Tuesday, March 09, 2010

Passion, accuracy, and politics

I admire the President and really hope a health care bill is passed by Congress, but I wonder if his overstatement of what the bill does might ultimately cause him to fail. Here's the latest, as reported in today's New York Times:

Boiling down his proposal to a few sentences, Mr. Obama asked, “How many people would like a proposal that holds insurance companies more accountable? How many people would like to give Americans the same insurance choices that members of Congress get? And how many would like a proposal that brings down costs for everyone? That’s our proposal.”

Is that really the proposal?

As for holding insurance companies more accountable, a number of state insurance commissioners have their doubts, at least with regard to federal regulation of premium rate levels.

Will we have the same insurance choices as members of Congress? Well, maybe to the extent that they can choose from a number of plans, but that is not the full set of benefits to which they are entitled.

And, as for bringing down costs, every person in the industry knows that is just not true. David Brooks explains why in his op-ed today.

From the beginning, I pointed out that Mr. Obama was over-promising when he was offering (1) a reduction in health care costs; (2) an increase in access for people currently uninsured or under-insured; and (3) maintaining choice for people in their selection of doctors and hospitals.

Opposition to Mr. Obama's plan is often characterized as a politically motivated attack from the Republicans. Certainly, some of that is true. But some portion of the opposition also arises from this kind of overstatement, which in turn generates mistrust or at least concern among educated members of the public.

Mr. Obama is betting, though, that his energy and passion will carry the day in motivating members of Congress in his own party to muster enough votes.


RICKSTER said...

Well said, Dr. Levy. Part of the challenge with these types of sweeping policy changes is the need to over-simply in order to deliver the message to a less informed or sophisticated audience. The irony, as you point out, is this can lead to overstatements which, in turn, undermine the credibility of the overall message and can backfire in the end. BTW, I have been interviewing for a position at BIDMC and I am very impressed that you as CEO have embraced a blog. It's well done. Regardless of what happens for me, I wish you and your organization great success. RICK SWEENEY

Anonymous said...

You raise very good points. The scale of the bill is too big. We need to reform a few key items at a time, so the public understands what is being done and trusts the process.

We will repost your thoughts on our blog today for our readers to see as well - on www.actionforbetterhealthcare.com

All the best -
Kester Freeman

Steven M. Rauscher said...

Part of the President’s problem is that he has described the proposed bill as health care reform. It would be more accurate to describe it as an expansion of taxpayer-financed, fee-for service healthcare, combined with some new regulations for health insurance companies. Other than some clearly needed protections for consumers with pre-existing health conditions, there is very little reform in the bill. There is no equalization of the tax treatment of insurance purchased by individuals separately, compared to individuals who buy insurance through their employers. The vast majority of health care will still be purchased based on disaggregated fee-for-service inputs instead of integrated patient outcomes. There is no mechanism to improve price transparency.

By expanding access to care without changing the way it is purchased, the total cost of healthcare can only go up. These costs will be realized by consumers as a combination of new taxes, higher health insurance costs and longer waiting times.

Protections for pre-existing conditions and improved access for the uninsured are worthy goals. But this is not reform.

Steve Rauscher