Amy Traub
The Last Gasp of the Bush Health Plan
Crazed stories of a nefarious Democratic plot to kill grandpa notwithstanding, overall American opinion about President Obama's health plan hasn't really changed in the past weeks. If anything, the sound and fury has simply limited the President's ability to be heard making the most clear and compelling case for his reforms. But none of this answers the real question: what do people think of President Bush's health plan?
I ask because of the editorial in yesterday's Wall Street Journal in which John Mackey, CEO of union-busting Whole Foods Markets, pulls the Bush health plan out of the dustbin. It was never very appetizing to begin with. And now it's moldy too...
It's all there, fresh as the 2007 State of the Union Address.
First Mackey proposes high-deductible health insurance plans and health savings accounts - Bush favorites - which effectively redistribute health care costs from employers and the public on to individual families and households, forcing ordinary Americans with no medical training to evaluate which tests and treatments are worth the cost. Not surprisingly, research indicates these "consumer-driven" policies encourage people to pass up care they need because of the costs.
Mackey also suggests changing the tax treatment of health plans, a key Bush proposal, that does little for the uninsured and provides multiple perverse incentives: for employers to stop offering care and for well-off and healthy people to leave traditional employer-sponsored plans and go off on their own. With a lower risk of illness, these healthy people may get cheaper coverage in the marketplace, but they leave behind a weakened insurance pool, raising the cost of coverage for older, sicker, and lower-income Americans.
The Whole Foods honcho further suggests throwing out the state regulations that prevent insurance companies from - for example - denying cancer treatment or throwing women out of the hospital right after giving birth. Certainly, insurance companies could charge less for their policies if only they didn't have to cover anything.
Mackey even dusts off that favorite Bush whipping boy: medical malpractice lawsuits. After all, we might be able to lower health costs by as much as a half a percent if we got rid of them. In the process, of course, we'd eliminate one of the most significant incentives for hospitals and nursing homes to avoid negligence and medical mistakes, like those that already harm patients 40,000 times a day in American hospitals.
Mackey rounds out his wish list with an insistence that health care is not a right. "Just like food and shelter it is best provided through voluntary market exchanges." Fair enough, except that U.S. health care today is case of tremendous market failure, in which sky-high health spending produces mediocre outcomes and leaves millions without the care they need. At this point, the same could easily be said for the U.S. market in "shelter."
In his conclusion, Mackey even stoops to blaming the sick, all but suggesting that if we only shopped at Whole Foods more often, nothing would ail us in the first place. In the end though, Mackey's tired prescriptions are sadly not likely to be the last gasp of the Bush health plan. After all, as I've noted Senator Enzi's alternative to the Obama health plan is also a rehash of Bush proposals. Other than scare-mongering, conservatives seem to have no new ideas to offer.
Amy Traub: Author Bio | Other Posts
Posted at 8:05 AM, Aug 13, 2009 in
Health Care
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