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Thursday, May 7, 2009

Politics and Health Care Reform: Good Ideas and Parking Lot Ideas

One of my favorite moments in explaining corporate culture to non-cubicle folks was explaining the facilitation idea of the Parking Lot to my wife. I explained that the Parking Lot was ideally used for ideas that are not really applicable to the present topic but don't want to be forgotten. Practically it is often used when someone brings up a bizarre idea and that's the quickest way to get them to stop talking about it. 15 minutes later after this explanation, we were talking about dinner, and I suggested my favorite divey buffet. My wife answered: "That sounds good but let's put that in the Parking Lot for now."

Republicans and Democrats have had some good ideas for health care reform and with some ideas that belong in the Parking Lot. Lately, I just saw a proposal that belonged in the "You're Frickin Kidding Me at Least Pretend Like You're Trying" Lot. Actually, I brought up the Parking Lot just because I just wanted to tell the story about my wife. There have been some horribly dumb health care reform ideas by the parties.

Good Democratic Ideas

  • Expansion of basic government programs like COBRA and SCHIP SCHIP offered coverage to vulnerable, low income citizens and the COBRA subsidy turned an expensive program into a viable one. The COBRA subsidy was also not too high to cause people to bypass other insurance options

  • Just being serious about health care reform By emphasizing it as a priority, the insurance industry has launched a series of proposals such as getting rid of honerous health screening and welcoming more regulation. All of the insurance industry proposals are very do-able and would level the playing field. I never would have imagined that my industry would make the offers that they have been.

  • Framing health care as an economic issue It's true and this simple framing has gotten reform more traction.
Good Republican Ideas

  • Taxing Employer insurance and giving a tax credit to individuals This was McCain's health care reform idea and it raises good questions about why we allow employers a tax break on health insurance but not individuals. While I don't think that it's practical, it brings a possible funding mechanism to the debate.
Pretty Dumb Democratic Ideas

  • The Public Health Plan to Keep Insurance Companies Honest I have blogged about this here and here. Basically the Obama administration thinks that despite having no experience in the health insurance business, they believe that they can launch a better, cheaper health plan by not paying agents any commissions and not making a profit. This Public Plan is a great way to threaten the insurance industry but adds very little value to our health care system. It would not coordinate care, provide more information to consumers, or improve outcomes. Hopefully, this is just a political threat.

  • Not being serious about cost containment The insurance companies can add only so much costs to the health care system. Providers and especially hospitals have been the ones whose costs increase well beyond the rate of inflation every year. Bob Laszewski's Healthcare Policy Blog has been very vigilant about pointing out the lack of hard choices around real cost containment.
Pretty Dumb Republican Ideas

  • Selling Insurance where you're not licensed One of McCain's really unpractical ideas was that carriers could sell insurance in states where they were not licensed and did not follow the regulations. While it was portrayed as a free market ideal, in reality, it was like me allowing to get my medical degree in Guyana and than practice in the states. This removes the power of state insurance divisions, allows one state's laws to apply to other states, and would create a jurisdiction mess.
Republican Idea that was so Dumb, I laughed and it inspired me to write this Post
I am crediting the Republicans with only one good idea and think that their latest proposal was so bad that it warranted this post. You could accuse me of being partisan but in reality, health care is not the Republican area of expertise. They don't really value it and Democrats love health care reform. Therefore, the results are not surprising. However, their press release below ranks right up there with their 18 page budget proposal with no numbers. Today, I saw this article:

On Wednesday, a House Republican health care task force announced several principles that will serve as the foundation for a plan that will be developed over the next few weeks, CongressDaily reports.
In a letter to Republicans scheduled to be sent out Thursday, the task force wrote that it will hold between six and seven briefings over the next two weeks before issuing a final version of its overhaul plan, intended to serve as an alternative to Democratic plans.
According to CongressDaily, the task force's principles include:

  1. Opposing the creation of a public option;

  2. Allowing U.S. residents to keep their current insurance plan;

  3. Keeping the government from intervening in health care decisions; and

  4. Promoting prevention, wellness and disease-management programs
(Edney, CongressDaily, 5/6).

Here is why I find it so lacking:

  1. The Public Option was my 1st pretty dumb Democratic idea so I agree. However, disagreement with the opposition is not a reform principle! This reinforces the Party of No Ideas image. Disagreement with the Democrats is a given, like the sun rising. It does not warrant a separate principle.

  2. How is maintaining the status quo of keeping current insurance a new principle? The whole idea of reform is to change things not to vow to keep them the same. Second, I think that only 30%-40% of America is really happy with their insurance and there just as many who are dissatisfied or feel misled by their insurance. Finally, this is poorly disguised attack on Democratic reform work by creating the impression that they will take something away

  3. The government is involves with health insurance for 1/3 of the country so they are already involved with health care decisions. Health care is a highly regulated industry where laws require government oversight. Does someone need to explain to the Republicans how the health care system actually works?

  4. With this list, why don't they add cute puppies and smiling babies to the list? This is the only proactive idea that is proposed and this is on every single other health care reform list. It's the one thing, along with ice cream tasting good, that we actually all agree on.
I am trying to decide if the fact that a major political party can only come up with a proposal this empty is funny or just pathetic. I think I'll put that thought in the Parking Lot.

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