Monday, July 02, 2007
Say what?
According to the e-mail, and these words are verbatim:
- Health policy should focus on making health care of ever-increasing quality available to an ever-increasing number of people.
- To achieve "universal coverage" would require either having the government provide health insurance to everyone or forcing everyone to buy it. Government provision is undesirable, because government generally does a poor job of improving quality or affordability. Forcing people to get insurance would lead to a worse health-care system for everyone, because it would necessitate so much more government intervention.
- In a free society, people should have the right to refuse health insurance.
- If governments must subsidize, they should be free to experiment with cash subsidies, vouchers, insurance coverage, public clinics & hospitals, uncompensated care payments, and tax exemptions, rather than be forced by a policy of “universal coverage” to subsidize people via “insurance.”
The first point certainly is valid. Wide availability of quality certainly is a worthy goal. But does it mean availability to everyone who wants it?
The other points all raise questions, such as, if government intervention in healthcare is so bad, why is Medicare so sacrosanct in U.S. policy-making and why is the Veterans Health Administration held in such high esteem?
Sure, some people may lose the right to refuse health insurance under certain proposals, but that likely will end up varying state-by-state, similar to automobile insurance laws. (Here in Illinois, people have the right to refuse to wear helmets while riding motorcycles, but is that really such a great idea?)
I'm guessing that this Cato e-mail was prompted by two things: the push for universal coverage in key states like Massachusetts and California and the release of the movie "Sicko." Well, California Gov. Arnold Schwarzenegger gave the closing keynote address to the annual meeting of America's Health Insurance Plans the week before last, and he was warmly received since private health plans stand to benefit greatly from his flavor of universal coverage.
As for "Sicko," the rumored appearance of Michael Moore at the AHIP meeting never materialized, but the filmmaker's presence certainly was felt. The impending release of the movie was on the minds of a lot of attendees, and I heard an AHIP media representative on the phone, giving an impassioned defense of private insurance to an out-of-town reporter. (At the time, the film hadn't been released, and nobody I know had seen anything more than the trailers.) Further, AHIP CEO Karen Ignani had an op-ed in USA Today last Friday, the day of the movie's release.
I haven't seen the movie myself yet, but I have noticed that the debate so far has delivered a deafening silence in the areas of quality and efficiency. How can any discussion of healthcare reform forget such important points?
Labels: AHIP, Sicko movie, universal coverage
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1 Comments:
"why is the Veterans Health Administration held in such high esteem?"
Is it?
"In general, the level of medical care provided by the VHA is fairly high. But like all single-payer health systems around the world, the VA controls costs by imposing a "global budget" – a limit to how much it can spend on care. Thus, year-to-year funding varies according to the whims of Congress, not what consumers want or are willing to spend. And so when resources can't meet demand in a given year, the VHA does what other single-payer systems do: it rations."
"The VHA recently suspended enrollments on more than 250,000 veterans to cut costs, and it maintains a very restrictive pharmaceutical formulary – the list of approved medicines – that often denies veterans access to the newest and most effective drugs. A study by professor Frank Lichtenberg of Columbia University estimated that the restricted availability of drugs has reduced the average survival of veterans under VHA care by as much as two months."
"Rationing is also beginning to delay or deny care altogether to some veterans, particularly in special areas like mental health. The Miami Herald reports that nearly 100 local VA clinics provided virtually no mental health care in 2005. The average veteran with psychiatric troubles gets almost one-third fewer visits with specialists than he would have received a decade ago, and several have been turned away from VA hospitals, which helps to explain the recent rash of suicides of veterans with post-traumatic stress disorder."
See:
You Say You Want VA-Style Health Care?
and
Curing Walter Reed Syndrome
for more details.
By 
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8:19 AM, July 09, 2007
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