Reinhardt Inconsistent On Heathcare?

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The Fiscal Times

November 28, 2010

Reinhardt: Repeal Health Care, Make GOP Cut Costs

By John Greenwald

In a freewheeling interview with The Fiscal Times, (Uwe Reinhardt) critiques the new health care reform law — including its lack of cost containment — and recent proposals from the president's deficit-cutting panel. Never one to mince words, Reinhardt also discusses what he sees as the real culprit behind soaring health care costs, why he doubts a single payer health care system could work in the United States — and where he believes the country's founding fathers went wrong.

The Fiscal Times (TFT): What would a high-performing national health care system look like?

Uwe Reinhardt (UR): I think the Germans, the Swiss, the Dutch have a perfectly fine approach. It's not a single-payer system. While I'm a Canadian I am not for [single payer] in the U.S. because we do not have a political system that can handle it responsibly. Canada has a parliamentary system that insulates considerably the public program from lobbying.

TFT: So you favor universal coverage but not a single payer system?

UR: For other countries I do [favor single payer] but we can't run it. You need a responsible system of governance. Whatever you can say about U.S. governance, you cannot call it responsible. You really couldn't. I think the founding fathers gave us an impotent government that acts quite irresponsibly. I don't think parliamentary systems are that bad.

http://www.thefiscaltimes.com/Issues/Health-Care/2010/11/28/GOP-Health-Reform-Repeal.aspx

Comment:  Single payer advocates frequently are perplexed by Uwe Reinhardt's positions on health care reform.

He seems to support health care justice. He frequently uses the example of the waitress who is trying her best to support herself and her child, but who is unable to afford health care. By extrapolation, a just society would not let her or her child go without the essential health care services that they might need.

Yet what about single payer? He is a supporter for single payer, but for other countries. In this interview he states that he does not support single payer for the United States. The reason he gives is that "the founding fathers gave us an impotent government that acts quite irresponsibly."

Right now the British and the Canadians are facing an assault on their public health systems by their conservative governments. In the United States, we are facing an assault on our Medicare program by the conservatives and right-leaning moderates. Although we don't know how much damage, if any, will be done to the systems, it is highly probable that all three of the systems will survive intact considering the strong public support in each nation.

Does our government act irresponsibly? Wars? Income transfer from the workers to the wealthy? Neglect of poverty and other social inequities? Of course our leaders have been irresponsible, and so have the leaders of all other nations, but only at times. Social Security? Medicare? Our national parks? Most government activities are quite responsible and certainly do not set us apart from other nations.

Although Reinhardt criticizes the new health care reform law for failing to contain costs, he states, "The private sector is the inflationary component of health care, not Medicare or Medicaid." Can he seriously contend that these government programs are irresponsible and impotent when they continue to outperform the private plans on cost containment? Considering this, how can he support single payer for other nations, yet reject it for the United States?

Government impotence and irresponsibility are not reasons to reject single payer. They are merely an excuse as to why we haven't enacted it yet. What we need is more responsible people power. Let's get busy stirring it up

Related articles

• Economix: The Case for Raising Taxes (economix.blogs.nytimes.com)
• A Chinese Minister on Chinese Health (economix.blogs.nytimes.com)
• Economix: How Medicare Sets Hospital Prices: A Primer (economix.blogs.nytimes.com)
• The Complicated Algorithms Used by Medicare to Establish Hospital Compensation (ducknetweb.blogspot.com)
• Princeton Professor Uwe E. Reinhardt, Ph.D., to be Awarded the 2010 William B. Graham Prize for Health Services Research (eon.businesswire.com)
• What makes the US health care system so expensive (theincidentaleconomist.com)

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Published on Monday, September 28, 2009 by The Guardian/UK

The Public Option Is Nothing To Fear

Republican opponents of a public option for US healthcare are defending the insurance industry, not conservative principles

by Dean Baker

Back in the good old days, the conservatives were the folks who favoured individual choice. Not any more. In the current healthcare debate, the top priority of the so-called conservatives is to deny people choice. They want to make sure that Americans do not have the option to buy into a Medicare-type public healthcare plan. These alleged conservatives have come up with a variety of arguments against allowing people the Medicare-type option, but the only one that makes sense is that they work for the insurance industry.

The argument against a Medicare-type option always begins with the assertion that the government can't do anything. This is a peculiar claim given the popularity of Medicare, but it also makes no sense as an argument against giving people a buy-in option. Suppose the government gives people the option to buy into its really bad plan. Everyone would just stick with the good private plans we have now, right?

The so-called conservatives then tell us that people will end up buying into the bad Medicare-type plan instead of the good private insurance options because the government will subsidise the Medicare-type plan. A little bit of arithmetic is sufficient to dismiss this argument.

How much money would be needed to get people to choose a bad healthcare plan rather than a good one? This would have to involve some serious subsidies. People are not going to sacrifice their health and the health of their families for another cup of coffee at Starbucks.

Suppose it took a subsidy of $1,000 a year to get people to choose the bad Medicare-type plan over the good private sector plans. With a non-Medicare population of more than 250 million, this would imply government subsidies of more than $250bn a year, if the Medicare-type plan was to fully replace private sector plans, as the so-called conservatives warn.

Is it really plausible that Congress will approve $250bn a year in subsidies ($2.5tn over a 10-year budget window) for a Medicare-type plan that everyone thinks is awful? Is there another altogether wasteful programmes that gets public subsidies even one-tenth of this size?

This one just doesn't pass the laugh test. If conservative politicians don't think they can prevent such an enormous waste of taxpayer dollars being perpetuated year after year for the indefinite future, they should probably consider another line of work.

In short, there is no genuine conservative argument against allowing people the option of buying into a Medicare-type plan. If the plan proves to be inferior to private insurance plans, as is often argued, then the consequences will be relatively minor. Some number of people who choose to sign up with this plan will find that they don't like it, and then will switch to a better alternative. In time, a bad public plan will soon flounder, since few people will buy into it. There may be some effort to provide subsidies to even a bad public plan, but it is not plausible that the subsidies could be large enough to displace private plans.

It is also clear that the opposition to a Medicare-type public plan does not stem from townhall-type mass opposition. A recent New York Times poll found that by an overwhelming majority, 65% to 26%, the public favours giving people this option. If there is a member of Congress that risks defeat by supporting a public plan, it is not because of their constituents' views.

The opposition to a Medicare-type option is not based on public sentiment or the fear that the plan will be bad. Rather the opposition is based on the fear that the plan will be good and that people will choose to buy into it. This will cost the insurance industry tens of billions of dollars in profit over the next decade and could mean the end of big paycheques for the industry's CEO's and other high-level executives.

But the people who oppose giving the public the opportunity to buy into a Medicare-type plan should not be called conservatives. Honest conservatives would have no objection to giving the public a choice. The people who oppose a Medicare-type plan are doing the bidding of the insurance industry - there is no conservative principle at stake. And we all know what Joe Wilson has to say about people like that.

© 2009 Guardian News and Media Limited

Dean Baker is the co-director of the Center for Economic and Policy Research (CEPR). He is the author of The Conservative Nanny State: How the Wealthy Use the Government to Stay Rich and Get Richer ( www.conservativenannystate.org) and the more recently published Plunder and Blunder: The Rise and Fall of The Bubble Economy. He also has a blog, "Beat the Press," where he discusses the media's coverage of economic issues. You can find it at the American Prospect's web site.