Monday, August 31, 2009

The Creator of the Obama Death Panel Myth Speaks

Last week the “Daily Show” aired an interview with Betsy McCaughey, widely considered the creator of the Obama death panel myth. Dr. McCaughey is the former Lieutenant Governor of New York State and has a PhD in history from Columbia University. Dr. McCaughey never actually used the words "death panel." In fact it was failed Vice Presidential candidate and failed Alaska Governor Sara Palin who, inspired by McCaughey’s comments, coined the term death panels. Nationally prominent Republications soon joined in. Here is Senator John McCain supporting Palin’s comment (click here). And here is a video of Republican Party Chairman, Michael Steele agreeing with Palin (click here).

The interview between Betsy McCaughey and Jon Stewart is available on the Daily Show’s website (click here to view it). It’s an amazing spectacle. I urge you to view it and draw your own conclusions. If you would like to read the relevant section of the health care bill follow this link. (See pages 432-434). It is amazing that an educated person could read this bill and conclude that the bill is in any way creating anything that could be considered a death panel. It’s more amazing that so many serious national politicians believe it does.

Thursday, August 27, 2009

Should Obese People Pay Higher Health Insurance Premiums?

I was at dinner the other night with several friends and naturally healthcare reform came up in conversation. One person suggested that people who are obese should be charged higher health insurance premiums than people who are not obese. This proposal has been gaining support. While it is currently not in any of the health reform bills I have looked at, I have been hearing more and more people making this suggestion.
Before I comment, I would love to know what you think.

Tuesday, August 18, 2009

My new favorite Member of Congress

This morning, while drinking my “morning Joe” and watching the MSNBC TV show by the same name, I saw my new favorite member of Congress. He is Anthony Weiner, a Democrat from Brooklyn, New York. I assure you my admiration for Congressman Weiner has nothing to do with the fact that I am also a native Brooklynite. My admiration for Mr. Weiner comes from his cogent defense of the “Medicare for All” proposal. Medicare for all would work like this. Currently the government-financed Medicare program pays for healthcare for Americans age 65 and above. “Medicare for all” would lower the eligibility age to birth. Even people without jobs would have access to health care. Your employer would be relieved of the responsibility of providing health insurance, and if you changed your job you would no longer have to change your doctors.

Medicare for all currently lacks the 218 votes needed to pass the House of Representatives. I talked with Congressman John Conyers of Michigan about the proposal back in the spring of this year. As of that time there were 86 co-sponsors (including Conyers and Weiner). It’s an even bigger long-shot in the Senate. The politics are too complicated. But, the policy is sound. Several months ago at the beginning of the healthcare reform process a fellow patron at my barbershop (knowing I am a health policy professor and believing my job title meant that I knew something about health policy) asked me how I thought healthcare reform would turn out. My answer then as now is: We will probably pass something this year that will be a slight improvement (for example disallowing health insurance companies from declining people for coverage because of preexisting health conditions), but the 2009 “reforms” will not address the major healthcare problems (rapidly raising costs, too many Americans without access, inadequate quality, and inequality in access and quality), then we will muddle along for 20 more years before we are finally left to conclude what Congressmen Conyers, Weiner and at least 84 others have already figured out. Medicare for all, while imperfect, is the best option.

Friday, August 14, 2009

As with Medicare in the 1960s, Dems should do it alone

Like most health policy professors I have been thinking about healthcare reform for years, so when the issue finally took front stage I was elated. I strongly supported President Obama’s objective of working with Republications to find a bipartisan solution, so although I favor Senators Edward Kenney and John Dingell’s “Medicare for all” approach, I understood that would never secure Republican support. So I got behind the President’s strategy of taking single payer off the table. But now, I must conclude I was wrong. There is no hope for biparti sanship. Republications have no interest in solving the healthcare problem. They merely want to see the President defeated. Republican Senator Jim DeMint made the strategy clear when he fashioned healthcare reform as President Obama’s Waterloo.

In last Tuesday’s New Hampshire town hall meeting, President Obama gave a “shout out” to Republication Senators who he felt were working in a spirit of bipartisanship to find solutions. Said the President, “now, I think that there are some of my Republican friends on Capitol Hill who are sincerely trying to figure out if they can find a health care bill that works -- Chuck Grassley of Iowa, Mike Enzi of Wyoming, Olympia Snowe from Maine have been.” (Click here for the text of the President’s remarks).

Less than 24 hours after the President’s “shout out” Senator Chuck Grassley was caught on tape spreading the "Obama death panel" lie. At an appearance at a town hall meeting in Iowa Senator Grassley told the crowd they were correct to fear that the government would "pull the plug on grandma."

Where did the death panel lie originate? Republication Senator Johnny Isakson of Georgia proposed that doctors be reimbursed by Medicare for time spent counseling patients and their families on end-of-life decisions, such as making a living will, or informing doctors about the patent's desire whether or not to remain on life support. This inherently reasonable Republican proposal somehow morphed into Obama's “death panels.”

Senator Grassley is not alone. Other national Republication leaders are also distorting Republican Senator Isakson’s proposal and acting as if the proposal was made by the President. Perhaps the most egregious case came from failed Vice Presidential candidate and failed Alaska Governor Sara Palin who went as far as to state that “Obama's death panel," might kill her infant son, Trig. “The America I know and love is not one in which my parents or my baby with Down syndrome will have to stand in front of Obama's ‘death panel’ so his bureaucrats can decide, based on a subjective judgment of their ‘level of productivity in society,’ whether they are worthy of health care. Such a system is downright evil.”

So here are three facts that seem to be getting lost in all the noise:

(1) President Obama has not presented ANY healthcare plan. He has left it to Congress to work out a bill.
(2) There are proposals making their way through the House of Representatives, but there still is no final House bill.
(3) The Senate has not even written a Bill yet.

Tuesday, August 11, 2009

The President's Town Hall Meeting

The president appears to be taking a new tack in his effort to make the case for healthcare reform. I watched his town hall meeting from New Hampshire today. He made all the right arguments. He focused on the personal stories of individual Americans who had suffered in the present system. He defused the lies and rumors… death panels, and such. I always get a chuckle when I hear people rant against “government healthcare” while insisting that the government not “mess with their Medicare.” But, most importantly he responded to the reasonable concerns that people have about healthcare reform. For example, one man suggested that a public option would inevitably kill private insurance companies, since “no company could compete with the government.” President Obama’s deft reply was that Federal Express and UPS are able to compete effectively against the US Postal Service, and in fact it is the USPS that has the constant financial problems. Another man asked about tax increases. The President pointed out that the previous administration (self-defined as fiscally conservative) added a new pharmaceutical benefit to the Medicare program without figuring out how to pay for it. Many of the same members of congress who now express concern about costs of healthcare reform voted to create this new benefit even in the face of massive income tax cuts, two wars, and a mounting budget deficit. My only quibble with the President’s message is on the cost issue. If you provide care to 47-50 million people who currently don’t have access to care, you are going to have to pay for it, and there are only three possibilities. (1) Increase revenue by raising taxes, fees or some other device; (2) cut services somewhere else in the budget; (3) add the costs to the deficit. None of these are pleasant options. However, in the end one of these things will have to be done.

Thursday, August 6, 2009

Mental Contortionism Reigns

Healthcare reform is very complicated to explain, but very easy to distort. And, opponents are doing a great job of distortion. Their mantra - do you trust the government to run healthcare? - dredges up images of your last visit to the Department of Motor Vehicles. Now, that is scary! The fact that Medicare is a government run program somehow seems not to matter. I watched Keith Olbermann tonight with absolute awe and wonder as Medicare recipients shouted down Congressmen Ross and Snyder at a town hall meeting in Little Rock. Their demand? They didn’t want government to take over their health insurance - Medicare. Wow!

But, it is a particularly impressive act of mental contortionism to hear an actual sitting member of Congress warning Americans about the risks of “government run medicine” when government run medicine is precisely what Congress has voted to provide to the military, veterans and (most interestingly) themselves.