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Clark Vandeventer: Health Care — What’s Right, What’s Wrong and What’s Missing
The health-care system in America is a mess. The vast majority of Americans, whether they like their coverage or not, intuitively know this. And all reasonable Americans agree that we want to see the cost of health care come down, we want access to go up and we want to do it in a way that in no way compromises the quality of care we receive or the patient-doctor relationship. Furthermore, we want to do all of these things while remaining consistent with the expectations of individuals in a free society.
I am for those things, so I am against the health-care reform packages proposed in Congress and championed by President Barack Obama.
The House health-care bill, HR 3200, gets some things right. Any health-care reform package passed by Congress should include many of the provisions in the 1,000-page-plus piece of legislation.
Seniors should be happy that the bill finally would address the “donut hole” in the Medicare Part D prescription drug program. Currently, seniors under the plan are responsible for 100 percent of their prescription costs until they reach the catastrophic coverage threshold. HR 3200 would immediately give seniors in the plan 50 percent discounts on brand-name drugs, and more importantly, it would give the government the ability to negotiate lower prices from the drug companies.
Doctors should be happy that HR 3200 addresses reimbursement to physicians. Currently, doctors who live in areas where the cost of living is quite high receive the same reimbursement rate from Medicare as doctors who live in less-expensive rural areas. Because of that, doctors in areas where the cost of living is high are disinclined to take Medicare patients. The reforms proposed in HR 3200 should fix the problem.
The proposal also would take steps to train more primary-care physicians and to offer loan repayment to doctors who agree to practice in underserved areas. When facing the proposition of loan repayment, many doctors opt to become specialists because the pay is better. The result is a shortage of primary-care physicians. We need to address this, and HR 3200 does.
Those are just a few of the excellent reforms included in the proposals on the table, and Americans should insist that Congress include measures such as those in any bill passed by Congress and signed by the president. However, there is plenty in the bill that should make us very nervous. Others have spoken and written at length regarding the faults of a single-payer system (which
HR 3200 is not) or a public, government option (which is included in HR 3200).
I suspect youʼve heard these debated ad nauseum. Americans don’t have total agreement on this issue. I know great Americans who support the public option, and I know great Americans who oppose it. But I think all Americans should be alarmed by how the bill would affect their personal liberty and privacy. This intrinsic fear of government is deep in the roots of all Americans.
Recently I saw a scene that I loved very much. Two cars were parked right next to each other in a parking lot. One had an Obama sticker. One had a McCain-Palin sticker. But they each had a second sticker, too, and it was the same on both cars. It read: “I love my country but I fear my government.”
My new friend Dr. James Kahn, who represented the presidentʼs plan at The Vandeventer Group town-hall meeting on health care a few weeks ago, recently posed this question to me: Why are conservatives in a fuss over privacy as it pertains to this bill when President George W. Bush launched his own assault on privacy?
Here are Dr. Kahnʼs exact words to me: “Bush launched an unprecedented invasion of privacy, monitoring everyone’s phone calls, domestic as well as foreign, invading anyone’s computers if their e-mails had words in the subject line like ‘Arab,’ and everyone on the right supported that as necessary to our security. Yet, this bill provides for limited kinds of data collection in order to improve the health-care system of the nation — which is currently killing lots more people every year than 9-11 ever did — and now conservatives are outraged about privacy issues.”
My answer led me to reach back to something I had previously written to him. An intrinsic fear of government runs deep in the roots of all Americans. Yet, when Republicans are in power, conservatives tend to forget this fear, and when Democrats are in power, liberals tend to forget this fear. The result is that the establishment always wins. The power of government to own us, control us and destroy us increases. It happens regardless of which party is in power.
Americans should be very concerned about how this health-care bill is yet another blow to the right to privacy. If you donʼt believe me, check out the bill for yourself and take a close look at Section 431(a), Section 245(b)(2))A) and Section 1801(a). It will get you started on the track at least. This is an unprecedented, mandated collection of personal, financial and medical data by the federal government. Thousands of federal employees would have real-time access to information regarding transactions from your credit cards and checking account.
If a Republican were in the White House, I imagine Dr. Khan would oppose such measures. Many of my conservative friends were silent on the infringements of the Bush White House on personal privacy.
One of the biggest points of division at our town-hall meeting was whether a person would rather go to battle against a private insurance company or the federal government. Honestly, I have no desire to do battle with either. But the worst my insurance company can do is deny a claim and send me a bill. The federal government can and will not hesitate to absolutely destroy me. Take my house. Send me to prison. Destroy.
Whatʼs missing from the reform package?
First, we need litigation reform. It is consumers — patients — who inevitably must pay the cost that doctors and the medical community face because they are forced to carry expensive insurance to cover themselves from the threat of frivolous lawsuits. Currently, a doctor can’t even use the words “Iʼm sorry” without it potentially being used against them as evidence of implication. Tort reform is essential to real health-care reform.
Second, we need to go after those cheating the system. Earlier this year, Malcolm Sparrow, a Harvard professor and author of License to Steal, testified before the Senate Judiciary Committee and said: “The units of measure for losses due to health-care fraud and abuse in this country are hundreds of billions of dollars per year. We just donʼt know the first digit. It might be as low as $100 billion — more likely two or three, possibly four or five (hundred billion dollars).”
But these issues are still on the periphery. We must enact tort reform and beef up efforts to eliminate fraud, but this is only a tinkering with the system. The greatest single contributor to skyrocketing health-care costs is the gap. It is the wedge between the person who receives a service and the person who pays for a service.
Until two years ago, I rarely thought about the cost of the health care I received. As an employee, I had an employer-sponsored health plan. I never considered the cost of the plan or the value of the plan based on what my employer was paying for the plan. That all changed when I started my own business and was responsible for paying my health-care premiums. Suddenly, I was very interested in value.
Whole Foods CEO John Mackeyʼs Wall Street Journal piece on health care last month had seven practical suggestions for health-care reform. Two of his suggestions dealt directly with this issue.
He wrote:
» Equalize the tax laws so that employer-provided health insurance and individually owned health insurance have the same tax benefits. Now, employer health-insurance benefits are fully tax deductible, but individual health insurance is not. This is unfair.
» Make costs transparent so that consumers understand what health-care treatments cost. How many people know the total cost of their last doctor’s visit and how that total breaks down? What other goods or services do we buy without knowing how much they will cost?
Consumers who are spending their own money on health care will demand value. Arthur Laffer weighed in on this issue, writing in the Wall Street Journal that “when the government spends money on health care, the patient does not. The patient is then separated from the transaction in the sense that costs are no longer his concern. And when the patient doesnʼt care about costs, only those who want higher costs — like doctors and drug companies — care.”
He continues: “According to research I performed for the Texas Public Policy Foundation, a $1 trillion increase in federal government health subsidies will accelerate health-care inflation, lead to continued growth in health-care expenditures and diminish our economic growth even further. Despite these costs, some 30 million people will remain uninsured.”
The health-care packages on the table actually widen the wedge between the person who pays for health care and the person who receives the service. The plan would eliminate — completely eliminate — co-payments by patients on a wide range of health care. That means that consumers have no financial responsibility whatsoever. This can only lead to overuse and a burdening of the system.
President Obama has repeated over and over that opponents of his plan would have us do nothing. That simply is not true. We all know our system is unsustainable and plain maddening. But doing nothing is actually better than the prescription prescribed by Obama.
While I believe that the vast majority of Americans understand this common-sense approach to health-care reform, I have little hope that Washington gets it. Thatʼs why a recent Rasmussen poll showed that 42 percent of Americans think we would get a better Congress if we randomly selected names out of a phone book. Frustration with Washington is mounting.
From my vantage point, I see no sign that a change to the business-as-usual approach is on the horizon.
— Clark Vandeventer is a social entrepreneur and is the founder and chairman of The Vandeventer Group. He’s committed to developing practical ideas that make government work and make government work for us.
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» on 09.12.09 @ 09:41 AM
Thank you Clark for your work in clarifying the health issue that concerns everyone regardless of their politics. Unfortunately, many of us have reached the point of not believing the President or many elected officials who go along with the party line and forget that they are supposed to represent WE THE PEOPLE who pay their salary and THEIR health care. Keep up the good work and as Timothy said: Fight the good fight”. God Bless.
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» on 09.12.09 @ 02:12 PM
This is a GREAT article on health care and not just that but the government’s attack on our privacy. I for one and sick and tired of the estlabishment Republican or Democrat I, can’t stand it when uninformed folks start making assumptions that the government knows what they are doing and are the best at running whatever issue that comes up all be it healthcare or whatever else you can think up.
Here is my suggestion why not let the American people decide what they deam to be best if the government wants to get into providing healthcare then go for it just don’t make me pay for it let people choose and pay for what they want. The other thing is people need to get thicker skin so that when a Doctor tells them that they are fat and need to loose a few pounds that they can’t sue them because they don’t like what they said… lets start here and see what we can do.
Butter lover in Buellton
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» on 09.12.09 @ 02:23 PM
Vandeventer’s article is very interesting and informative. I hope to read more of his views on health care and other issues regarding the future of our nation.
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» on 09.12.09 @ 03:39 PM
I agree with Vandeventer. The system is broken, but doing something in a rush isn’t always better than doing nothing. Many say this healthcare reform has been many years coming. That may be true, but this particular bill is so new and so huge it deserves more attention, revision, time. I watched the Presidents speech and was so disappointed. He seemed to have overlooked everything that went on in August. It was business as usual for Obama, generic and superficial. We need real solutions.
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» on 09.12.09 @ 03:43 PM
Why A Strong Public Option Is Essential - By jacksmith — Working Class
Robert Reich explains the pubic option: http://bit.ly/dDYSJ http://robertreich.blogspot.com/
It’s not just because more than two thirds of the American people want a single payer health care system. And if they cant have a single payer system 77% of all Americans want a strong government-run public option on day one (86% of democrats, 75% of independents, and 72% republicans). Basically everyone.
It’s not just because according to a new AARP POLL: 86 percent of seniors want universal healthcare security for All, including 93% of Democrats, 87% of Independents, and 78% of Republicans. With 79% of seniors supporting creating a new strong Government-run public option plan, available immediately. Including 89% of Democrats, 80% of Independents, and 61% of Republicans, STUNNING!!
It’s not just because it will lower cost. Because a strong public option will dramatically lower cost for everyone. And dramatically improved the quality of care everyone receives in America and around the World. Rich, middle class, and poor a like.
It’s not just because it will save trillions of dollars and prevent the needless deaths of millions more of YOU, caused by a rush to profit by the DISGRACEFUL, GREED DRIVEN, PRIVATE FOR PROFIT MEDICAL INDUSTRIAL COMPLEX!
It’s not just because every expert in every field, including economist, and Nobel laureates all agree that free market based healthcare systems don’t work. Never have and never will. The US has the only truly free market based healthcare system in the World. And as you all know now, IT IS A DISASTER!
It’s not just because providing or denying medically necessary care for profit motivations is wrong. Because it is WRONG! It’s professionally, ethically, and morally REPUGNANT!, Animalistic, VILE and EVIL.
THE REASON THE PUBLIC OPTION IS ESSENTIAL:
The public option is ESSENTIAL because over 200 million of you are trapped in the forest of the wolves. Which is the forest of the DISGRACEFUL, GREED DRIVEN, PRIVATE FOR PROFIT MEDICAL INDUSTRIAL COMPLEX! With no way out except through needless inhumane suffering, and DEATH. While the wolves tear at your flesh, and rip you limb from lib. Then feast on your lifeless bodies like a dead carcase for transplant parts.
At the most vulnerable times of your lives (when you were sick and hurting), millions of you have had to fight and loose cruel, but heroic battles. Fighting against the big guns of the DISGRACEFUL, GREED DRIVEN, PRIVATE FOR PROFIT MEDICAL INDUSTRIAL COMPLEX! in the forest of the wolves. All because you have no place else to go. You have no other CHOICE!
But the PUBLIC OPTION will give you someplace safe to go. And it will give us someplace safe to take you. The public option will be your refugium (your refuge). Where the wolves cannot get at you when your down, hurting, and vulnerable. Where everyone who needs it can find rest, security, comfort and the care they need. Protected by the BIG GUNS of We The People Of The United States. THE MOST POWERFUL PEOPLE AND COUNTRY ON EARTH.
This is why it is so critical that we do not lead another 50 million vulnerable, uninsured Americans into the forest of the wolves, without the protections of a Strong Government-run public option. We The People Of The United States MUST NOT LET THAT HAPPEN to any more of our fellow Americans. If healthcare reform does not contain a strong public option on day one. YOU MUST! KILL IT. Or you will do far more harm than good. And millions more will die needlessly. Rich, middle class, and poor a like. NO INDIVIDUAL MANDATES! without a Strong public option on day one.
To those who would continue to obstruct good and true healthcare reform for the American people, and who seek to trap millions more vulnerable Americans in the forest of the wolves. We will continue to fight you. We are prepared to wage all out war against you, and will eagerly DESTROY! you. Time…is…UP! YOU HAVE BEEN WARNED! No Co-op’s! No Triggers!
Healthcare reform can be the GREATEST! Accomplishment of our time and century. A time when future generations may say of us, that we were all, AMERICAS GREATEST GENERATIONS.
BUT WE MUST ACT!
I therefore call on all my fellow Americans and the peoples of the World. To join us in this fight so that we may finish becoming the better America that we aspire to be for everyone.
SPREAD THE WORD!
I have been privileged to be witness as many of you fought, and struggled to take your first breath, and your last breath on this earth. Rich, middle class, and poor a like. Life is precious.
Whatever the cost. WE! MUST SUCCEED.
God Bless You My Fellow Human Beings
jacksmith — Working Class
No Triggers! http://www.huffingtonpost.com/jason-rosenbaum/a-trigger-for-the-public_b_277910.html
Triggers http://www.huffingtonpost.com/david-sirota/weve-seen-these-triggers_b_283583.html
Krugman on heathcare (http://krugman.blogs.nytimes.com/2009/07/25/why-markets-cant-cure-healthcare/)
Senator Bernie Sanders on healthcare (http://www.youtube.com/watch?v=RSM8t_cLZgk&feature=player_embedded)
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» on 09.12.09 @ 03:59 PM
Why health care ever got attached to employment is beyond me. Why not have your employer provide insurance on your house and car while you are at it? It makes no sense.
It does not really matter if you trust the government or not. The government is bought and paid for by big business. Who else can afford 1.5 million dollars a day for lobbyist? I find it interesting that the insurance industry is the only business I can think of where the most satisfied customers are the ones who never used the services. What a concept.
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» on 09.12.09 @ 05:04 PM
To jacksmith:
Where did you get your stats? Must have been from a biased source!
You should check out Rasmussen Poll (unbiased source):
32% favor single payer not 77.
Not “basically everyone”
You use such broad strokes ex…“It’s not just because every expert in every field, including economist, and Nobel laureates all agree that free market based healthcare systems don’t work. Never have and never will.” Really? I can’t believe you would make a claim like that!
I see that you are passionate, but your facts and claims just don’t hold up.
Here are a few more facts from RasmussenReports.com:
Most Americans don’t approve of the current Health Care Reform Bill
Just 34% of voters nationwide support the health care reform plan if the public option is removed, and Democratic support evaporates. The previous week, 42% of voters nationwide supported the plan with the public option included.
Whether the public option is include or not, however, just 35% of voters say passage of the bill currently working its way through Congress would be better than not passing any health care reform legislation this year. Most voters (54%) say no health care reform passed by Congress this year would be the better option.
Thirty-two percent (32%) of voters nationwide favor a single-payer health care system where the federal government provides coverage for everyone. A Rasmussen Reports national telephone survey finds that 57% are opposed to a single-payer plan.
Fifty-two percent (52%) believe such a system would lead to a lower quality of care while 13% believe care would improve. Twenty-seven percent (27%) think that the quality of care would remain about the same.
Forty-five percent (45%) also say a single-payer system would lead to higher health care costs while 24% think lower costs would result. Nineteen percent (19%) think prices would remain about the same.
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» on 09.12.09 @ 05:12 PM
1) The medicare/advantage part d was a bush/republican congress era bill that was a give-away to the drug and insurance companies, essentially middleman to skim off federal dollars to go directly to the CEOs of drug and insurance companies. So why should we trust any conservative proposal? 2) I’ve recently learned that there is no left and right in this country. There is only the center and the right. 3) If I am not mistaken tort reform has already occurred and the center-right in California has already limited your “right” to sue your doctor for no more than two-hundred and fifty-thousand dollars, even if you die due to negligence, in that case your heirs rights are impinged. 4) Yeah! let stop the abuse. If 100 billion is accurate that could just about pay for HR 3200. 5) Sincerity of the author of this column is in question. Challenging our current president’s sincerity by stating “this is not true” essentially calling President Obama a liar. (please see Congressman Joe Wilson >>> http://www.opencongress.org/articles/view/1219-Joe-Wilson-Voted-to-Provide-Taxpayer-Money-for-Illegal-Immigrants-Healthcare)
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» on 09.12.09 @ 07:23 PM
Big government needs to stay out of healthcare. We all know that government can’t manage themselves out of a paperbag. This is just a grab for power and managing our healthcare is one of the steps. This has been brewing for over 50 years and now the liberals have a “perfect storm” with a majority in DC. My 17-year old and I are heading to DC tomorrow to lobby congress along with at least 200 others. Private citizens, paying our own way.
Stop big government and big government spending.
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» on 09.12.09 @ 08:05 PM
Thank You Clark! This bill is so lengthy and I don’t have the time to read it. I am glad you summed it up and gave us some great points to consider. I agree with you and hope this opens up the eyes of the public. We need people like you to tell us the truth!
Karen Miller
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» on 09.12.09 @ 10:39 PM
This is a very informative article on the current debate. It is refreshing to hear from someone who is truly non-partisan!
A further comment: We just need to look at history for evidence why we need to look at all options on the table, not just the current bill. When Medicare was introduced in the ‘60’s, it caused such a shortfall for hospitals and physicians, that they needed to raise their prices to compensate. If a government option is introduced, it will again cause an increase in cost, not a decrease as proponents are saying.
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» on 09.12.09 @ 11:04 PM
If an insurance company doesn’t do a good job or is to expensive we replace them with another insurance company. We can’t do that with the government, once they take over health care we are stuck! I think we need to make Clark our health care czar!
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» on 09.12.09 @ 11:43 PM
Obama is a liar, along with jack smith and Don Mcdermott.
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» on 09.13.09 @ 06:54 AM
GREAT ARTICLE.I HOPE TO SEE MORE INSIGHTFUL ARTICLES FROM CLARK. JIM
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» on 09.13.09 @ 01:17 PM
I believe that most Republicans and Democrats want the same basic changes: lower medical costs, no exclusions for pre-existing condition, closing the medicare loop hole for medications, and retaining our doctors of choice. But how do you get the “for profit” health insurance companies, drug companies and hospitals, whose goal is to bring in profits to stock holders, to show responsibility to provide quality care for not just a select few, but for everyone? Only government has the power to make these companies responsible to us all, not just a select few and their shareholders. Maybe we should use our American education system as a model with a combination of public and private entities. The profit motive has been excluded from public education. Why should it not also eliminated from health care?
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» on 09.13.09 @ 02:59 PM
We found Vandeventer’s article very informative and we would hope that continued public discourse would encourage public response that might translate into Washington becoming more aware of the real issues accompanied by real solutions. Keep up the good work, Clark.
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» on 09.13.09 @ 04:17 PM
Clark is right. It’s not about Democrats or Republicans. It’s about the government taking over more and more of our freedoms. Health care costs cannot be controlled until the people who use the health care have participation in the costs. If lobster were free a lot more people would eat Lobster. The same for a Mercedes, a beach house, or anything else that is desirable for that matter. The free market controls the market for most things. But not health care. This is controlled by Medicare and Medical (the government) and these programs are nothing more than a Ponzi scheme with no way to meet future guranteed payments. They are the “public option” for elderly people who use the most health care. Like any governemnt program you can name (the post office, DMV, IRS, etc.) they are inefficient bureaucracies. Most of the rest of health insurance is controlled by employers who provide health insurance benefits to employees. They have no more business being legislated into having to provide helath care than they should be required to provide houses, cars, and food to employees. Follow the recommendations of people like the CEO of Whole Foods who have real market solutions for real people and not failed government policies and lies.
PS I have never read anything so far off the mark as the comments from jacksmith. If he had his way we would be socialist or marxist. He would destroy the greatest civilization in the history of the world. One that has provided more opportunities and rewards, to achieve the highest standard of living for the most people, in the history of the world. I wonder if he has ever read any history books to understand how these socialist and marxist systems played out, whether he has ever ran a business and had to meet payroll, or if he has ever taken a class in economics? No, I think he is one of those people who think that everyone else owes him a living. We don’t need anymore people who want everyone else to pay for them. For those folks, my advice is move to Cuba and see if Fidel will listen to all your whining!
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» on 09.13.09 @ 05:42 PM
I believe that most Republicans and Democrats want the same basic changes: lower medical costs, no exclusions for pre-existing condition, closing the medicare loop hole for medications, and retaining our doctors of choice. But how do you get the “for profit” health insurance companies, drug companies and hospitals, whose goal is to bring in profits to stock holders, to show responsibility to provide quality care for not just a select few, but for everyone? Only government has the power to make these companies responsible to us all, not just a select few and their shareholders. Maybe we should use our American education system as a model with a combination of public and private entities. The profit motive has been excluded from public education. Why should it not also be eliminated from health care? Why should there be profit taking? This is a conflict of interest. Surely there is a better way!
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» on 09.13.09 @ 06:29 PM
I believe that most Republicans and Democrats want the same basic changes: lower medical costs, no exclusions for pre-existing condition, closing the medicare loop hole for medications, and retaining our doctors of choice. But how do you get the “for profit” health insurance companies, drug companies and hospitals, whose goal is to bring in profits to stock holders, to show responsibility to provide quality care for not just a select few, but for everyone? Only government has the power to make these companies responsible to us all, not just a select few and their shareholders. Maybe we should use our American education system as a model with a combination of public and private entities. The profit motive has been excluded from public education. Why should it not also be eliminated from health care? Why should there be profit taking? This is a conflict of interest. Surely there is a better way! Why do some people thank they cannot trust their elected public officials but can trust the CEOs and executives of health institutions who developed exclusions for pre-existing conditions, the medicare medication loop hole that causes great financial hardship to senior citizens who are poor, and seek profits for wealthy investors in our health care system at the expense of their client’s welfare? The response is well you have choice. What choice is there if you are not employed and are denied coverage for a pre-existing condition? No insurance company will insure someone who has been denied coverage by another company. And state high risk insurance pools have high deductibles and are very pricey. That we have so many uninsured people under our present system is not surprising. To whom besides our elected public officials can one turn for help?
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» on 09.18.09 @ 09:44 AM
Noozhawk.. how does this post not conflict with your ground rules: “1. No personal attacks.”
» Natzo fast wrote on 09.12.09 @ 11:43 PM
Obama is a liar, along with jack smith and Don Mcdermott.
[Noozhawk note: While the comment may toe the line of being unacceptable under our rules, we are stewards of free speech and try to censor only those comments that are flagrantly attacking another person’s integrity and character. This particular comment, in our minds, simply expressed disagreement with other posts.]
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» on 09.18.09 @ 09:47 AM
Good article and I share the concern about privacy. But I think we may have already lost that battle; credit scores are used in a number of situations that have little to do with credit risk. Perhaps this would accelarate that trend.. but there is also some benefit from having medical information shared between pharmacies and doctors..
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