Tuesday, October 28, 2008

Obama health care plan is about getting people insured, not about running hospitals

In my last post, about health care, I got a critique in which the poster pointed out that the hospital that had kept an injured and uninsured woman waiting for nineteen hours was a county hospital, and then suggested that the Obama plan would put all hospitals under government control. I responded by pointing out that privately run hospitals have the same kinds of problems (I referenced, for example this post about a person who died after more than a day in the waiting room of a privately managed (though government owned) hospital.

However there is a far more fundamental misconception on the part of people who like to bash the Obama plan. The misconception is that it involves some kind of nationalization of the health care industry. It does not. There is nothing at all in the Obama plan about taking over the private hospitals and making them part of the government.

The Obama health care plan is about insurance. Right now, most hospital emergency rooms have a two tiered system for serving customers. Those who have insurance stand first in line. The uninsured are the equivalent of 'stand by,' being seen only when and if there are no insured customers waiting to be seen.

Given this reality, and the fact that there are around fifty million uninsured Americans (this is more than the population of California) the Obama health care plan is pretty basic-- it wants to make sure that everyone has access to insurance they can afford. The plan does achieve this goal by heavily subsidizing health insurance that is offered to people who might otherwise not be able to afford it-- be they too poor to be able to afford it, or be they cancer survivors or other people at high risk who might otherwise not be able to purchase insurance.

The program is voluntary for adults. It is mandatory that parents purchase insurance for their kids. There is precedent for this though-- we require drivers to purchase car insurance so they are covered against any damage they may inflict upon other drivers by their own negligence, so it is hardly irresponsible for us to require that they purchase insurance to cover their own kids (not doing so would indeed be negligent.) But under the Obama plan, if they insist they don't want any inurance, they don't have to buy any for themselves. Adults have every right to be stupid, and the Obama plan recognizes this. But they don't have the right to by their stupidity endanger other people (especially children, theirs or anyone else's.)

Incidentally, there is one other industrialized country-- Japan-- which has achieved universal coverage via private insurance with a partial government subsidy. And the Japanese have among the longest lifespans in the world, so it seems to work pretty well.

But to jump from Obama's plan to help people purchase insurance, to arguing that Senator Obama plans to take over and run private hospitals, is ridiculous and represents the kind of paranoid thinking that seems to have hijacked otherwise reasonable people on the right.


Robert Rouse said...

A couple of months ago, the New York Times ran a story about hospitals who were repatriating patients to their native countries without their permission. I think we do need a few more regulations for ALL hospitals to keep shit like that from happening.

forHealth said...

The problem with the Obama plan is it doesn't solve the problem of affordable health care. Health insurance introduces an intermediary that funnels the money and results in higher prices for everyone (insured or not). Now some argue that insurers negotiate prices, but if you actually sit down and discuss the cost of an office visit, you will find there is no real discount.

shrimplate said...

A hospital in Phoenix wanted to send a patient back to Mexico. They ended up keeping her and providing tens of thousands of dollars in free care due to the public outrage.

The cost of that patient's care is of course going to be added to your own insurance premiums.