The Bush Republicans are also very reactionary in their health policy. But, there are other Republicans around the country that are starting/proposing reforms that may come if Bush wins. Not all the reforms are bad (but most are) so it begs the question why is Kerry not winning the election on a strong health reform agenda. It is completely bizarre on self-interest alone that this is not a stump staple or other Democrats do not DO more. There are difference between the parties but they are not too meaningful and the Republicans are often less reactionary.
Quoting Nathan Newman <nathanne at nathannewman.org>:
> As as for Kerry's proposal
> >Jim Westrich's argues it is, "not only wrongheaded but is
> >quite literally "reactionary". There are a lot of things wrong with the
> >healthcare system and I hardly think "access" for a few working families
> is the
> >most pressing."
>
> I'm not sure Kerry's plan is perfect, but I find it intriguing and
> definitely dealing with many of the cost-savings issues, since it massively
> socializes the most expensive part of health care, namely chronic and
> extreme medical costs.
>
> Think about this-- this plan would socialize exactly the areas where
> premiums go out of control for many sick individuals. Without the threat
> of paying out massive catastrophic costs, insurance will be be much more
> available. And progressives can make advances just by lowering the rate at
> which the government takes over costs.
>
> The plan has a series of other subsidies and costs savings, but this core
> socialization of catastrophic costs is very radical, not reactionary.
Ah yes, the old "radical trickle-down reinsurance". Please follow the money more carefully.
Getting the government to reinsure private insurance risk for their private employer business is in no sense of the word "radical". I do think government can play a role in reinsurance but the benefits are received directly by the reduced risk to the insurer. It thus enables them to (considering prices are sticky much of this will go to "load"/profit) lower their price to employers. The premium is the cost of doing business and thus some employers can offer more insurance or lower the employee contributions (but they might NOT either).
To reiterate, I do not think socializing risk even for private entitities is a horrible thing but the direct benefit goes to insurers and then to employers (yes some employees might benefit but generally those already in a good bargaining position).
Also, in your response you referred to this helping the disabled and chronically ill. Again, this not really true. Yes some privately employed, well positioned employee, might get better coverage and lower premiums under President Kerry. But most of the expensive care of the disabled and chronically ill is already paid for by the government in MEDICAID. It is important to reiterate that Medicaid already plays a de facto role as insurer of last resort. If an insured person gets real sick, they often have limits/caps on benefits. So after the limit is reached someone has to pay--by that point the person usually can be determined disabled (SSI or DI) and get Medicaid to cover the rest of the expensive costs. [Also, a lot of people do not that many private employers exclude types of coverages for poor employees--like mental health or orthotics--helping them get Medicaid to pay for that as "wrap around"].
Anyway, Kerry's reinsurance is about insurance costs and my beef is about health care costs (which is different). The "load" of insurance can be lowered (or removed under single-payer) but far more important is the cost of delivering health care.
Kerry is proposing to subsidize hospital/clinic/provider implementation of electronic medical records here. There is nothing wrong with this, but there is nothing new or radical or even Democratic about it (Republicans generally support this as well). Following the money again, the subsidy goes directly to the provider in purchasing something they should on clinical grounds already want to buy (this is what is fascinating about EMR--why don't they do it already considering the clinical benefit in reduced harm and mistakes? ANSWER:
money). So, Kerry is helping providers reduce their cost of business and it will likely have indirect benefits both in cost and outcomes. This is very small potatoes in the health care world.
I have prattled on long enough.
Peace,
Jim
[Alice (in Wonderland)]: "Chesire Puss . . . would you tell me, please, which way I ought to go from here?" [Chesire Cat]: "That depends a good deal on where you want to get to."
--Lewis Carrol, *Alice in Wonderland*