Health Care Politics

Originally published at on June 23, 2009

Consistent with his free-market approach to all things economic (emergencies aside), President Barack Obama has given some suggestions on how he believes reforms can make health care more affordable and efficient.  Mr. Obama has endorsed the creation of a public insurance entity from which Americans could choose to buy their health insurance, and which would offer competition to private insurers.

This approach is par-for-the-course for a President who addressed the financial crisis with public-private solutions instead of wholesale nationalization, and who believes in helping all Americans obtain health insurance but rejects the Canadian and European approaches to socialized medicine.

Mr. Obama has also smartly pressed for putting medical records on line as a way to track care and results in order to find ways to reduce costs and provide superior care.  A much-talked-about article by New Yorker writer and M.D., Atul Gawande, has illustrated that high costs in health care sometimes serve private financial interests at the patient’s and public’s expense rather than primarily reflecting patient needs.  Reformers hope that a public insurer could seek to both lower costs and provide high-quality care, inducing private insurers to match better care for lower cost.

While Congressional Republicans, some Democrats and insurance companies are speaking out against the public plan, saying it will undermine private insurers, recent public-opinion polls show popular support for a public insurance entity. Seventy-two percent of respondents in a nationwide poll supported the idea, including one in four Republicans. The President is going on the offensive, going so far as to mock lobbyists and legislators for protecting the insurance industry from competition.

Congressional Democratic leaders Henry Waxman, Charles Rangel and George Miller have unveiled a house bill containing the outlines of a public plan and proposal to insure 95% of Americans.  Senate legislation, being spearheaded by Democrat Max Baucus and separately in the offices of Senator Kennedy and others, is still being developed.

Any reform of such a massive sector of the economy is bold.  But with health care costs eating up an ever-greater share of public and private resources, change is required.  It will take years for the new legislation to transform our health care system, but the mantra of “more for less” is a good guiding principle.  Our spending on health care is unsustainable, damaging to public sector budgets and private business competativeness.  If we don’t want to give up the excellent care a majority of us enjoy, we will have to innovate.  Looking to competition, even that created by the introduction of a public insurance entity, and trying to bring more people into an efficiently-managed program, makes sense.

It’s about time Mr. Obama and Democratic leaders on health care received some bipartisan support for their efforts.

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