Gephart vs. Obama: Health Care

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Former Democratic Congressman and presidential candidate Richard A. Gephardt (Mo.), is saying Obama should not attempt universal health care (UHC) this year. His argument is that without first lowering the cost of health care delivery, the funding additions to create universal health care will cause the effort to fail. Gephardt recommends a more piecemeal approach. Pres. Obama bills universal health care as essential to future productivity, economic growth private sector competitiveness with other nation's whose corporations are not burdened by shouldering the costs of health care for employees. Who is right?

My take is that Obama is right, and Gephardt may be proved to be right, but, also may not. The polls however, indicate that Gephardt may be wrong. Universal health care is now popularly supported by the majority of the public, 57% to 38%, even if it means higher taxes. Backed by a very popular president, the battle lines are being drawn between the public and Congress, yet again. As if Congressional approval ratings needed another hit.

Gephardt, an advocate and lobbyist for labor, does seek universal health care which would relieve employers of health care costs making American companies more competitive and employing more American workers. It would appear however, that he fears the special interest lobbies will spend enormous sums to torpedo universal health care this year if proposed as a comprehensive holistic health care reform bill. That is no doubt a justified fear.

However, a lot will rest on how organized consumer groups can become in lobbying for the UHC plan against other special interest lobbyists like the Pharmaceutical industry, who stand to lose some pricing power if they are negotiating contracts with the federal government as primary insurer of health services. If President Obama's approval ratings remain high, and the public demand for UHC remains strong, it is hard to argue against taking advantage of these factors in an attempt to get a holistic health care reform package passed.

Richard Gephardt is however on to something when he expresses concern over the funding aspect of such a package. Pres. Obama's proposal to increase taxes on the wealthy falls far short of funding the cost of implementing such a reform package. Pres. Obama's team is going to have to come up with some hard numbers that demonstrate the following if the proposal is to pass Congress:

1) Overall cost of health care in America will go down over the next few decades. This is essential as Medicare will begin producing federal deficits in 2019 under the current system, and Pres. Obama must demonstrate this will not occur or, be significantly delayed far into the future, under the new UHC plan. Otherwise, the federal government's debt trajectory will not be reduced and the nation's economic future will remain under threat of debt induced collapse.

2) The Private sector health care deliverer's quality of medical services will improve, or at least not worsen. This is potentially easier to insure with provisions for electronic records infrastructure and accessibility by health care deliverers, and more centralized oversight of health care services under a universal health care insurance system.

3) The public is ready to accept limitations and changes in last year of life health care services. Of the 454 billion dollars annual health care cost of Medicare, beneficiaries incur 27%-30% of lifetime charges in the last year of life, and most of those charges occur in the last 3 months of life. Hospice care, for example, saves 10's of billions of Medicare dollars over in-hospital end of life care, while extending life by an average of 2 months over hospital end of life care. Making greater use of hospice end of life care will be one of several ways to reduce UHC spending that the public will have to accept.

No insurance coverage for experimental treatments at astronomical costs, and other limitations of coverage under the UHC plan will have to become part of the public's acceptance. Of course, with the advent of a UHC system, a private sector additional coverage industry will arise providing those with the financial resources to pay the premiums for health care services above and beyond what the UHC system can cover.

Pres. Obama's team have not yet outlined the details of any universal health care insurance system, yet. So, there is a great deal of speculation and hyperbole regarding the, as yet, unknown plan. A cliche often heard in the discussion of a universal health care system is, 'the devil will be in the details', and appropriately so. Essentially, however, if such a plan provides a rescue from the current health care federal debt trajectory to the stratosphere, provides well care and essential injury and illness care for all Americans while reducing cost of operations for businesses, increasing their global competitiveness and growing jobs, the polling indicates a majority of Americans will support the plan.

Regardless of public support however, political support in the Congress may prove harder to come by as corporate and wealthy special interests lean hard on our representatives to prevent passage of such an enormous reform to our health care system, its cost and profit potentials, and the bargaining power of the federal government as primary insurer for all Americans. How the Obama plan treats the very high cost of end of life care will be of significant interest to the public and private health care sector, alike.

In a year when jobs are crucially important to the public, Pres. Obama's argument for a health care system that will create jobs, protect jobs, and provide every American with affordable health insurance, Richard Gephardt may be proven wrong about the prospects of getting a universal health care package through the Congress over the next 12 months. We shall see.

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This page contains a single entry by David R. Remer published on April 14, 2009 12:58 PM.

Debt & Deficits: Necessary vs. Unnecessary was the previous entry in this blog.

Gov't. Crime: Obama's Judgment Fails. is the next entry in this blog.

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