Health Care: Obama vs Insurers

Two articles in the last week have done an interesting job of describing the current state of health care reform in Congress. The first is Obama's Op-Ed in the NY Times on August 15, laying out the basic principles of his coverage plan. The second is Business Week's cover article from August 6 titled the Health Insurers Have Already Won.

Both articles are informed by our previous health care discussion which focused on health care costs


  1. The two thoughts that immediately jump to mind when reading these articles are that 1) I am glad we are trying to get some positive health care reform going. I would be disappointed if this all got shot down and nothing was done.

    2) I'm concerned that nobody is addressing the root causes of a lot of medical spending, as we discussed after reading Atul Gawande's article (linked in the previous discussion). If unnecessary and unhelpful medicine is being performed, who is keeping an eye on this?

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  3. I'm also concerned by the BW article. Scott, I don't want to put words in your mouth but I know you feel strongly that we shouldn't charge the same premiums to everyone, because some people are more healthy than others. Or, if we want to do that, we might as well go all-out and apply universal health care.

    My concern is that the reason that option isn't even on the table is due ONLY to the influence of the insurance companies, which make billions of dollars a year. They are simply too big to just die, and so they fight.

    Is there any way to escape their influence, though? Otherwise we have to take these intermediary steps, right?

  4. This seems to be a great bureaucratic approach that solves some problems, but creates new ones.

    1) It is great that everyone will be able to get and keep coverage, especially in light of pre-existing conditions.

    2) I have absolutely no idea how "reform will finally bring skyrocketing health care costs under control, which will mean real savings for families, businesses and our government. We’ll cut hundreds of billions of dollars in waste and inefficiency in federal health programs like Medicare and Medicaid and in unwarranted subsidies to insurance companies that do nothing to improve care and everything to improve their profits."

    I would specifically like to see where the hundreds of billions of dollars in waste and inefficiency is going to add up.

    I honestly have no idea how insurance companies are going to be able to cover everyone and every condition AND lower premiums. I do understand that with a large enough pool, insurance companies can more accurately predict costs and claims, but I don't think any individual company is capable of this.

    My less educated guess, is that there will be a few for-profit insurance companies that will decide it makes more fiscal sense to liquidate everything and close shop than try to pay for everyone's care with increasing premiums.

  5. Point #2 is valid and the most important aspect of this. Details will hopefully emerge when Congress reconvenes.

    I pulled the following detail about DHEA's legality from our PEDs in the NBA article, but I think the following quote also applies to why insurers are getting such a big voice at the table in the above Business Week article:

    "(Also, as recently detailed by Jeff Passan at, DHEA is only legal without a prescription because of some wrangling by U.S. Senator Orrin Hatch of Utah, whose son worked as a lobbyist for a company that made DHEA. Another Republican senator, Charles Grassley of Iowa, has been trying to regulate DHEA for two years.)"

  6. A recent BW book review for Health Care: Lessons for America provides some interesting abstract info regarding other health care systems. I was heartened a bit by the following quote:

    'Despite opposition from insurers, drugmakers, and business, the plan passed by a bare majority and went into effect in 1996. Switzerland now spends 11% of its gross domestic product on health care, just as it did before. But everyone is covered, insurers are more profitable than ever, and its high-quality health care has been maintained.

    The lesson, as laid out in The Healing of America: A Global Quest for Better, Cheaper, and Fairer Health Care, by T.R. Reid, is that "health-care systems can be changed, even in the face of powerful...interests." '

    It's nice to know that despite a lot of opposition by those invested in making money from the current system, a developed nation was able to change things up and ultimately ended up better off. Hopefully we can make some positive headway.

  7. Another link on the health care topic, this one disheartenening. It's an Economist podcast of a conversation with Dick Armey - he leads a group of 700k conservatives, many of whom showed up at the town hall meetings - in which he makes me realize how much trouble we're all in if this is the kind of person defining our health care conversation.

    To skip the rhetoric, fast forward to the last two minutes for the Economist reporter's recap of the conversation. She does a fantastic job pointing out the, ah, gaps in his logic: "Like all politicians, Mr. Armey is prone to talking in circles and using hyperbole"

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  9. Our first, non-contributor addition...and it's the blog equivalent of a sales call! How depressing.

  10. Better than nothing? Nah probably not...