Tuesday, August 04, 2009
White House Office of Health Reform communications director Linda Douglass appears in the rebuttal video below, trying to fight back against the Naked Emperor video that Drudge posted a few days ago, which went viral, including right here on TigerHawk.
It is notable that the White House felt the need to respond to the video, which in fairness to President Obama, also features clips from Reps. Frank and Schakowsky (who might be more adamantly pro-single-payer). Previous administrations might have seen this as swinging at a pitch in the dirt, but it perhaps illustrates the power of big grid blogs in 2009.
It's interesting that Douglass, formerly an ABC News correspondent, used the clip of President Obama from his June 23 presser stating that a public option is an "important tool to discipline insurance companies." Of course, the competition among different insurance companies provides some discipline -- the discipline of the market place -- and in nearly every state, there is a state insurance commission that provides regulatory discipline with respect to any number of matters, including, importantly, rate hikes.
While the bureaucracy of Independence Blue Cross in Pennsylvania that I occasionally deal with is not a model of perfection, it's pretty good, and I would rather deal with it that with a new form of federal government health care bureaucracy. Most good service firms rate out their customer assistance personnel (which is why you might get the blurb at the beginning that the call might be recorded for QA reasons), and the ones that don't grade well -- based on both customer complaints that are reasonable, and in-house evaluations -- tend not to stick around. Because it is an infrequent occurrence that a federal employee is terminated, I would not feel the same level of confidence that my initial contact would be handled as professionally. This is a common public sector / private sector observation, and perhaps the counter to it is that the public option servicing would be staffed out to private companies (as is the case with some aspects of Medicare). Every iteration of the bills that I have read about includes the creation of a significant new federal bureaucracy, however.
I think it is good that President Obama states that if you have a plan you like, you can keep it. The question that many Doubting Thomases have, including me, is whether that will be true 5 years from now, or 10 years from now. As earnest as President Obama may be, the White House is not writing and marking up these bills -- he certainly won't veto anything that gives him most of what he wants -- and even if he gets a "perfect bill" from his standpoint, he can't foresee what are genuinely unforeseeable consequences, good and bad, of such a massive intervention. Furthermore, there are clearly Democrats on the Hill that he would have to fight against to preserve private insurance in the out years. It's safe to say that everyone in the Progressive Caucus wants single-payer without any private option, perhaps even without a private supplement (as is available for Medicare).
"in fairness to President Obama, also features clips from Reps. Frank and Schakowsky (who might be more adamantly pro-single-payer)"
Yeah, but the clip has a pretty absolute quote at the one minute mark: "I happen to be a proponent of single payer universal health care coverage." Now he can claim he's changed his mind, but he can't change what he said. As a litigator I'd ask: "were you lying then or are you lying now?"
If the GOP opposition starts pushing a bill much like the Wyden-Bennett bill, legalizing insurance companies selling across state borders, making insurance individual, prohibiting insurance companies from dropping individuals from coverage and making pre-existing conditions a non-issue, this whole controversy will end. Insurance will no longer be an "employee benefit", that can be lost when you change or lose your job, and price competition will return to the market after a generation of absence. Prices will drop, coverage will improve and the government can go back to buying golden toilet seats for the air force, as they should. To cover the poor, we can vote an expansion of the very successful and very economic federally supported clinic program.
That was easy!
The continuing love affair between the President and the MSM went hilarious today, as the President sang harpy birthday to Helen Thomas. She wished for "world peace and health reform" before blowing out the candles.
Really, she did.
Somehow, I wish Sandra Bullock had been consulted in advance.
Now you all kn ow I am not in favor of government run healthcare but I have a point. Right now anyone, including my family, who has insurance from any of the companies like United Healthcare and Blue Cross, the decisions on what is to be done and what is allowed is not made by the doctor in conjuction with the patient, it is made by clerks sitting at a call center, god knows where. the doctor has to abide by the decision of the "professional", with no leeway. If you want to get approval for a test or a referral, the doctor doesn't have the authority to make that the decision, the call center person does. believe me, I know from experience. No insurance company is noble, they are all out to make a buck and have some of your Senators and Congress people in their back pockets.
Vicki, I'll shock you and agree. Between state legislatures, Medicare rate setting and insurance companies funneling money into political campaigns, it's hard to get a decent deal.
Just a few changes would cure the whole mess: allow insurance companies to sell in any state they wish, prevent state legislatures from deciding what must be covered, and allow insurance portability. Companies would finally be forced to compete on price and service.
Vicki - I have heard some bad stories about denied claims, but have not experienced it first hand the way you have. I've been covered in PA by Blue Cross affiliates for two decades and have never had a procedure or a claim denied. I have been pretty healthy, and have needed fairly plain vanilla orthopedic surgical procedures as a result of athletic injuries (still a $10,000+ deal at retail prices, all-in, without coverage). My orthopod is well established and known in the BC system and does not get overruled by insurance companies very often (if ever), so I suppose I am fortunate. If there was a question about (non-)coverage, the decision is kicked up above the level of "a clerk at a call center" rather quickly, and under PA law, I have well-defined rights to quickly appeal. There are actually doctors who work at the Blues who make the final decisions about coverage for a particular procedure that has been denied at a lower level.
I might be interested in an experimental procedure in the future (relating to one of my old injuries), but that would not be covered, and almost no carrier pays for surgery involving devices not yet approved by FDA. Also, if I ever leave PA and change carriers, it might be challenging for me to get coverage for my "pre-existing condition," so I would not mind that tweak to the rules.
It isn't just rate hikes, but policy coverage that is controlled by the Insurance Commissioner or the State Legislature!
Vicki - my sister had RA - and gets the latest meds for it. Each treatment is something like $1600 retail. She has had it 30+ years. No problems with getting approvals, but she has developed a good relationship with the clerks at the insurance office who have to sign off.
I know it is a cliche, but large organizations (like the Federal government) typically are not very responsive to customer demands. DMV and all that - shoot, I work with the National Guard and some days its worse than the DMV.