The Pragmatic Idealist

This is a fantastic overview of the problem, the political and policy background, and the proposals on the table. Required reading, in my opinion. For an entirely different take, I highly, highly recommend This American Life 's two part explainer on the health care cost problem and health insurance . Fascinating, understandable and, no lie, funny. A must listen. An important and illumating fact, presented by conservative Marketplace commentator (and former member of the Bush administration's economic team) David Frum: In terms of income growth and poverty reduction, Bush performed worse than any two-term president of the modern era. Even in the best year of his presidency, 2007, the typical American household still earned less after inflation than in the year 2000. The next year, 2008, American households suffered the worst income drop since record-keeping began six decades ago. . . . So, what went wrong? Liberals criticize the Bush tax cuts, but it's impossible to see a...

Insurance Group Says Health Bill Will Mean Higher Premiums - washingtonpost.com : After months of collaboration on President Obama's attempt to overhaul the nation's health-care system, the insurance industry plans to strike out against the effort on Monday with a report warning that the typical family premium in 2019 could cost $4,000 more than projected. . . . At the heart of the argument is whether the Finance Committee bill does enough to draw young, healthy people into the insurance risk pool. By postponing and reducing penalties on people who do not sign up for health insurance, industry analysts predict it would attract less-healthy patients who would drive up costs. Ummm. Duh. If you drive the sicker people into the pool and let the healthier ones stay out, it's going to cost more for the sicker ones. This is really a "pox on all their houses" situation. The lily-livered senators aren't willing to make a "mandate" really stick, and the insure...

Martin Feldstein - A Better Way to Health Reform - washingtonpost .com : A good system should not try to pay all health-care bills. That would lead to excessive demand, wasteful use of expensive technology and, inevitably, rationing in which health-care decisions are taken away from patients and their physicians. Countries that provide health care to all are forced to deny some treatments and diagnostic tests that most Americans have come to expect. Here's a better alternative. Let's scrap the $220 billion annual health insurance tax subsidy, which is often used to buy the wrong kind of insurance, and use those budget dollars to provide insurance that protects American families from health costs that exceed 15 percent of their income. From an economist's perspective, this makes sense. Fundamentally, there are two macroeconomic levers for keeping prices low: increase supply or decrease demand. A frequent criticism of "first dollar" insurance is that it makes healt...

What If They Passed Single-Payer and Didn't Tell Anyone? - WashingtonPost.com : The Wyden folks quietly slipped in an amendment giving states enormous flexibility to experiment upward. Essentially, states can ask the federal government for a waiver that allows them to keep the federal funds they're receiving and do pretty much anything they want with them, so long as the coverage they provide is "at least as comprehensive as required under the Chairman’s Mark" . . . . If we don't end up with a public option at the federal level, at least have the ability for states to broaden the public participation in the system. The states are often considered, and allowed to be, crucibles of experimentation for policies like this. It's got the potential to do some real good.

Obama quietly tries to shore up Senate support for public option -- latimes.com : Despite months of outward ambivalence about creating a government health insurance plan, the Obama White House has launched a behind-the-scenes campaign to get divided Senate Democrats to take up some version of the idea for a final vote in the coming weeks. President Obama has cited a preference for the so-called public option. But faced with intense criticism over the summer, he strategically expressed openness to health cooperatives and other ways to offer consumers potentially more affordable alternatives to private health plans. In the last week, however, senior administration officials have been holding private meetings almost daily at the Capitol with senior Democratic staff to discuss ways to include a version of the public plan in the healthcare bill that Senate Majority Leader Harry Reid (D-Nev.) plans to bring to the Senate floor this month, according to senior Democratic congressional aides. ....

Vets Loving Socialized Medicine Show Government Offers Savings - Bloomberg.com : Rick Tanner is one American who loves his government-run health care. After serving in Vietnam and spending three decades in the U.S. Navy, Tanner retired in 1991 with a bad knee and high blood pressure. He enrolled in the Veterans Health Administration and now benefits from comprehensive treatment with few co-payments and an electronic records system more advanced than almost anywhere at private hospitals. “The care is superb,” said Tanner, 66, a San Diego resident who visits the veterans medical center in La Jolla, California, and a clinic in nearby Mission Valley. The record- keeping, he said, is “state of the art.” As Congress considers changing Americans’ access to health care, the veterans agency, whose projected budget this year is $45 billion, is evidence that the government can provide care favored by patients that may offer savings when compared with private insurers." I recommend following ...

Following up, the Kaiser Family Foundation says the following about Medicare advantage costs : Medicare Advantage plans are currently paid more, on average, than FFS costs in their area. According to MedPAC, payments to Medicare Advantage plans per enrollee in 2009 will average 114% of FFS costs for the counties where Medicare Advantage enrollees reside (Figure 3). (Emphasis added.) So, the numbers are not geographically cooked. It appears that the 14% number is an apples to apples comparison of geographically adjusted costs between traditional Medicare fee for service and Medicare Advantage Plans, on average.

Seniors Worry As Medicare Advantage Is Threatened : NPR : For more than 40 million senior citizens, questions about plans to overhaul the nation's health care system come down to one word — Medicare. Bills being considered in Congress look to cut $400 billion or $500 billion from the growth of Medicare over the next decade. About a quarter of those savings would come from something called Medicare Advantage. It's a popular program that allows seniors to choose privately run health plans that offer all the services covered by Medicare — plus extra benefits like dental and vision care. Nationwide, about 25 percent of senior citizens are enrolled in Medicare Advantage plans. In Florida, the plans are even more popular — nearly a third of the state's 3 million-plus seniors are enrolled in one plan or another. . . . While seniors love it, the government's problem with Medicare Advantage is that it has steadily gotten more expensive. Across the country, the government is now ...