September 2009 Archives

Our ability to constrain American health spending may lie in theanswer to one basic -- and increasingly contentious question  --whether patients with the same condition basically get the same carewhether they are treated by doctors and hospitals in Manhattan orMinneapolis.      If they do, we've got a serious problem and will have to drasticallyratchet back our anticipated savings from estimated efficiencies. Ifthey don't -- a position embraced by President Obama ...
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How are health reformers to respond to someone who says he chooses not to buy health insurance?  Someone with a fair amount of sophistication on this issue has made that decision and wrote about it recently. Many proposals, including the one now being implemented in Massachusetts, would impose a fine to require compliance.  That's not impossibility in a society where all workers are required to pay for Medicare that promises to ...
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Dueling rallies on health reform issues accurately reflect public frustration with the system, but it would be a mistake to think that people would calm down if the issue was resolved.  In fact, health questions are a symptom. The underlying disease is a structural political problem that pits the interest of the political professionals in both parties, who have a preference for remaining in power backed by an impregnable base, ...
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For a few days, I've been watching the escalation of a national brawl over whether "illegal immigrants" will or will not be covered under a revamped healthcare system. I think this is a manufactured debate meant to distract and frighten oldsters into a tizzy.  It has Karl Rove's fingerprints all over it. It's just not a substantive  issue, and I will tell you why. Before I wonk out, though, I ...
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Is it time for a new approach in lobbying the Blue Dogs? The evidence suggests so. For the past six weeks progressives have been warning conservative Democratic and moderate Republican legislators that failure to vote for a public insurance option will prove that they are the corrupt and stupid vassals of the evil special interests and that they deserve to be ousted from office in the next election and subsequently ...
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A new book reportedly suggests that LBJ couldn't have won Congressional approval to create Medicare had he shared good-faith estimates of what it would cost . That's plausible and raises a series of tough questions, particularly for those of us who are big boosters of transparency.  The first is when - or if - Medicare would have been enacted had legislators had good numbers.  Another is how things would be ...
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