Health Care For America Now

I'll have more later, but I've just had a chance to sit down with Uwe Reinhardt and heard a great speech on health care by Chairman Henry Waxman. Here are the highlights.

Uwe Reinhardt on the public plan:

Obama's health care plan wouldn't work well without it. It would limp along without it. Conservatives will argue that the private sector can't compete. Why would they say that? For one, you already have competition, it's called Medicare. Even though privates are payed 15% more, so far they've only got 20% of the elderly. 80% preferred to stay in a program conservatives think is abhorrent. Should America be run by eggheads in conservative think tanks [CATO, Heritage]? Or give people a choice? Put the public plan there, make it actuarially sound, then let it compete.

On choice:

The essential difference between Americans and Canadians, Americans wake up at 4am in a sweat worried about their choice of insurance. Canadians are the other way, they care about freedom of choice of doctor and hospital, and they don't care that there's only one insurance policy. Americans live for the choice of private insurance.

Why have private insurance? In the 80s, private insurance said they could insure people for 25% cheaper, and we let them try. It turns out they never delivered. Eventually, they said they could do it for the same actuarial cost, and they still couldn't do it. And I know why. Medicare has 2% administrative cost, and they've got 15-20%. Bush realized this, and he gave 15% on top of even.

Now, it's unconstitutional to not let them play, but make it a level playing field.

On the insurance industry:

The insurance industry shouldn't be allowed to get by making their own rules. If they break the rules, they should lose 10 cents off their earnings per share. This is what you could do if you wanted to punish them for something egregious. It would have to show up on the balance sheet.

We need fine print that a normal human can't live with. Have a mandated benefit package.

On the federal health board:

I have supported it as long as I can remember. The question is, where it's located. Congress should not control it. In the long run, I'd like to see it funded with $1 billion.

On the economy and health care reform:

A friend of mine said, "We will not have it unless we have World War III or a great depression, an epidemic, something that will threaten everyone." Well, if you look at the economy now, I personally believe we're near a depression. They have their fingers in the dikes. They [Paulson, Bernanke] couldn't believe it. There were some who saw it coming, Krugman, Baker, etc…

The down would be to say we just don't have the money. The up would say it's the first time the middle class is really getting devastated. Even Joe Plumbers will finally get it. There are occasions when government is really the only institution. Do you think you could have the debate on privatizing social security now? See how much has changed? If you had a private annuity, it's half of what you thought it was. Has your Social Security check been cut in half?

There are some risks that can be very well handled by the private market, car insurance etc…, but no private company can insure you against a depression because their portfolios will be gone.

Henry Waxman also had some great quotes on health care reform and his efforts in the House.

Waxman on reform now:

We have a President who's put the provision of affordable, accessible health care for all Americans front and center on the agenda. This is the time, this is the year, this is why I decided to run for the chairmanship.

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We have a number of coalitions, labor, business, etc… engaged in finding a common solution, common ground that can unite us all. In 1993, we had a lot of groups who wanted health care, but their way or nothing. And that's what we got. Now these groups realize that's a problem.

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The situation is critical. Every year it gets worse. With the recession, more people are going to lose their jobs and insurance. The House provided subsidies for Cobra and Medicaid as part of the recovery package. Those provisions are only a temporary fix. Costs are too high. All of this is unacceptable, and in our current economic situation it's truly a catastrophe.

There are some who say in this economy, we have to put off the goal of health care for all. I look at it a different way. It's critical to restoring the health of our economy. The costly failure of our health care system affects our businesses, our workers, or competitiveness, and every family. This is something to do right now, to help fix our economy!

My colleagues in the House are all as anxious as I am to move ahead rapidly. I welcome Democrats and Republicans to engage in this effort. We don't intend to let delays spoil the opportunity. The situation is to critical, the need is to great. This is our time, we need to work together, get this job accomplished, this year, to get the bill to the President's desk.

Waxman on health care reform plans:

I'm not here to tell you I know the right way to coverage. The best approach is one that assures the goals of universal coverage and sensible controls on cost, and can pass the House and Senate. I've supported single payer. I've supported pay-for-play. I have my own views as to what I would do if I were the only one in charge. What we're determined to do is work to find an approach that is broadly acceptable to the American people. Build on the system we have today.

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That's the point that was recognized by President Obama. Protect and build on employer based coverage. People can keep it if they like. Or they can buy into a public plan, we leave the choice to them.

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Reject the false dichotomy of everyone in the government plan or left at the mercies of the market. There will be a significant role for private insurance, but it is critically important that we have a public program alternative. Both will work better if there's some creative tension between the two different choices. Put both in place, let individuals and families make choices about what's best for them.

More to come later!