July 7, 2008
Economic Anxiety and Healthcare Reform (John Feehery)
I am reading a very interesting book by Peter Gosselin titled High Wire: The Precarious Financial Lives of American Families that analyzes the current economic situation of many in this country.
Gosselin’s thesis is that the new economy is a bad deal for many American families, because while they may have access to the possibilities of more economic success, they also have a greater chance of taking a great fall from which they may never recover.
He profiles several people who seemed to have it going all their way, until a minor slip puts them in an economic abyss from which they never recover.
Gosselin, a Boston Globe reporter, seems to looks fondly upon the good old days, when most Americans seemed to have more security, if less ability to ascend rapidly up the ladder of success. He is not a big fan of the philosophy of “creative destruction” where the churn in the economy leads to some insecurity but also greater economic progress for the country as a whole.
The safety net for the upwardly mobile is not that secure, Gosselin argues, and the government should do more to make it stronger for everybody.
I don’t agree with all of what Gosselin says, but I agree with his basic assertion that we are living in an age of great economic anxiety. I believe that President Bush’s greatest political liability has been his inability to communicate an effective program to deal with that anxiety.
Looking at the common thread that links all of Gosselin’s profiles, it is clear that the biggest cause of anxiety for most Americans is healthcare costs and healthcare access.
This issue is especially dangerous for Republicans because most Republicans don’t like talking about healthcare. In poll after poll, Democrats are seen as having more credibility than Republicans on this issue.
Democrats have a simple, but wrong, solution on healthcare. Have the government run it. This is the wrong solution, because government control of such a huge part of our economy will be bad for taxpayers, bad for doctors, bad for hospitals, and ultimately bad for patients. It will lead to healthcare rationing, and it will stifle healthcare innovation.
But the idea of government-run healthcare is gaining more traction, and not only from labor unions and left-wing Democrats. Within the business community, more and more business leaders are toying with the idea of just having the government deal with the increasing burden of healthcare costs.
Some Republicans believe that the best solution to the healthcare mess is to give individuals more purchasing power, so they can use the power of the marketplace to drive down costs. But I am not sure if the majority of Americans are comfortable with this model. My guess is that most want somebody else to pick up their healthcare tab. For the last hundred years or so, that tab has been paid by their employer.
We shouldn’t just throw in the towel on the employer-based healthcare system. We should seek ways to strengthen that relationship while creating incentives to drive down costs, whether through health IT, wellness initiatives or malpractice reforms. And for small businesses, allowing them to band together to offer a bigger pool for risk management is an idea that needs to be tried tomorrow.
It is not practical to present a comprehensive plan that will cure every American of their intense bouts with economic anxiety. But it is possible to come up with common-sense plans to deal with some of the root causes of that anxiety. Healthcare is a big driver thereof, and coming up with credible plan and a better way to communicate that plan should be a priority for Republicans in the coming election.
Visit www.thefeeherytheory.com.
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The first thing that will happen under government health care is that there will quickly become a shortage of doctors. Why go to school for 12 years or more, plus constantly train, to become a government employee? Some do it for the military because of the benefits, but overall, many will run from this insanity. When the America people get the equivalent of free health care, and that's what it really will become, they will wait for months just to get an appointment. Emergencies will lead to two to three day waits. If you don't die before you see a doctor you may wish you might have when you see a doctor that speaks little in the way of English, and is a hack to begin with. Good luck. Maybe you will get what you want, which will not be what you need in terms of health care.
Comment by Robert Rosencrans — July 7, 2008 @ 7:52 pm
I disagree with Mr. Feehery's position on healthcare reform. As a politically active practicing physician, I think I come from a place where I see the failings of our current employer-based system. Throwing more money at the already severely overpriced and inefficient Medicare Advantage program is much like giving the energy giants tax incentives to gouge the American taxpayer. It does not get to the root of the problem, greed and corruption. A single payer system modeled after Medicare would save hundreds of millions a year and insure nearly all, without the insane incentives now doled out to the HMOs and their executives.
Comment by Dr. Robert Gross — July 8, 2008 @ 8:52 am
JOhn: I appreciate your taking a look at my new book. But you;re going to land me in trouble with my employer. I left the Boston Globe nearly 10 years ago and have been working for the Los Angeles Times here in D.C. Any chance you could change that in your column today? I'm working at home today at 202-363-6903. Office is 202-824-8365.
Best -Peter G.
Comment by Peter Gosselin — July 8, 2008 @ 9:23 am
Make no mistake about it, the costs in todays healthcare market are crippling to businesses. While most businesses, big and small, do everything they can to provide health insurance to employees, it has become a staggering burden. And just because it is provided by the employer, that doesn't mean that it is effective, because claims are still denied for pre-existing conditions and other sundry excuses. Many employees are unisurable in todays market and that goes into hiring decisions. Much of the outsourcing of jobs, is caused by this. It is much easier to put jobs in countries with government run healthcare, than it is to wade thru the costs and paperwork that is required here in the US. The added costs in money and time also mean that fewer employees can be hired. Yes, I'm a small business owner, but it is way past time to look at this problem, not just from an individual's point of view, but from the employer's point of view. Any healthcare plan that puts all of the burden on the employer is doomed to fail. It can only cause less hiring and lower wages for all.
Comment by Al, KS — July 8, 2008 @ 10:11 am
I look at this a bit differently. I have always believed that globalization is a driving force for economic growth and was a great fan once. Lately, the negative effects of globalization on job security and income distribution have become more and more apparent to me, as I wrote here several times, and in my mind these negative effects do not compensate the overall economic growth in terms of leading to what I consider a desriable outcome, which is an America that is free and prosperous.
It's hard to give up on absolute freedom to outsource abroad. Yet I believe that for as long as the rest of the world is teaming with much poorer people who are also a lot less costly to provide health insurance to, there will be inevitable loss of health coverage through private employers. This is just one of the negative effects of outsourcing. The inability of the displaced workers to cope with the misfortunes that befalls them leads them to use their vote to shape the government to be more socia.list. So the unintended consequence of economic freedom is the loss of overall freedom.
The best way to provide health coverage for millions of people is to have a strong manufacturing base. "Knowledge " work has not shown itself to be a sufficiently proficient employer of "surplus" workers. The stratification that accompanies globalization cannot be politically sustained in its current form, and the GNP gains that globalization brings will eventually be lost to a Marxist government. Time for some industrial policy while there is still time.
Comment by Igor R. — July 8, 2008 @ 3:02 pm