July 23, 2009
Why The Health Reform Debate Is Confusing
Dr. Jon LaPook: You're Not Stupid If You Don't Understand Health Care Reform
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Play CBS Video Video The Economics Of Health Care Dr. Jon LaPook speaks to two industry insiders about rising premiums in light of insurance company profits.
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(IStockPhoto)
Surgeon: You need an appendectomy.
You: What are my options?
Surgeon: Either I take out your appendix or you die.
Now that’s a conversation people can understand. But what if, instead of whisking you up to the operating room, the surgeon kept talking and invited a few other people into the discussion?
Surgeon: Do you think I should take it out by an open operation or laparoscopically?
You: Huh?
Laparoscopy equipment salesman: You know, cutting you open the old-fashioned way and leaving a big scar or having a tiny incision. Laparoscopy is much better than the open procedure.
Guy who sells scar-removal cream: Wait a minute. Better for who? Laparoscopy takes fourteen minutes longer.
Hospital administrator: But hospital stay is reduced by 0.7 days on average, patients have less pain, and you can return to work sooner.
Surgeon: Laparoscopy costs more than an open operation while you’re hospitalized but less once you're home. What's your co-pay?
You: Doc, my belly’s hurting a lot more now.
Guy who owns shares in a drug company: What if we just treat him with antibiotics?
Surgeon: Don’t be silly. His appendix could burst.
Funeral director: What about doing nothing?
Very smart people are zoning out of the health care reform debate because they think it’s just too complicated. The latest poll out today from the Kaiser Family Foundation, a nonpartisan health-care-policy research organization unaffiliated with Kaiser Permanente, says only 27 percent of the public has been following the health reform debate closely. Despite this, more than half (56 percent) of Americans think health reform is more important than ever.
Simply put, there are four main goals of the legislation:
Defining the goals is relatively easy to understand. Implementing them is tough and that’s where people are made to feel stupid - partly by special interest groups who intentionally or unintentionally confuse the debate. Drew Altman, Ph. D., the President and CEO of Kaiser Family Foundation, told me there’s "all kinds of spin, mis-statement of fact and plain old mis-truths being bandied about and the debate is getting nastier and nastier." He added that people are becoming confused and "it’s beginning to make the public more anxious and antsier."
Half-truths feed on fear. People are afraid of losing or compromising what coverage they already have. They’re afraid of higher taxes and lower quality of care. Who has the time or patience to read the 1,000-page bill proposed by the House of Representatives? So we rely on summaries and are susceptible to all sorts of misrepresentation. And nobody wants a plan with major faults rammed down their throat in the name of political expediency.
Today’s Kaiser Family Foundation report suggests that the tactics of special interest groups are working. Sixty percent of adults surveyed support a public option. But "(w)hen those who initially support the public plan are told that this could give the government an unfair advantage over private companies, overall support drops to 35 percent. Conversely, when opponents are told that public plans would give people more choice or help drive down costs through competition, overall support jumps to roughly seven in ten."
It’s in the interest of those who oppose health care reform to make us feel that it’s just too hard to understand. I have certainly felt that way at times over the past year. But the stakes are too high for Americans to bale out on the discussion. Our common sense and sense of fair play are crucial to the national conversation. We should hear out the special interest groups; they often have legitimate concerns and thoughtful analysis. But we need to remember where they are coming from. And we must seek out information from sources that try to be nonpartisan, such as the Kaiser Family Foundation.
No, you’re not stupid if you’re confused about health care reform. But you may be psyched out. You probably know a lot more than you think - but you may need to do some homework in order to participate in this extraordinarily important national debate. The national debate needs you.
For this week's CBS Doc Dot Com, I moderate a debate about the public option between Wendell Potter, former head of public relations for Cigna and Rob Schlossberg, Executive Sales Director for BenefitMall. Mr. Schlossberg opposes it and Mr. Potter favors it.
To view the debate on a public option, click here.
To view a brief discussion of for-profit vs. not-for-profit health insurance organizations, click here.
For Rob Schlossberg’s blog on the public option, click here.
For Wendell Potter’s blog on the public option, click here.
For Janet Adamy’s excellent summary, "Ten Questions on the Health-Care Overhaul," in the July 21st issue of the The Wall Street Journal, click here.
© MMIX, CBS Interactive Inc. All Rights Reserved.
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- Infant mortality (Number of deaths in the first year per 1000 live births)
#1 Singapore 2.31
#2 Bermuda 2.46
#3 Sweden 2.75
(...)
#7 France 3.33
(...)
#44 Cuba 5.82
#45 United States 6.26
Source : https://www.cia.gov/library/publications/the-world-factbook/rankorder/2091rank.html - Reply to this comment
- The health care debate is not confusing, it is just that most people are STUPID! They fall for the manipulation and propaganda from the for profit greed mongers. Wake up and get your friggin head out.
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- The propaganda system has been lobbied to sell the health system as "TOO COMPLICATED"& the ins. rip off must then continue-I bet they win -they still have our military & some public believing these men are fighting fot THEIR country & PEACE!!!!
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- I think the article has a major error. The exchange is for EVERYONE. All private insurance will be controlled and dictated to by the government. Section 203, I believe.
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- The real trouble is that the people Obama wants to pay for it all GET nothing and the people who get all the benfit PAY nothing. That's typical Obama reasoning.
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- Really VERY simple-the ins co gets 1/3 of all funds & will bribe the political & propaganda system massively to make it too confusing to EVER stop.This bribe system is legal the propagandists are directed to call them lobbyists-the "media" & their family can stop for a 10 min speech for a few hundred thou anytime!
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- Finally, someone who makes sense! We should be getting answers to these important questions, but we can't get answers from those who have no clue about what the real problems are, let alone how to fix them. If you look at the 1018 page HR bill it is painfully obvious how clueless they are. This bill is a disaster waiting to happen. Do we need healthcare reform, oh yes! Is anyone offering it, not even close! There are many issues that create our healthcare problems, so why is congress ONLY addressing health INSURANCE??? Why, because it is an easy out, since we all love to hate insurance companies (at least until we have a claim).
The currrent bill is only health insurance reform and the reality is that health insurance profits only account for 3% of health insurance costs. So why are they only addressing the 3% factor??? There are issues that need to be addressed with health insurance, but could be done so quite easily without completely destroying our current system, as the HR bill does. We already have government agencies in place to do so, all they would have to do is start doing their job. But since they aren't doing their jobs, the HR bill wants to put even more agencies in place with sweeping authority to decide nearly every aspect of health insurance. Who you will have to buy it from, how much it will cost, what coverage you can have, what types of plans you will be allowed to buy, to name a few.
The HR bill will eliminate the most affordable types of health plans available. It's mandated coverage is far less then any QUALITY health plan already offers. It only offers 3 plans which you can buy, rather than 100's that are currently available. It will replace highly trained, licensed brokers who can help you find a plan that's right for you, whose services are currently paid for by insurance companies with a government "exchange" to help you select from their 3 options. Health coverage will be mandated, but the tax for not buying insurance will be a small fraction of the cost to buy it, so what do you think an economically challenged company is likely to do, buy very expensive coverage or pay a small tax, or even better yet, 1099 their employees and get rid of the problem all together?
The bottom line is REAL health care issues will not be helped by this bill but it will cost tax payers hundreds of billions and more likely trillions of dollars. We need to ask what are we going to get from any legislation, what will change, and how much will it cost us and be sure that we get clear answers! - Reply to this comment
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- "The currrent bill is only health insurance reform and the reality is that health insurance profits only account for 3% of health insurance costs. So why are they only addressing the 3% factor???"
SOURCE, PLEASE!
IT'S TRUE THAT 98% OF ALL STATICS ARE 'MADE-UP'.
- "The currrent bill is only health insurance reform and the reality is that health insurance profits only account for 3% of health insurance costs. So why are they only addressing the 3% factor???"
- I am amazed but not surprised that the right wing fronts for the insurance and health care profit maximizers and then uses fear to convince people that they should continue to be ripped off. People wake up, you have been conned and taken for the last 3 generations. $2.5 trillion per year is going to make the rich richer and everyone else poorer.
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- Anyone who is old enough to remember or who has been paying attention will know that the whole issue of health care became as complicated as it is today when Kaiser became a large part of the problem.
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- We have researched this almost to death. We know who the culprits are (lobbyists, pharmaceuticals, insurance corporations, and others). Why can't we just put them all in a large room with no food or water, no restrooms, and no chairs, and give them 24 hrs to come up with an agreed upon program. No one goes home until a viable program is up and running! We are spending too much effort not making a decision!
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- Think about it.You get 1 vote at election time. CEO's of every Mega Corp. get 1 vote plus 30 lobbyists that are in Washington 24/7.Can you stay in Washington and watch your Rep? At what point does the Legislative/Corporate relationship become so entwined that you don't know where the line is??
- We can do this now or we can wait again, like we did back during the time of Clinton when there were 33 million uninsured which today has grown to 46 mllion, even back to the days of FDR. We are the only industrialized country without universal health insurance because our health care is in the hands of an industry that is operated for profit: which means they can exclude unprofitable individuals, for one.
But every year the health care costs take a bigger slice of our GDP, more families drop out of coverage, more people experience bankruptcy from medical bills. These are problems you don't see in Canada, or France, or UK, or .... any developed country. And yeah McConnell is worried we'll end up rationing health care. We have that already. But our problems are even bigger.
Doing nothing now puts us in the hole deeper. When we have to act, it's not gonna be pretty.
- Look at Rasmussen if you want to find out what the people are thinking about health care reform. Who the hect is Kaiser and how far did you have to dig to get that polling data?
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- We don't care what the adminstration says about the great aminities of their health care reform, that's not what people are confused about. It's questions like; "Can I keep my doctor and my current coverage?", "What is this going to cost?", "How can we afford this with the current deficit and out of control spending?", "Will health care be rationed?" And the answer to all these and more are the wrong answer for most Americans. Get to the meat of the issue!
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- From the Kaiser web site...
"A leader in health policy and communications, the Kaiser Family Foundation is a non-profit, private operating foundation focusing on the major health care issues facing the U.S., as well as the U.S. role in global health policy. Unlike grant-making foundations, Kaiser develops and runs its own research and communications programs, sometimes in partnership with other non-profit research organizations or major media companies."
Notice that they are involved with the "US role in global health policy". They work with "major media companies". So they have no agenda and are unbiased? - Reply to this comment
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- Before we argue about agenda and bias, what's wrong with Kaiser? What are they doing that makes them part of the problem instead of finding ways to lower costs and improve access and outcomes? Once you can answer this question, whatever maybe Kaiser's agenda or bias is their business. See, everybody's got their own.
- Mitch McConnell says he's worried the best health care system in the world will begin to ration health care. That's what we already have. They're worried about people having to get in long lines just to get health care. We already have that too. http://www.wisecountyissues.com My father died and rationed care played a part.
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- The flexibility of health insurance companies to exclude unprofitable individuals outright or upon renewal of policy--those with preexisting conditions, those who fall ill and require expensive treatments--appointments that need to be made several weeks in advance, denial of service and so-called "mix-ups" that result in insured patients being on the hook to pay for their care, the soaring costs of premiums that are increasingly a burden some people just choose to do without, the 20% of people with insurance who delay going to their doctors because of concerns about their out-of-pocket costs: these have the effect of rationing health care. Like any resource, health care is best rationed and it is rationed in any economy.
- In spite of McConnell's stature in American politics, his arguments sound like he is functioning intellectually on the level of a high school idiot. At his age and given his exposure to all kinds of domestic issues, you can't say he lacks, or has failed to acquire, innate awareness or that he doesn't have access to the best sources of information. Is this real, he is really worried Obama's effort at reform will end up rationing health care, as if rationing health care was an ideal that actually exists in the real world? And what's this nonsense about the best health care system? We don't even rank among the top 30 in the world, we have the worst life expectancy and infant mortality of any industrialized country, we have the worst case of medical errors that result in death, pathetic outcomes for breast and cervical cancer, asthma, etc., etc.
I suppose I should see some silver lining in the fact that we have the lowest average life expectancy in the developed world. Folks like McConnnell wouldn't be long with us to do more harm than good.
- McConnell is just another thief. Living very high on bribe money and telling the most outrageous lies to support his benefactors' evil acts.
- I find it hard to believe that Mitch McConnell is worried about anything to do with healthcare with the exception that the Democrats, if successful, will have a leg up on the Republicans. He has not been too worried the last 8 years when the Republicans had the power to do something. He's confusing worrying about party popularity versus public good.
