There was an interesting article yesterday in the Wall Street Journal about the reason that Obama is having so much trouble passing a national health care plan. For many people who are left/liberal (term varies depending on where you live in the world) the opinions of so right/conservative a paper are of little value of course, but whatever your political orientation, the similarities in outlook between all the elements of the US political system is so striking. Their conclusion
This is interesting because here we have Rasmussen the commercial pollster, widely acknowledged to be a conservative, and a Clinton pollster both agreeing that the widespread opposition to the Obama health care plan is due mainly to the fact that people are opposed to its budget and public spending implications. The odd thing about this is that it places exactly the same emphasis of what is important in health care that Obama himself did. I think that this is fairly strong evidence that the "spending" over "health care" emphasis nearly defines 'establishment' thinking in the United States.
It is of course, very important to note that, yes, the health care plan is not supported by the public, but I must also say that I think that this analysis is almost entirely wrong. It was scarcely news that many people opposed national health care on cost grounds. What was new with Obama was that the number of such people had declined to a level that was clearly less than half of the public at large.
The assumption seems to be that what has changed to make so much of the public who previously supported national health care change their views, is simply that the financial crisis makes the public regard national health care as being unaffordable.
I am very doubtful of this, because the financial crisis has made ordinary people very worried about their jobs being lost in company cutbacks, and there is plenty of news about employers cutting back on the health insurance that they offer. Either job loss or company economizing would endanger the ordinary person's health care, even if they are satisfied with their health insurance. If the public, a majority of whom were satisfied with their insurance before, wanted national health care before, the financial crisis with associated high unemployment is not going to reduce their desire now.
"The reason President Obama can't move the numbers and build public support is because the fundamentals are stacked against him. Most voters believe the current plan will harm the economy, cost more than projected, raise the cost of care, and lead to higher middle-class taxes."
This is interesting because here we have Rasmussen the commercial pollster, widely acknowledged to be a conservative, and a Clinton pollster both agreeing that the widespread opposition to the Obama health care plan is due mainly to the fact that people are opposed to its budget and public spending implications. The odd thing about this is that it places exactly the same emphasis of what is important in health care that Obama himself did. I think that this is fairly strong evidence that the "spending" over "health care" emphasis nearly defines 'establishment' thinking in the United States.
It is of course, very important to note that, yes, the health care plan is not supported by the public, but I must also say that I think that this analysis is almost entirely wrong. It was scarcely news that many people opposed national health care on cost grounds. What was new with Obama was that the number of such people had declined to a level that was clearly less than half of the public at large.
The assumption seems to be that what has changed to make so much of the public who previously supported national health care change their views, is simply that the financial crisis makes the public regard national health care as being unaffordable.
I am very doubtful of this, because the financial crisis has made ordinary people very worried about their jobs being lost in company cutbacks, and there is plenty of news about employers cutting back on the health insurance that they offer. Either job loss or company economizing would endanger the ordinary person's health care, even if they are satisfied with their health insurance. If the public, a majority of whom were satisfied with their insurance before, wanted national health care before, the financial crisis with associated high unemployment is not going to reduce their desire now.
Rather, I believe that the problem is with the Obama administration's health care plan itself, and particularly the emphasis that both he and his administration put on it. People are concerned that the health care that they receive is not going be reliably thorough and of high quality, mainly due to government rationing.
At this point, the average Democrat finally is distinguished from the establishment at large by rolling their eyes at this concern. The public concern is not just an artifact of Republican propaganda however. Rather, the concern is due to the Obama administration's plans, and even their own comments on them.
Obama himself, when questioned about his plan in the New York Times, used his OWN GRANDMOTHER as an example of potential rationing. His grandmother had broken her hip, and as it happened, also had cancer. While the cancer was clearly a serious threat to her longevity, it was not clear that she was going to die in the next days or weeks, and so the broken bone was repaired. This, according to Obama, was a matter that society, and his panels of experts were going to need to have
and at the end of this process, you, when caring for your Grandmother would need to
How does this impact the national health care scheme, why
At this point, the average Democrat finally is distinguished from the establishment at large by rolling their eyes at this concern. The public concern is not just an artifact of Republican propaganda however. Rather, the concern is due to the Obama administration's plans, and even their own comments on them.
Obama himself, when questioned about his plan in the New York Times, used his OWN GRANDMOTHER as an example of potential rationing. His grandmother had broken her hip, and as it happened, also had cancer. While the cancer was clearly a serious threat to her longevity, it was not clear that she was going to die in the next days or weeks, and so the broken bone was repaired. This, according to Obama, was a matter that society, and his panels of experts were going to need to have
"a very difficult democratic conversation" about
this conversation needed to be
"guided by doctors, scientists, ethicists"
and at the end of this process, you, when caring for your Grandmother would need to
"have to have some independent group that can give you guidance".
How does this impact the national health care scheme, why
"that’s part of what I suspect you’ll see emerging out of the various health care conversations that are taking place on the Hill right now."
After Obama said such a thing, anybody who is talking about Republican propaganda is simply not paying attention to the real problem. Many Democrats have made excuses for the worrisome statements of Obama's advising health-car ethicist, but the fact of the matter is that Obama's conversations with this creature led him to question the wisdom of repairing his own grandmother's broken bone because she had a serious, but not immediately lethal illness. Broken bones are very painful, and very few people would be happy with the notion of their beloved Granny being forced to spend her last months or years suffering the agony of an untreated broken bone and trapped in bed because of it. Indeed, being locked into near total inactivity in this way is very likely to trigger one or another health problem in an elderly person, and cause their demise.
This little horror would be quite enough reason to distrust the president's health care scheme, but it also points to something else. Many people like to point to other developed nations around the globe, and say "they have national health care and are okay, so national health care in the US is okay too." Indeed building on this misplaced theme, many people around the globe have taken pleasure in poking fun at Americans who have reservations about the plan.
There is a big difference between the US plan and those throughout the globe however. The US national health care scheme is to my knowledge, the ONLY national health care scheme in the world that was planned at the very beginning to REDUCE the amount of health care services consumed that are the standard of care in that nation.
There is a lot of puffery and bluster about eliminating unnecessary care, but it is by no means clear that this care is in fact unnecessary. It is true that much associated with health care is run for profit in the US, and this might confuse someone, particularly if they do not live in the US, but the for-profit health care insurance industry in the US, which ends up paying most health care providers, can only make its money by rejecting unnecessary treatments. Since the insurers make that much more money by rejecting necessary treatment, many Americans are denied treatment that they in fact need. In a system of this sort, there is no real 'low hanging fruit' of clearly unnecessary treatment. When it in fact becomes clear that a treatment is unnecessary, the system weeds out that treatment. There are many ineffective treatments to be found in past medical history, and there will doubtless be more in the future, but the question is whether or not the medical system knows (or at least may easily find out), that a lot of treatments now in use are ineffective, but is using those treatments anyway. It is not objectively clear that "yes" is the answer to this question, much less clear that treatments which are known to be ineffective, but which are in use for some reason after all, will see those reasons overcome. What is left to cut where treatment is concerned, is treatments that some people need, and others do not, at least for the time being.
All those people around the world who now have national health care thus actually have something to worry about. As most people know, medical treatments that begin only in the US are likely to arrive in other developed nations eventually, because it would be difficult to justify not providing health care that is more or less up to "international standards". If a US national health care scheme based on REDUCING the level of care provided becomes law however, any budget troll lurking in the dark corners of your nation's Health Ministry, will now have a nice big international precedent that says that YOUR life isn't actually worth that much, and spending the money on your treatment is a waste.
Many people around the world complain that the United States does not place enough value on human life, and on quality of life. A health care plan of this type is not altogether aimed at making America like the most generous or compassionate of nations. Rather this health care plan aims to reduce the standard of care in a way that more than half of Americans are afraid of, and anchor that cheapened standard of care in claims of effectiveness.
This little horror would be quite enough reason to distrust the president's health care scheme, but it also points to something else. Many people like to point to other developed nations around the globe, and say "they have national health care and are okay, so national health care in the US is okay too." Indeed building on this misplaced theme, many people around the globe have taken pleasure in poking fun at Americans who have reservations about the plan.
There is a big difference between the US plan and those throughout the globe however. The US national health care scheme is to my knowledge, the ONLY national health care scheme in the world that was planned at the very beginning to REDUCE the amount of health care services consumed that are the standard of care in that nation.
There is a lot of puffery and bluster about eliminating unnecessary care, but it is by no means clear that this care is in fact unnecessary. It is true that much associated with health care is run for profit in the US, and this might confuse someone, particularly if they do not live in the US, but the for-profit health care insurance industry in the US, which ends up paying most health care providers, can only make its money by rejecting unnecessary treatments. Since the insurers make that much more money by rejecting necessary treatment, many Americans are denied treatment that they in fact need. In a system of this sort, there is no real 'low hanging fruit' of clearly unnecessary treatment. When it in fact becomes clear that a treatment is unnecessary, the system weeds out that treatment. There are many ineffective treatments to be found in past medical history, and there will doubtless be more in the future, but the question is whether or not the medical system knows (or at least may easily find out), that a lot of treatments now in use are ineffective, but is using those treatments anyway. It is not objectively clear that "yes" is the answer to this question, much less clear that treatments which are known to be ineffective, but which are in use for some reason after all, will see those reasons overcome. What is left to cut where treatment is concerned, is treatments that some people need, and others do not, at least for the time being.
All those people around the world who now have national health care thus actually have something to worry about. As most people know, medical treatments that begin only in the US are likely to arrive in other developed nations eventually, because it would be difficult to justify not providing health care that is more or less up to "international standards". If a US national health care scheme based on REDUCING the level of care provided becomes law however, any budget troll lurking in the dark corners of your nation's Health Ministry, will now have a nice big international precedent that says that YOUR life isn't actually worth that much, and spending the money on your treatment is a waste.
Many people around the world complain that the United States does not place enough value on human life, and on quality of life. A health care plan of this type is not altogether aimed at making America like the most generous or compassionate of nations. Rather this health care plan aims to reduce the standard of care in a way that more than half of Americans are afraid of, and anchor that cheapened standard of care in claims of effectiveness.
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