A conspiratorial fantasy

A disclaimer:

I don't write much directly about politics here, and I don't profess to be a political analyst, at least in this particular context. I know my own particular points of view on political issues surface from time to time, but generally I prefer to leave a lot of the heavy lifting of debating politics to others.

Now, an exception...

I'll acknowledge being very pleased with the health insurance reform legislation that passed this week. I'll also acknowledge that, if it were up to me, I'd like it to have been a lot different -- probably something much more like a single-payer model. At the same time, I think what we have now is a very good start, and I think the most rabid right-wing critiques of it ("government takeover!" "socialism!" "death panels!") are hooey. Or "bovine feces," as someone else on the net said today about, I think, a somewhat different topic...

But...

I've been reading a lot lately that this is basically Mitt Romney's Massachusetts plan -- mandated health insurance and all. Or that it's very similar to ideas that came out of the Heritage Foundation about a decade ago. Or, in fact, the GOP alternative floated in the 1990s to the Clinton reform proposal. And then we hear people like David Frum lament that the GOP should have engaged the actual bill instead of carping on the sidelines and might have gotten more from it...

(An aside: As a newspaper reporter in the early '90s who covered some ideas in health care reform at the time, through the lens of a Business Desk workplace reporter, I recall doing a story about a set of proposals coming from a guy who at the time worked for Liberty Mutual. It was, in essence, a private-sector approach to universal health care. Mandated insurance was an important part of his proposal.)

And I wonder...

What if all the hysteria on the right -- the Tea Party Town Hall protests, the crazy association of Obama with Hitler -- was just some crazy-ass feint? What if the whole thing was the GOP saying, "Please don't throw me in the briar patch!"? Because in the end, they got their plan from 1994 or so, didn't they?

Just sayin'...

Faith-based groups and health insurance reform

Catholic forces have been blamed for threatening to throw health care (or at least health insurance) reform under the bus in the name of stopping abortion. Yet other Catholic forces, allied with other faith groups, are trying to turn up the heat on insurance companies to help promote health care reform.

Discuss.

In this together

On the NY Times web site, a column from Roger Cohen of the International Herald Tribune succinctly frames the mindsets in favor of--and opposing--health care reform:

Whatever may be right, something is rotten in American medicine. It should be fixed. But fixing it requires the acknowledgment that, when it comes to health, we’re all in this together. Pooling the risk between everybody is the most efficient way to forge a healthier society.

Europeans have no problem with this moral commitment. But Americans hear “pooled risk” and think, “Hey, somebody’s freeloading on my hard work.”

I am witness to the fact that Americans can embrace a "we're all in this together" philosophy and that such an approach can help lower the cost and spread the availability of health care. More than two decades ago I covered health and medicine in Rochester, New York. At the time Rochester had an impressive system that helped hold down health care costs, achieve better outcomes, and broaden the reach of health insurance across the population. I covered this system on an ongoing basis for the Rochester Democrat & Chronicle and later wrote about it for the Washington Monthly.

It was a complex system that centered on hospitals agreeing to accept essentially a yearly cap on their revenues, which was the focus of my Washington Monthly story. But another part of what made it work is that employers and insurers agreed to "community rating" -- which meant that the entire population, rather than each workplace or other sub-group, was considered one "risk pool." This raised the cost of insurance for the lowest-risk groups (the young and wealthy), but lowered it for those at highest risk, and contributed overall to a better quality of life where health care was concerned.

I haven't been back to Rochester in many years and I've heard second-hand this progressive system is no longer in place. (That's an unfortunate contrast to predictions people made when I wrote about it that it would become a national model.) I'm not sure why it was dissolved, and I do plan to look into that question some time, but based on how it was working when I was there, all I can say is, more's the pity.