HorsesAss.Org » Blog Archive » Cantwell on Public Option

@7 Dave S.

Trying to double guess Pres Obama on not making his own healtcare proposal is hard. Hillary effed up hig time by doing just that.

I like to think that what BHO has done is laid a base. When healthcare passes, esp if it is done by over riding the filibuzz-bomb, the Repricans are going to look asinine and he will get huge cred.

I am convinced this is the strategy, but am concerned about the details. Liberal orthodoxy in these issues is a problem too. There are a number of myths that could hurt the final plan:

1. Insurance/admin overhead. Maybe BUT from what I read the costs of cooperatives, where one assumes there is no profit, are as high as the costs of insurance plans. There is something to be said for competition ... IF the bill is written so as to encourage that!

2. Preventative medicine in adults. This does prolong life but it increases healthcare costs.

3. "death panels" of course any health care plan will have some sort of utilization/triage process. This is NOT just a matter of who gets what final care it is also a matter of who gets different forms of preventitive medicine.

4. cost shifting ... I suspect that a huge part of American inefficieny is do to endemic cost shifting. Some illegal immigrant is injured in a state where state law prohibits paying for =care but federal law requires it. Who do you suppose pays for this?

5. American Subsidies .. All this debate about Americans being able to buy drugs in Canada misses the point. The drug companies operate accdording to a bottom line. If CA gets a discount, we pay for it. If we become more rigorous, then something will go .. the mix of drugs developed will change to conform to whatever is most profitable. That mix may or may not be what is best for patients.

6. Education ... our current model .. $200,000 and more in loans .. is untenable. Med schools are also overly slective in the US. We need to educate more students and do so without creating a debt structure that forces students to choose specialty by recompense.