oral arguments before the Supreme Court.
Donna, after the fact, would have answered Justice Samuel Alito argument that most uninsured people either do not want to pay for insurance or cannot afford it, a lot better than the government did.. He said anyone can get health insurance.
Donna Dubinsky said if you're not employed, and you want to purchase insurance in the private market you cannot unilaterally to do so. An insurer does not have to accept you as a customer. And quite often they do not. Insurance companies prefer group plans because it spreads the risk. Can you blame them? The individual plan is a lot of work, a higher risk, and produces little revenue.
The Government Accountability Office found that on average, 19% of the applicants nationwide are denied. One-quarter of insurers denied more than 40% of the applicants they considered. The reasons were not limited to deadly illnesses. You can expect to be denied if you have asthma, if you take just about any prescription medicine, or if you are more than 15% overweight. Expect to be denied if your doctor has recommended any procedure for you.
The Supreme Court successfully framed what can now be considered the limited conditions of the commerce clause in the constitution.
Donna Dubinsky thinks the government failed in its response because(1) health-care is a service or product that everyone must have at some point in their lives (2) the market for that service does not function if it can turn away buyers.
You might ask, how about burial services? Good question,it passes the first test, but fails on the second because no seller of those services will turn your away.
Why couldn’t Congress pass a law requiring insurance companies to accept all applications? That obviously would fail because only sick people would seek insurance-because healthy people would wait until they got ill, knowing health Insurance was guaranteed.
The only answer for now is the Affordable Health Care Act because it expands the pool and spreads the risk.