When conservatives rewrite history, as they frequently seem to do, we will go directly from Clinton to Obama, with the two being responsible for all our problems. As I’ve noted previously, during the Bush years everything was Clinton’s fault. No matter what the problem, to conservatives it was inherited from Clinton and not Bush’s fault. Now conservatives are beginning to ignore the Republican domination of government the past several years, along with both programs and problems beginning in the Bush years, and blaming everything on Obama. This includes imaginary problems from improving health information technology.
There is little doubt that we will see expansion of government in certain areas during the Obama years (along as declines in government action in other areas). Conservatives are certain to ignore the fact that this is in response to problems which developed when the Republicans were in power, and that many of the examples of increased government they oppose began during the Bush years.
I’ve previously noted the scare tactics conservatives are using with regards to health information technology. Ezra Klein has another example from a highly inaccurate column by Amity Shlaes on the topic:
The administration seems almost to relish the sinister aspect of government-run health care. Otherwise it wouldn’t have created a position called “National Coordinator of Health Information Technology.” That’s a title worthy of Rhineheart, Neo’s boss, who tells him, “This company is one of the top software companies in the world because every single employee understands that they are part of a whole.”
Ezra responds:
This idea that the stimulus bill “created a position” called “National Coordinator of Health Information Technology” got its start in another Bloomberg column written by Betsy McCaughey. She called the National Coordinator of Health Information Technology a “new bureaucracy.”
But this just isn’t true. It’s not sort of true or arguably true or caught in arguments about the nature of truth. George W. Bush created the position of National Coordinator of Health Information Technology in 2004. Five years ago. The current director of the office is a Bush appointee by the name of Robert Kolodner. He has served there since 2006.
Shales’ column is packed with distortions. She began her column by trying to compare health care reform to The Matrix. The comparison does not hold up at all, as Steve Benen discussed.
There are certainly arguments which might be raised against Obama’s proposals on health care reform. Medical information technology is not the panacea to increased costs, but it is also not a horror out of The Matrix. If only conservatives such as Shales could stick to the real issues as opposed to resorting to these scare tactics.
For obvious reasons, any reform of the health care system that does not benefit the insurance industry is anathema to the corporate-commercial economic establishment. How many Medicare supplement plans, HMOs, PPOs, and hospital corporations advertise on television every week? Every one of those organizations goes out of business if single payer is ever passed, and they all take big hits to their profits if an affordable government backed policy of the kind President Obama promised during his campaign hits the market. If it is truly reasonably priced, and truly covers quality care, the competition it presents to established corporations will draw prices down across the market.
Couple this with bad economic times and health management corporations and insurance companies in the health business are naturally worried for their survival and will do what they feel necessary to protect their interests.
I think truly substantive reform that lifts the burden of paying for national health care policy (which, if there is to be a national policy, is the government’s job) from American business is necessary for the economy. I think truly substantive reform that guarantees quality medical care (as opposed to ‘universal coverage’, which is not the same thing) to every American citizen is morally necessary by any standard of decency, even ethically necessary by the rules of the medical profession.
The problem is that such specific reform completely changes the nature of the health care industry in America and many Americans do not appear willing to face that.
The health insurance industry is willing to accept health care reform much more now than in the past, seeing this as preferable to a growing number of people being lost as customers because they can no longer afford coverage.
I bet that one aspect they will fight is having a the option of a public program such as Obama proposed. They know that they would have difficulty competing with a Medicare-like program. It would also be interesting to see how many Republican voters, who might now say they oppose “socialized medicine,”would go for the government plan if it provided quality care at a lower cost (as Medicare does in its market). (Of course single payer is not socialized medicine as with the British system as there would still be private providers of health care being paid through the government as opposed to private insurance companies.)
One compromise might be to have a buy in for Medicare available for people starting in their 40’s or 50’s. This would still leave the younger population available for the insurance industry, while providing an option to the age range which has more trouble finding affordable coverage.
Single payer would not entirely put all the insurance companies out of business. Medicare works with a series of intermediaries–basically insurance companies which handle the day to day administration. This is a minor point which does not really change your argument as the insurance industry would still come out way behind with single payer and would certainly fight this.
I believe the health care industry wants the McCain plan as their ‘dream scenario.’ A completely open national market with state lines erased so that providers in the least regulated states could short circuit the requirements of the most regulated is exactly what the industry would like to see in the way of ‘reform.’ I have to admit to skepticism about willingness beyond that level. What I have read from the industry skews one of two ways: the acknowledgment of the need for single payer or even ‘socialized medicine’, mostly from doctors, or the denial of the need for what I would call ‘real’ reform at all but merely a modification of the existing system to extend ‘coverage’ to more individuals in some manner that makes them money even if the government foots the bill, this mostly from businesspeople.
I agree with you that the Federal coverage program would be fought tooth and nail, but I think it is the very least of what is necessary. I think, when it comes to the Republicans, it depends. Republicans don’t mind government programs if the government pays inflated costs and the industry makes more money than it would under normal circumstances (forgive my cynicism please) but are leery of anything that would actually lower costs because of their economic theology.
I think a transformation from multi-billion dollar entities to bureaucratic intermediaries would be close enough to ‘out of business’ from the perspective of the health industry. However, you are correct to correct my semantics. 🙂
It probably depends upon which aspect of the health care industry, and there are likely to be differences of opinion between different individuals.
Insurance companies would like McCain’s plan from the perspective of being left free to do what they want. On the other hand, this would do little if anything to change the problem of less and less people being able to afford coverage.
In the long run the insurance companies do need a change which would allow them to continue selling their product. Therefore they might prefer something like the Massachusetts plan which would greatly increase their number of customers.
Most states have done this with liability automotive insurance, and said states are full of people with the minimum mandatory liability coverage… but still, no one really has collision insurance, and that’s what people really need.
My problem with a Massachusetts plan style program is that I foresee too many people getting the equivalent of the cheapest available liability insurance when they really need collision. Metaphorically speaking. If qualitative care were mandated and prices regulated either by statute or by the provision of a government plan to set a standard, it could work. But in that case, I don’t see the insurance companies loving it, not if they actually have to pay for health care in return for their money. If they don’t, if they can get away with selling the equivalent of cheap liability insurance to meet statutory requirements (as is currently the case, to the best of my knowledge, IN Massachusetts) then it really doesn’t matter if everyone is ‘covered’ or not. But sure, they’ll love it.