The 5 key Strategy Questions the White House is Considering on Health Care

I hope those aren't the questions. Because universal coverage isn't the final goal, the final goal is a market structure that will drive US spending on health care down to inline with all the other first world nations. The US could *save* $1 trillion a year if we spent the same per capita on healthcare as the other first world countries. $1 Trillion PER YEAR in the private or public pocket is HUGE. How to save that money is the goal of reform. Universal coverage and a public option are just the two clear ways that every other first world nation has used to achieve that incredible cost savings.

As a sidenote, referring to the cost as $700 billion without giving the timeframe is atrociously poor reporting. I believe you mean $700 billion over ten years - not $700 billion a year, nor $700 billion to fund it in perpetuity.

George, you've got your questions backwards. First you want to kill the public option, then you want to figure out whether any Republicans would still support the bill after the store's been given away.

If no Republicans will support the bill no matter what's in it (which seems increasingly likely), there's absolutely no reason to kill the public plan. It can win with Democratic votes if the Dems hold together.

The President and Congress would do a disservice to all to drop the public option and movement towards Universal Care for the sake of special interest money, re-election self-preservation and a party seemingly dedicated to obstructionism relying on lies, fear and a worked-up radical fringe.

The Public Option is -wanted- by a majority of Americans. And President Obama and the Democratic majorities were voted in by people wanting REAL change, not business as usual in Washington. The Public Option -is- the compromise.

It's bad enough that the health care reform debate came to the table without the Single Payer option even being on the buffet to discuss. After all, many who are distrusting of govt would lose steam or perhaps even find reassurance in knowing that all government officials, including the Congress, would have the exact same plan and healthcare realities as they.

There is not near enough attention being paid to examining the realities of for-profit insurance within this system.

US Insurance CEO's average a 11.9 MILLION salary. Their profits are up 400% from 2.4 B in 2000 to 12.7 in 2007 - while those Americans without insurance grew 19% during that same period. In the Clinton era (remember that, when we were regularly shown pictures of the insurance/HMO company CEO's gated luxurious compound estates?), 5 cents on every health care dollar went to profits. That number has risen to TWENTY CENTS per healthcare dollar. 31 cents including overhead and administrative costs, apparently. In Canada, it's 1.5 cents.

Not to mention the extraordinary amounts of money that pharmaceutical and insurance industry lobbists are pouring into our "representative process" and advertisements. Money that could and should be going to healthcare needs.

The WhiteHouse reports that insurance companies denied healthcare coverage due to for Pre-Existing Conditions to 12,600,000 citizens within the past 3 years. For those who are allowed to get that insurance, the premiums are higher - often impossibly so.

Co-ops were tried in 30's-40's and FAILED. The funding was cut off.They don't affect Insurance pricing, % of GDP or consumer price. Co-ops that become actual competition (e.g. BC/BS) are bought up & run by Insurance Industry to keep prices steady and preserve the status-quo.

Then look to the Grassley ad airing now, in which a Republican points out that people -want- a public option, including Republicans. He also points out the nearly 3 million dollars Grassley has received from insurance lobbiests and asks whose side the senator is on.

Where are the comparisons to Social Security and Medicare obstructionism? Where are the highlights on the for-profit interests driving our healthcare system, creating a situation in which the American citizen is a causality of competition instead of a benefactor of it when it comes to health care in the US?

I personally know of US citizens on disability who have to buy their medications in Canada (for a fourth the cost) because they can't afford them in the US and were having to choose which essential medication they would refill month by month. Far more US citizens go to Canada or Mexico for their healthcare than the other way around. Medical-related bankruptcies are an epidemic. We all know this system is inherently broken and people are suffering. Medical professionals included in that number.

I can't say it better than two Republicans said it just yesterday.

Bob Lupton, in an article entitled 'Republicans Want Health-Care Reform Too!', stated the following: " I am coming to believe what the rest of the modern world has concluded — that health care is a basic human right. To be last in line of industrialized nations to provide medical treatment for all our citizens is not something I am proud of....Do I like what Obama is proposing? Actually, I do!"

John Bohrer wrote "The tide is about to turn in the debate over health care reform. The lies and the screaming that captured the discussion in August have a lot of Republicans thinking they've got the Democrats right where they want 'em. They are wrong. And they are wrong because their castle is built upon a pile of sand... a pile of crazy, crazy sand.... David Brooks points to Obama losing support among independents, supposedly frightened of debt tied to his health care reform. What Brooks does not acknowledge is that they're not so much opposed to reform as they are confused as to what it will do. It's hard not to be confused with so many lies being so carelessly tossed around... But once the din dies down, and the conversation moves on to the why and the what behind the opposition, Republicans are in for a rude awakening. Because people want change -- not a restoration. And here the Republican Party is utterly unprepared. Their alternatives are lousy....Nor, as Tanenhaus suggested, have they pushed the lunatics and extremists away from the debate; if anything, they've pushed them to the front."

If TRUE reform does not happen which SERVES the American people, it only breeds MORE distrust in the government - on the left and in the middle. Is the American system of democracy broken? Should we trust it to work for us, the people?

There is a lot of talk about a 1 trillion dollar figure. According to Weiner, we could save a trillion in 10 years just by reducing costs 10%. The question is whether the politicans have the will to do what it takes to get there.

And one cannot help but look at the media's responsibility in this as well. By and large, our news coverage of this has looked like the worst of the very bad reality tv shows and highlighted mentalities and activities that shame us.

The industrialized world is filled with great examples to draw from as to what works. Where is the American spirit to learn from those models and tweak what does not work about them so we can take pride in saying truthfully that the US does it best?

We need our President and Congress to set the bar and insist on nothing less.

This is not a political game show of strategy. It is people's lives we are talking about here. People who need help yesterday and live in true fear. And the American people are watching.

Most Americans will happily support true health reform, which must include tort reform. Why has Obama taken tort reform completely off the table when it would save 30% of health care costs? Could it be the huge money donated to Democrats from the trials lawyers association? Jees, this group in Washington is as bad as the Bush group - just different special interests buying them off.

What in the world is going on? The problem for the prez is how do we communicate this to the public?

The public's problem is how do we communicate with a government that instead of serving us keeps trying to sell us more government?

Now HE has enlisted the AFL-CIO and the AARP to try to sell us.

All the more reason to back off and drop membership in both AFL-CIO and AARP!

Stephanie2009 You as most liberal just dont get it. The gig is up, America has said no to the Goverment run healthcare which is where Obama was heading with this boondoggle. The dems have no choice now, they can go with the libs and meet certian death in 2010 or go with mainstream america and try and salvage their political careers. they will choose the latter.

We should first of all admit that the people who put together the current plan did a terrible. A plan like John Mackey's of Wholefoods fame, is a much better plan that actually reduces costs by increasing competition. Further it reduces costs by cutting the insurance paid by doctors for malpractice.

None of the proposals put forward by congress actually reduce the cost of procedures. They mainly reduce costs by encouraging old people not to get treatment.

George, since you're talking to your buddies at the White House, maybe you can ask them why they want to sacrifice the public option, when polls show overwhelming support for it among voters?
Look, history (your history, George)shows that the failure of the Clinton administration to pass health care doomed that generations equivalent of the Blue Dogs. That means that, whatever they say, if Obama says the bill needs a public option, the Blue Dogs will back down.
On the other hand, the Progressive Coalition has no incentive to back down. Indeed, the only way they lose support and get primaried is if they cave on the public option.
I don't know who's calling the tune over there at the White House, but apparently they're not terribly good at math.

It's simply a question of taking control of the dialogue on reform. The downward spiral will continue as long as the conservative myths get more traction than the White House talking points/the facts.

The Democrats have 59 Democratic Senators. If they just add Olympia Snowe then they will have 60 Democratic Senators and thus they will NOT have to go through the reconciliation process.

George,
It seems to me the White House has to ask itself "What is the proper role for government in health care?"

To many Americans, that role should be one of providing a safety net, not attempting to gain complete control as in the overreaching House bill HR 3200.

Obama needs to scale back.. simplify...

Democrats and Republicans alike can agree no one should lose their home or face bankruptcy due to costs of an unforeseen illness.

Let the government underwrite the costs of catastrophic illnesses so no American is ever put in this situation.

Americans can then purchase gap insurance that would cover anything up to the catastrophic amount (let's say $5000-$10,000). Private insurers could provide cheap gap coverage knowing they would not have high risks. Everyone wins.

Lower income Americans can be subsidized for premiums for the gap insurance on a sliding scale.

So there. We have covered every American while drastically lowering premium costs across the board. All without creating an onerous government plan and extra bureaucracies.

You might want to pass this idea on to your buds at the White House.

Where has he been?????? oh yeah VACATION

Oh please, George.

Obama will give up the public option AND the mandates, and pass a bare-bones "Healthcare Bill" just to say he did. Then he'll move on, quickly.

The left won't like it, but Obama knows they have nowhere else to go. He'll cut them loose as quickly as possible, just to save his own butt in 2012, and to preserve his "brand," as his staff calls it.

It's who he is, and who he's always been. All the rest is noise.

Get the cost down to $700 billion over ten years?

Oh goody. That's a great way to save money.

This really is insanity.

Jerry J | Sep 2, 2009 1:13:45 PM - Good post. I have been proposing the same thing, but not getting traction. The primary change to what you said is to set the $5-10,000 to a percent of income of the person. Also, I would probably set a limit of $50,000 per year for what Insuance company will pay per person. After that, the insurance company and government will each pay 50%. That way the insurance company still have to monitor costs and government can just audit to be sure insurance companies are not cheating all of us. These are just variations on the basic concept you are proposing.

Save the sick from the profit sharks!
Make Healthcare and Pharmaceutical industries not-for-profit.

Save the sick from the profit sharks!
Make Healthcare and Pharmaceutical industries not-for-profit.
Posted by: Robert | Sep 2, 2009 1:42:53 Sorry Robert he already made a deal with the pharma not to reduce cost.

Things that must be on the table for any true health care reform: 1) Tort reform, 2) free market competition amongst the existing insurers without restriction, and 3)NO universal healthcare or single payer system.

That is what main stream America is after. True reform without a government take-over.

The people will not stand for the plan set forth. Period.

billy bob | Sep 2, 2009 12:39:30 PM. If the republicans prevents a health bill from going through because of lies, then they will be the ones in trouble in 2010. We cannot continue to live with the current system when it costs about 12% more every year and rations health care to the rich and those that can afford a good health insurance plan. Many Americans can only afford the one their job provides them (which is sometimes lousy)because they cannot pay 100% of a good plan from another provider. It seems strange to me that the wealthest nation on earth has been rationing the health care for decades so the rich don't have to wait in line.

John Mackey's reform plan is to deny anyone who is sick any access to real healthcare. They would be stripped of consumer protections and lose access to group health plans and be left to the mercy of insurance companies. But, it's OK. They can shop at whole foods and magically be cured! Let then eat organic cake!

If the white house throws away the public option, they will get crushed in the midterms. The base will stay home and not give money or time. They do not realize how important the pubic option is most Democrats. We are tired of our leaders betraying us. If dems continue to act like republicans, then there is no reason to vote for Democrats.

Triangulation is a stupid strategy. Good po.icy is good politics. Democrars won the election. It's time for them to act like winners.

jhw539: Good luck making the case that we can save a trillion per year when we already have seen the "incremental" plan is costing a trillion per. Suddenly you're claiming a 2 trillion swing?

David: Republicans are pushing for market based solutions. Right now it seems to be "How about Universal Healthcare now?!" "No." "Ok, how about Universal Healthcare later!?" "..."

Hopefully some good comes of all this. Somehow.

Rick McDaniel - Which plan are you referring to? Also, none of these plans come from the President. He is doing the opposite of what Clinton did, he is letting Congress work out a plan. However, it is time for him to step forward and indicate what he likes and dislikes about each plan to narrow the focus of discussion. And the bill needs to be much smaller. It is too easy to hid things in 1000 page bill.

Ed Taylor

No, it's you like most...I don't even know what to call it these days given true Conservatism is apparently dead, who don't get it.

The majority of Americans want a public option. We don't want people left behind. We don't want people bankrupt by medical disaster. We don't want people going without necessary and preventive care. We also voted for real change including true healthcare reform -by a much larger margin than Bush won with in what was considered a questionable election. We cast a vote for people over corporations this time. Soundly.

Paranoia, blantant ignorance and fearmongering have distorted the process - tactics the insurance industry itself created and the GOP apparently supports even while allowing it's own credibility to be further denigrated.

Corporate for-profit interests have no role in the health insurance business. The health of our people is not a commodity to be bought, sold and profited from. Removing that from the equation - or at least providing viable options from the public sector - does not destroy healthcare. It improves it. The rest of the industrialized world proves it.

And competition is as American as apple pie.

You can conveniently write me off as a liberal, but you write off the Independents and Republicans who recognize the insanity and inhumanity of our healthcare system and whose lives are being very severely touched by these very real issues every day in the process. Writing them off in favor of very vocal, ignorant people who scream "Keep the government away from my Medicaid!" and people who benefit from the status quo.

The sad thing is, though, that this system is costing all of us and people who think they are protected are one lay off or health crisis away from finding out otherwise. I should know. I'm one of them and I work with countless others. Heck, nearly everyone has a story. Many of them are tragedies.

Unregulated free market philosophies and practices are destroying the fabric of so many sectors it is ridiculous.

Even if you are right, though, and it would mean one term, going out after making real change in one term is more honorable than preserving a career and the status quo. At least people could preserve faith in the process or ONE of our parties that way. This system is a travesty and a national disgrace. People need someone fighting for them.

I'm not saying the proposal is perfect. I'm not saying it cannot be improved. It is surely a compromise from what I believe is right, just and most efficient, effective and American, too.

I wish desperately that the month of August had been spent with the Congress and the American people looking objectively at what works and what doesn't work in other countries that have much better ratings on healthcare and health than we do and figuring out how to create something building on those strenghts as well as our own and correcting those flaws. We didn't. We chose to have an unproductive, unreasoned viewing at the zoo instead. And now we are back to ground zero.

If the WH thinks they can give up the public option and keep their base, they don't have advisors that have a clue about Obama's base. He appealed to people with a message of change and his two main campaign issues were ending the War and health care reform with health care for all Americans similar to what people in Congress have. The only way to lower costs and provide that kind coverage is through a public plan. His core supporters were activists. Activists are not your typical voters. They will drop him like a hot potatoe is he betrays them and drops the public option. It doesn't matter if they have no place to go right now, they will sit out until they re-group. If the WH does not know this, they are not nearly as smart as they think. The beltway pundits have lost touch with Americans. Americas pay for healthcare every single month out of their paychecks or checking books. They know the cost are rising, the benefits are shrinking and the private market are shafting them. They expect Obama to offer up a government plan that works for them. Medicare, SCHIP and Tri-Care all work. Blue Cross, Aetna, Wellpoint, US Healthcare don't work for the consumer, only the insurance executives.