Is The Healthcare Bill As It Now Stands Even Worse Than Nothing?

This morning's San Francisco Chronicle pointed up the inconsistencies in comparing the proposed healthcare reforms with the Insurance Industry straw man (Canada and Britain) and the reality of the countries the U.S. system would actually be modeled like: Netherlands, Switzerland (which certainly must be the ultimate hero nation of all right-wingers and teabaggers today) and Germany.

Health care systems in the three nations more closely resemble the U.S. system of insurance-based coverage. Holland and Switzerland rely exclusively on private insurance, and all three rely on private doctors. The three European nations deliver universal coverage and world-class quality at a fraction of what Americans spend.

All of them require that everyone purchase insurance, make sure everyone can afford it and ban insurers from such practices as refusing to cover the sick that are common in the United States.

"We've got something worse than socialized medicine in this country," said Alain Enthoven, a Stanford University economist known as the father of the Dutch system.

"We have doctors causing hospital infections by not washing their hands because the incentives don't punish them for hospital infections, and we've got something that is financially destroying our economy. It's a disaster."

In many ways, the legislation in Congress builds on a broken system, experts said, reinforcing such features as relying on employers to buy health insurance rather than letting workers shop for their own plans.

European health care is universal, but contrary to popular perception, it is not all nationalized. Facing rapidly aging populations, many European countries have gone much further than the United States in using market forces to control costs. At the same time, regulations are stronger and often more sophisticated.

Most of Europe spends about 10 percent of its national income on health care and covers everyone. The United States will spend 18 percent this year and leave 47 million people uninsured.

Europe has more doctors, more hospital beds and more patient visits than the United States. Take Switzerland: 4.9 doctors per thousand residents compared with 2.4 in the United States. And cost? The average cost for a hospital stay is $9,398 in relatively high-cost Switzerland and $17,206 in the United States.

"In Switzerland, rich or poor, they all buy the same health insurance," said Regina Herzlinger, chairwoman of business administration at Harvard University and a leading advocate of the Swiss system. "The government gives the poor as much money as the average Swiss has to buy health insurance."

The Swiss and Dutch buy their own coverage from competing private insurers. Both systems address market failures that pervade U.S. health care: Insurance companies must provide a core benefit package and everyone must buy coverage. Consumers can shop for value and pocket the savings, as opposed to U.S. patients who hand the bill to someone else. Switzerland does not have a public program like Medicare or Medicaid.

Far from leading to poor quality and rationing, both countries and Germany, where government has a much larger role in health care, outperform the United States on many quality measures. These are not just broad measures such as life expectancy that could reflect higher U.S. poverty or obesity. Even Britain, much maligned by opponents of government-run health care in America, has made greater strides in preventive care.

"The data are pretty clear," said Peter Hussey, a Rand Corp. analyst. "Everybody (in the United States) is at risk for poor-quality care."

The Republicans rarely make any sense, and when they do, it's never for the right reasons. Their demand that we scrap the highly flawed healthcare reform package and start anew is because they would like to kill it outright or make it much worse. Their motivation is clearly partisan. Nonetheless, they're correct that Congress would come up with a better bill, a much better bill.

Alan Grayson and many other progressives make the point that this bill will save lives and should be passed for that reason. They have a good point. But is the bill so overwhelmingly and intrinsically terrible that Democrats should make a deal with Republicans to start over again and work to write and pass a more coherent and effective way to cover the healthcare needs of the country? The bill as it stands now is a disgraceful mess of corporate protections, payback from politicians who have been-- simply put-- bought off by lobbyists and corporate CEOs. Many say Obama's "change," at least as proposed in the bills before the House and Senate, is change for the worse, change that will give for-profit corporations even more debilitating and ultimately destructive power over the lives of ordinary American families.

The bill looks like it will force us-- something that will destroy the Democratic Party in the midterm elections-- to purchase third-rate insurance plans that can cost as much as the empowered insurance villains want to charge with absolutely no guarantee of quality. The goals are basically to transfer wealth from the consumer base to the shareholders and to enrich corporate management through unrestricted gouging of consumers. In other words, Obama and the Democrats are doing the Republicans' jobs for them-- having eaten at the same bribery-filled troughs for too long. Even the so-called public option is now so restricted and anemic-- rather than robust and universal-- that it will serve, at best, 2% of Americans. And it does this while serving another GOP wet dream: cutting Medicare and Medicaid.

Is this going to be Obama's legacy-- or this plus Afghanistan? What it says about the Democratic Party is just absolutely shameful. In 2010 and 2012, Republicans will cynically campaign on Medicare Advantage and sweep the Democrats out of power. The Republicans certainly don't deserve to return to power, but the Democrats are, in effect, just as bad. This bill should be scrapped, H.R. 1826 should be fast-tracked and passed, and Congress should start over again on a serious healthcare reform bill.


UPDATE: Black Leprosy Eating Away At The American Experiment

Are we still an experiment? My old friend-- and former Dictator-- Scott Kempner reminded me to read the new Matt Taibbi piece in Rolling Stone Sick And Wrong.

The system doesn't work for anyone. It cheats patients and leaves them to die, denies insurance to 47 million Americans, forces hospitals to spend billions haggling over claims, and systematically bleeds and harasses doctors with the specter of catastrophic litigation... The cost of all of this to society, in illness and death and lost productivity and a soaring federal deficit and plain old anxiety and anger, is incalculable — and that's the good news. The bad news is our failed health care system won't get fixed, because it exists entirely within the confines of yet another failed system: the political entity known as the United States of America.

And that was just the opening-- of a seven page tirade that every member of Congress ought to be reading this week.