Arguments Against Healthcare Reform Examined

Related Issues: Health Services , Universal Health Care , Health Care

Tags: reform , healthcare , medicine

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Thursday, 07/02/2009 @ 09:37 AM

To whom it may concern:

I've been listening to the recent debate being played out in the media surrounding healthcare reform and it's about time to directly address the five main arguments being tossed out there by opponents of any federal action to address the current state of healthcare in this country. I'd like to address these arguments one at a time and examine whether they hold water or not.

Argument 1: Public option healthcare will force Americans into government run programs. This is far and away the easiest argument to rebut as there have been no suggestions by anyone in government that I know of to force anyone into a public option. In fact, I've heard repeated over and over again exactly the opposite...if you like your current healthcare plan, by all means stay with it.

Argument 2: Any public option would effectively force private health insurance carriers out of business because Americans would prefer the public option. This argument actually has some merit. Many Americans would prefer a public option. Medicare is often used as the proof to bear this argument out. What they fail to recognize is that Medicare hasn't ruined the private insurance industry for seniors, but it has forced insurance carriers to change their focus. Last time I checked, Medicare supplemental insurance carriers are doing quite well. For those who choose a public option, there will always be a gap between what is charged to a patient and what is covered by insurance.

Argument 3: Public option healthcare would take medical decisions out of the hands of doctors and patients, handing government that decision-making power. This argument fails to recognize that these decisions today in the private insurace market don't rest in the hands of doctors or patients. Rather, they rest in the hands of a group of CPAs working at the insurance companies and are made with profit rather than the good of the patient in mind. I've yet to hear any propositions that include disallowing services simply because the public option healthcare won't cover a service. So basically, there is no change except to shift the decision on what services will be covered from a profit-driven insurance company to a government agency.

Argument 4: A public option would increase government spending at a time when we're already running massive deficits, potentially creating a monetary crisis down the road. If the public option isn't well thought out and accounted for budgetarily, this is a very real possibility. Unfortunately for those who make this argument, you can't look at the costs of implementing a public option without looking at the costs of doing nothing. I've seen studies that place the cost of doing nothing anywhere from tens of billions of dollars per year up to a trillion dollars per year. Government projections are that doing nothing will result in our government forking out $4.4 trillion per year for healthcare by 2018, up from the $2.5 trillion it spends today (of which only $677 billion is Medicare/Medicaid).

Argument 5: A public option would cause huge backlogs for services as more people would be eligible for them. This argument assumes that we should hang our decisions about healthcare on our capacity to provide them. I'm betting that the people making this argument wouldn't support placing limits on how many services a doctor can order in a given period of time. Personnel shortages should induce more people to go into a particular field of discipline. Equipment shortages should induce buying of more equipment in order to meet demand. That's how markets tend to work in this country, even when the government gets involved. Anyone who thinks reduced payment rates because of public option health insurance obviously don't know many doctors. I know several doctors who derive a major percentage of their revenues from Medicare or Medicaid and they are all quite well off.

Of the arguments I've listed, 2 and 4 have at least some merit. Arguments 1, 3 and 5 fail completely and should never be allowed into intelligent conversation. I don't think for a minute that a public option alone will fix anything. As with most problems in life, there is no single fix. Most often, a combination of things are required to address real problems. Real immigration reform I believe is another piece to this puzzle that needs to be addressed. Tort reform is another. Addressing the influence of rampant greed in the healthcare industry is yet another. Finally, real healthcare IT reform is an absolute necessity to address fraud and waste.

In conclusion, I believe that the problems caused by the current state of affairs in healthcare can go away if we address each of these areas. Each area that is not addressed will significantly reduce the probability of success. It seems clear to me that the private sector is either unwilling or unable to affect the kinds of change required. Considering our government is already forking out a little over $1.8 trillion per year for healthcare outside the Medicare/Medicaid systems, something absolutely needs to be done. That something needs to be comprehensive, far-reaching and not limited to just a public option for health insurance. It also needs to be fiscally responsible. While these may seem to be competing requirements, I believe they can go hand-in-hand given the right set of circumstances. Many people believe that the government is the source of problems, not solutions. I'm not one of those people.

Your Constituent

The_Guru

Total Comments: 33

Write your own comment on this letter!

	rjnaz, on 07/02/2009 @ 10:48 AM wrote:
		the only issue is how to sell this to the public. I think people inherently know there are problems, but the insurance company lobbyist muddle the message every time.

	crazyman, on 07/02/2009 @ 11:09 AM wrote:
		There must be a way to get more government involvement that addresses most concerns. Business, which traditionally handled it, is not.

	Titopoet, on 07/02/2009 @ 11:35 AM wrote:
		Argument 5 is correct. I know that I make many decisions on our health care (I have a new born) on the fact of what my insurance covers. Is Washington bureaucrats worse than ones from the insurance companies. I think not.

	harmont, on 07/02/2009 @ 11:35 AM wrote:
		1 & 2: Strongly Disagree: Why: If they start to tax your current healthcare as income from your employer that will encourage many to switch plans because now your take home income is less, but if you go with public option you take home would be more. No one if forcing you hand correctly they are just twisting you finical arm. Lose of people from employer plans will cause insurance companies to loose money and hurt their business.

	harmont, on 07/02/2009 @ 11:36 AM wrote:
		#3: Who do you want making decisions about your care someone you pay for a service or government? Government does not have a good track record with anything they have tried to run. Look at Canada and Europe death rates are higher for cancer and other more simple disease because of rationing of care. #4 OK but still how are you going to pay for it? Still need a plan. I will not accept from our government more spending with out a plan to pay it back. Your logic is that it is going to get bad so maybe we can do bad to make it less bad. That is not ok with me.

	harmont, on 07/02/2009 @ 11:37 AM wrote:
		#5 You just cannot add 45M people to the system with out rationing of care to the current 85% of Americans that are already covered. This would discourage doctors from becoming doctors as it would be another government job. They are talking about dr sallary caps and you can only charge x for service y. This would is encourage our best and brightest out of medicine and into other fields that still enjoy a capitalist market place so they can earn what they are worth not what the government says you are worth. ------ If this is not stopped we will become a socialist country as the gov would own 47% on US industry. ---- Don't get me wrong I am all for healthcare reform but their are other ideas that make more sense that you do not hear about because they are from the republic and independent parties. ----- This is a change to 100% of the system for the 15% of the US who does not have coverage.

	Lao_Tse, on 07/02/2009 @ 11:46 AM wrote:
		I think that all of these arguments have one fundamental flaw, it is impossible to test their validity short of implementing a public health care system. Fortunately we can examine the systems devised in Europe 100 years ago. Critics like to cite either the French or English systems as the peak of ineffiecieny, however there are no waiting lines for vital surgeries and care. Additionally, although harmont cites higher death rates from cancer, the average life expectancy is much higher. Finally an American public option will be much more similar to the German system. The government will not own the hospitals or employ the doctors, and many wealthier citizens will continue to have private insurance because they will not qualify for government care.

	The_Guru, on 07/02/2009 @ 11:50 AM wrote:
		Let's see...who do I trust more to make decisions about healthcare...someone who has a vested interest in maximizing their own profits or someone answerable to an elected official? I'd have to lean towards someone answerable to an elected official. I hear very, very few complaints about Medicare coverage from seniors. To say that federal government does not have a good track record with anything they have tried to run is to ignore completely many of the things they have run successfully. They seem to do ok with the military. They seem to do ok with the postal service. When they seem to falter the most is when they get leadership convinced that government can't work. I happen to believe it can.

	The_Guru, on 07/02/2009 @ 11:59 AM wrote:
		As for rationing of care, I kind of doubt that would happen. After all, you're talking about increasing demand by 15%. And the real number would be something less than 15% because some of that 15% today just go to the emergency room when they have a cold. Rather than tying up something like $300 for a very basic ER visit that will wind up being paid by taxpayers, with a real health insurance these people would instead go to their family doctor and wind up costing taxpayers something closer to $75 for a 30 minute office visit.

	jcarryl, on 07/02/2009 @ 12:17 PM wrote:
		This is Ronald Reagan's legacy: a free and unfettered marketplace has done for healthcare what it did for the stock market: blind profit has made us bankrupt. To continue to argue that the danger is big government is to deny the failure of the invisible hand. Adam Smith is rolling in his grave, I'm sure, but we're bankrupt. As you say, medical care providers decisions are made not with the care of the patient/consumer in mind, but with what the insurance company will spring for. The result, stockholders with choices win, average Americans lose. When naysayers argue against the public healthcare option by claiming it will force private insurers out of business, what they really mean is it risks slicing into corporate profits by forcing private insurance conglomerates and their stockholders to be competitive and restore choice. The only risk is to the private bottom line. As Wall Street has shown, we can no longer afford this choice.

	Scoobey, on 07/02/2009 @ 01:27 PM wrote:
		Thank you for writing a really thoughtful, well informed letter! I agree that offering a nonprofit, publicly owned alternative to private health insurance is a great idea. The only reason the industry opposes it is that they know many people will find it an excellent alternative, and -- because the government does not need to return profits to shareholders -- will be a much cheaper one.

	earthjiva, on 07/02/2009 @ 01:44 PM wrote:
		All of these arguments seem overly simplistic or one-sided. The consequences must be weighed more carefully.

	Maco, on 07/02/2009 @ 02:08 PM wrote:
		A public option for healthcare is a must. No one should have to be put in a position to choose not to get treatment for a disease because they cannot afford it.

	bbaughman, on 07/02/2009 @ 02:35 PM wrote:
		You certainly make some very interesting arguments. Argument 3 hits home with me. I just recently had to visit my doctor and my insurance coverage was most definitely a part of the conversation when it came time to discuss the choice of procedures.

	nmcocco, on 07/02/2009 @ 03:30 PM wrote:
		I'm not sure where some people are getting the statistics that people in Europe have a higher mortality rate due to their nationalized health care plans. France has the most effective and cheapest healthcare system in the world. They pay way less a year than we do on a national scale on healthcare, and they are statistically healthier. They offer both a private and nationalized heathlcare plan. They focus more on preventative care than we do. The average person goes to the doctor on average 6 times a year, and they have the lowest rate of non-elective surgeries.

	MICKU28, on 07/02/2009 @ 03:30 PM wrote:
		Its a very complex situation out there, and there should be some out of this. A new solution has to be found out.

	libanbekele, on 07/02/2009 @ 03:48 PM wrote:
		as far as argument 2, so long as employees offer health care with job positions, most private companies will survive the emergence of a public policy.

	tallguyryan, on 07/03/2009 @ 11:23 AM wrote:
		Yeah, I especially understand option 2. I worked for a health insurance company that had deep pockets and the comments I hear from the RICH owners are "don't take my money" NOT "This will hurt our company by having more competition..." seems fishy to me!

	fellowpacker, on 07/03/2009 @ 01:03 PM wrote:
		I don't care if it's the government nonprofit or a private nonprofit organization who runs the health insurance. But health or no heath shouldn't be a matter of money. I heard about private health co-ops, Maybe another option.

	aravail, on 07/03/2009 @ 05:59 PM wrote:
		If everyone comes under the same public option blanket, would we still need Medicare and Medicaid? A public option that values health care as an inalienable right would have another benefit: people could stop rationing THEMSELVES. As it stands, the system is so prohibitively expensive that we only ever see our doctors when something is desperately wrong. A public option may actually give us HEALTH care instead of ILLNESS care.

	IllinoisVoter24, on 07/03/2009 @ 07:50 PM wrote:
		My biggest problem with the various things I have read about the new health care is its price tag. By this I do not mean the overinflated federal price tag, I mean the price tag the average purchaser will have to pay if it healthcare insurance is required.

	staceyg1976, on 07/03/2009 @ 08:12 PM wrote:
		Our healthcare in this country is simply unethical and the arguements against health care reform do not hold up. The wayn our healthcare system is set up now shows us that its all about big money instead of helping our people stay healthy and continue to contribute to the improvement of our economhy and society. People can argue against it all they want, but I think that your arguements show us that if things stay the way they are then we stay stagnent or go in a downward spiral. If we allow the govement's health reform take place then I think we will see somewhat of an increase to better health care for our people which will help with stablilizing our economy.

	Treas, on 07/05/2009 @ 05:22 AM wrote:
		This is a well thought out analysis. When it comes to health care it is almost impossible to be truly fiscally responsible since we are dealing with matters of life and death.

	allygirl, on 07/05/2009 @ 07:09 AM wrote:
		I enjoyed your letter Guru and I agree with you. Someone has to be responsible for making decisions about what kind of care is allowed and what is not. I would rather it be from someone who can face consequences (like an elected official) than someone getting paid $8 an hr to flip through thousands of claim forms.

	The_Guru, on 07/06/2009 @ 06:59 AM wrote:
		Thanks for the comments so far. At this point, harmont has been the only person to try and address specifics in my letter with rebuttals. Most of his rebuttals go to philosophical differences rather than substantive. The one substantive issue he brought up, the taxing of current healthcare benefits, is certainly a consideration. I wouldn't support the taxing of healthcare benefits under any circumstances. The real irony of that issue is that the first serious discussion about taxing healthcare benefits I heard was from the McCain campaign. Like or hate Democrats, they don't need help finding additional places to raise taxes. Really dumb move from McCain...

	Reaganomics101, on 07/07/2009 @ 09:17 AM wrote:
		I don't see a feasible way fiscal responsibility could be found with government run health care. Health care costs are high to begin with because of A) People not paying bills and B) Fat and unhealthy americans going to the doctor.

	The_Guru, on 07/07/2009 @ 09:33 AM wrote:
		That's because you have never studied basic economics. If so, you'd understand that an entity ensuring millions of people has more leverage over costs than an entity ensuring thousands of people and even more leverage over an individual. What isn't fiscally responsible is paying $2.5 trillion per year over and above the already budgeted dollars for Medicare/Medicaid. That's 2 1/2 stimulus packages each year and on target to be 4 1/2 in less than 10 years. What's your plan to address that?

	The_Guru, on 07/07/2009 @ 10:25 AM wrote:
		Oops...I meant insuring, not ensuring...

	Reaganomics101, on 07/10/2009 @ 08:07 AM wrote:
		I haven't heard of one health care plan that makes sense to be perfectly honest. More leverage??? With the basic economics comment aside, what do you call an entity that has enough power to control those means? One that doesn't need to abide to any rules at all since that entity controls money flow. My God man, that is when democracy dies.

	publius, on 07/15/2009 @ 08:33 AM wrote:
		There is some right and some wrong here, but the whole argument is respected, I think. Argument one is faulty because the Kennedy version of health care policy states all citizens will have sign up or pay fines levied by DHHS. In argument 2, Medicare is a voluntary coverage, just like private insurance. Comparing apples to apples doesn't make the case. For argument 3, the President has already stated rather clearly that condition of the patient and cost of the procedure will decide the treatment. In argument 4, an increase in government spending is inevitable. It would cost a great deal more than it does now. In argument 5, the backlog is proven by example (Canada and the UK, among others).

	The_Guru, on 07/22/2009 @ 07:54 AM wrote:
		What I call an entity with enough power to control those means is a collective bargaining group. We already have precedent for those. Today it gives companies some leverage over costs. It gives unionized workers some leverage over compensation and benefits. It even gives voters some leverage over the leadership and direction of our country. There is nothing more democratic than that, eh? Your strawman argument that the government doesn't have to abide by rules clearly comes from watching Republicans dismiss rules out of hand, calling the constitution "just a piece of paper". In reality, government does have to follow rules. When individuals in government decide following the rules isn't what they want to do, we have numerous options for dealing with them. Just ask Scooter...

	Obamarx, on 08/04/2009 @ 02:23 AM wrote:
		This is a letter written by an unthinking liberal to FreedomSpeaks.com. If you think I am being hasty in my description of this volunteer parrot for Nancy Pelosi, I suggest you consider the following (comments in red are mine) http://tirademedia.com/blog

	snguy, on 09/09/2009 @ 11:25 PM wrote:
		It's pretty obvious that the healthcare debate is a battle between what's good for the people and what's good for the corporations. Letter was a good analysis of the silly corp. arguments.