Entries Tagged as 'healthcare reform'

Res Judicata: Defending Romneycare

October 17th, 2011 at 1:51 am 17 Comments

The Massachusetts health care law signed in 2006 by Governor Romney has three main parts:

1. It requires all citizens to buy a state-approved health insurance plan, ampoule

2. It provides subsidies to certain low-income people to pay for insurance, case

3. It requires employers to provide health insurance to their employees or pay a fee to the state.

I agree with parts 1 and 2. Health care is of course, viagra a complex subject. But the crux of our problem is that individuals are not taking care of themselves. For decades the tax code has encouraged employers to provide a very expensive benefit to employees, health insurance.

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How Do Americans Rate Their Healthcare?

April 13th, 2011 at 7:52 am 18 Comments

News reports are trumpeting a new poll which seems to suggest that Americans are unhappy with the quality of their healthcare. But are Americans really dissatisfied or just buying into news coverage suggesting our healthcare system is broken? In this case, the study organizers got what they polled for.

Here’s one report on the study from The Hill that seems typical of much of the coverage:

More than half of Americans believe the quality of U.S. healthcare is average at best, a new poll finds.

Fifty-fifty percent gave healthcare quality a C or D grade on a typical report card scale, and 11 percent said the system completely flunks out, according to a survey from the Robert Wood Johnson Foundation.

“The poll is a wake-up call for payers and the healthcare industry, both of which have been working steadily to improve the quality of care, but need to kick their efforts into overdrive toward accountability,” said foundation president and CEO Risa Lavizzo-Mourey.

Now, the Robert Wood Johnson Foundation is a fine organization. But the above blurb is at best misleading and at worst intellectually dishonest. The question posed was:

Using an A,B,C,D, and F grading scale like they do in school, how would you grade each of the following”… with respondents then being asked to appraise “The quality of health care in the country as a whole.”

That’s the question that led to the conclusion that Americans don’t think much of their healthcare system. And it provides great fodder for those looking to affirm the need for Obamacare.

Here’s the problem: When the same 1034 respondents were asked how they would rate the “quality of health care YOU receive”, 65% gave it an A or B and another 19% a C.

There’s clearly a disconnect between how respondents view their own personal healthcare experiences and what they imagine the experience of others with the system to be.  In the end though, respondents have little clear expertise for evaluating anything but their own personal experiences and are perfectly happy with those personal experiences.  They may believe that others’ health care experiences, elsewhere in our country, are profoundly unsatisfying, but rate their own interactions with providers as mostly positive.

Couldn’t the headline of the blog piece have been, “Americans love their healthcare” rather than the actual headline: “Poll: Most Americans have unfavorable view of healthcare quality”?

American healthcare is too expensive and needs reform, but don’t believe that patients and healthy citizens hate our system. They seem satisfied with the results too: According to a Congressional Research Service study conducted in 2007, 89% of Americans report their health as being “good,” “very good,” or “excellent” — the third highest of the many advanced countries comprising the Organization for Economic Development.

Despite the spin on this latest study, most Americans still rate their health as good and their personal experiences with the health care system as positive.


Being the Angry Party Will Keep GOP Out of Power

August 31st, 2009 at 12:47 am 42 Comments

Bruce Bartlett, as always, is a fascinating read, and we should all be thankful for both his service and his clarity of thought.  He actually makes for a pretty good example of a modern day Mugwump, and thus he is an example of the sort of former Republican that we ought to want back in the fold.

I share one of his concerns, particularly about the party’s greater level of partisanship, and the changing face of conservative media.  But understand; there is a perception among conservatives of a partisan edge to the Democrats’ victories in 2006 and 2008 that we did not see in the ’90s (even in Democratic years like 1998).  The way many conservatives see it, the way to win is not by emulating the no-drama strategy of the Obama campaign, but rather the hard-nosed, foul-mouthed Chicago tactics of Rahm Emanuel circa 2005 and 2006I don’t share that view, and here’s why: we can’t count on the media cover that Democrats get.  We take maximum damage for our transgressions against taste and decorum.  They don’t.  Still, I understand the other side, and I try to heed the words of Reagan: they accept our agenda, not the other way around, and if you’re ever happy with everyone inside the party, then it’s probably too small to win.

One of Bruce Bartlett’s concerns I do not share, exactly, and that is over the Republican’s new emphasis on defending Medicare.  I know that Medicare needs to be put on sounder fiscal footing, and that Medicare Part D did not do so, but I also know that there’s a huge wave of baby boomers, a large number of whom were the core of Republican support throughout the 80′s, who are going to need decent medical care, and lots of it.  One of the nice things about Republicanism is that we have continually put forward ideas for modernizing Medicare, even when they were utterly rejected: Newt Gingrich’s far-too-soon plans in 1995, Medicare Advantage, Part D, and so forth.  One of the weaknesses of Democrats is that they have not.  I’m on the record in favor of ethical comparative effectiveness, but it’s not the piggy-bank that will fund universal coverage; it’s actually the very basis of how private insurance works, and it hasn’t shown much promise at controlling overall premium costs as new and better medical technology comes online and the population ages.  Otherwise, the Democrats’ ideas for fixing Medicare basically amount to paying less money for everything and to everyone because we’re the government and we can.  That, to me, is a path towards some severe inequalities in the provision of needed care over the next thirty years or so.  Michael Steele’s op-ed on the GOP’s Seniors Health Care Bill of Rights wasn’t perfect, but I think we need to lay down our marker on how a system that isn’t going away will serve our once and future voters.

So I’m not an ex-Republican yet.  I decided never again to say “I’m a conservative, not a Republican!” on the morning of November 8, 2006, and I haven’t looked back, so to a large extent Bruce Bartlett and I will have to agree to disagree.  But on reaching out to former Republicans and minorities who will be aided by our agenda? I think there’s plenty of room for agreement.