Friday, September 18, 2009

Health care roundtable

Last night I attended a forum on health care sponsored by America's Future Foundation. Comprising the panel were Peter Suderman of Reason magazine, Phil Klein of The American Spectator, Christie Herrera of ALEC and Brenden Steinhauser of FreedomWorks (astroturfers!).

Suderman opened with a droll monologue, referring to true health reform -- working off of memory here -- as a puzzle locked in a safe hidden in a bank vault located at the end of a labyrinth inside a cave guarded by a dragon. In other words, a bit elusive. He then proceeded to give a rather typical libertarian-style pox-on-both-your-houses denouncement of Democrats as unreconstructed statists and Republicans as idiots mostly uninterested in actual health care reform.

He is, of course, not far off the mark.

Then, imagining that -- like Dorothy -- we were to be swept up in a tornado and transported to a faraway land where true health care reform had been enacted, he said that it would be a place where health insurance actually functioned like insurance, to be used only in catastrophic situations. After a few more remarks about free market health care, none of which made much of an impression on me (that is to say, I can't remember), he concluded by urging people to sit back, relax and enjoy the spectacle (his term: clusterf***) that is health care reform and all its unintentional hilarity.

While admittedly hilarious, I didn't find Suderman's remarks terribly insightful and his recommendation that we simply embrace the health care mess unsatisfying. While he certainly seems bright enough, he seemed more keen on going for the laughs than spelling out a libertarian vision of health care in any detail.

Next up was Klein, who began with an anecdote about living in London and talking to a British girl, who complained about the fact that burgers at McDonald's came with pickles on top. When Klein responded that she should simply ask for a burger without pickles she said the thought had never occurred to her. Klein used this to illustrate that Americans tend to be more demanding than Europeans in their breadth of choice and customization, which are strangely lacking in health care. The less dramatic conclusion is that this particular girl was simply not very bright.

In any case Klein went on to make some good points, a couple of which stood out to me:
  • While people with employer-provided health care are often viewed as fortunate for their status, Klein argued they aren't as lucky as may seem. After all, while they enjoy a plethora of choice in life, from potato chips to cell phones, they have very little choice in health care, frequently handed a plan by their employer or given the choice of only a few plans. The better approach is a system where we have dozens of choices in deciding which health care plan is most appropriate.
  • Since most Americans receive their insurance through their employer, and change employers several times during their careers, there is little incentive for insurers to develop a lifetime relationship with customers. Hence, there is little incentive for insurers to promote or reward lifestyle choices such as smoking cessation or weight loss, or attempt to keep their customer healthy over the long-term.
The third panelist was Herrera, who looked at health care more on the state level and the problems posed by mandated health insurance coverage for certain types of care, which raises costs. Herrera pointed out that such mandates, which cover an array of services, are cumulatively responsible for something on the order of 50 percent of the cost of health insurance premiums.

I believe it was Herrera, but may have been Klein, who also argued that customers should be "allowed to buy the health care you want, not what the government says you need."

Herrera then went on to detail the problems with Obama-style care already at work in the states, such as Maine's public option and the health insurance mandate in Massachusetts.

The last speaker, Steinhauser, spoke about the politics of health care reform and efforts to rally opposition. While somewhat interesting, the subject wasn't one of my motivations for attending the discussion.

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