Health Care That Works - Roger Hickey - Campaign for America's Future

[Mass]

Long, but worth clicking on the link to read the whole piece.

Health Care That Works

Roger Hickey
April 17, 2007



Roger Hickey is the co-chair of the Campaign for America's Future. The following is a part of the TPMCafe Book Club group discussion of the new book Sick: The Untold Story of America's Health Care Crisis—and the People Who Pay the Price by Jonathan Cohn.

The big debate in universal health care is over the role of the private health insurance industry. Some participants in the debate ask: Can we regulate and “incentivise” big health insurers to get them to achieve a system that will cover everyone, improve health and make the health care system much more efficient, even though their business model has produced many of the very problems the public wants solved?

A few others have plaintively insisted that all this talk about systemic change and the model of single-payer is politically unrealistic and therefore irrelevant.

...

I submit that one of the best things we on the “progressive” side of this debate can do this year is to engage the nation—and the politicians—in a public discussion about the private health insurance industry: about the many ways the industry deforms and cripples our health care system—and about how they actually kill people.

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We should be doing the same thing—but with the goal of channeling that anger to some productive conclusions:

• Insurance companies distort our health care system at great cost, and therefore:
• We should demand politicians tell us how they would make insurance companies change their business model—now based on insuring the well and the wealthy. or
• We should build our health-care-for-all vision around a public system—like Jacob Hacker’s Health Care for America —not the private insurance companies.

Even if you are one of those who believe the next president will have to capitulate to the insurance industry in order to get anything passed, you’ve got to see that having the companies publicly on the defensive—explaining that they don’t want to cut off peoples’ insurance or charge outrageous premiums—has got to give us an advantage even if our goal is getting a plan for America that is marginally better than Massachusetts or California.

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My essential fear though, is that we’ll only get to some kind of compromised quasi-universal coverage system that doesn't really cover everybody, keeps a role for a private insurance industry operating under the wrong incentives, and looks like welfare for the poor.

In that case this whole cycle will start again, and in about 15-20 years when we go into a more violent collapse—then we will end up with Soviet-style rather than Danish-style socialized medicine. And we ought to be able to do much better than that.