Novick’s Big Health Care Picture
Kristin Teigen
Sometimes I fall prey to thinking of issues in isolation. You know -- education in this corner, labor issues over here – and I try, with my checkbook and my time, to create some sort of priority. I admit it doesn’t make for very good politics.
Luckily, someone who sees the big picture, someone who can see, for example, how the health care bone is connected to the education - economy - labor rights bone, is running for office.
When it comes to our health, we worry about efficient and affordable access to quality care. What we don’t always see is the larger perspective -- the ways that the health care system creates crises in other sectors of our society and how improving the system will mean that these crises just might begin to fade.
Steve Novick understands this system. He sees how the extraordinary cost of health care, and the way it is provided, keeps this country from being what it can, and needs to be.
Novick sees health care as an education issue. The health insurance costs of many school districts are so onerous that they keep essential funds out of the classroom. Improving the system and freeing up some of that money would make a dramatic difference for kids across the state and country.
Novick sees health care as a labor issue. Imagine the day when people have the freedom to leave an oppressive workplace without fear of losing their health insurance. Imagine the day when a parent, caregiver or a student can work part-time and still have health care.
Novick sees health care as a fundamental issue of economic competitiveness. The United States spends 16% of its GDP on health care, much more than other industrialized nations. Many of our international competitors provide health care to their citizens, ensuring that their businesses are free to use their capital for research and development and aren’t weighed down by an inefficient system.
Novick sees health care as a family-values issue. Perhaps the most embarrassing and unforgiveable reality about living in the wealthiest nation on earth is that millions of children do not have health care. Novick loudly denounced Bush’s veto of the SCHIP program, as well as Gordon Smith’s failure to advocate for comprehensive health care reform.
Novick is also intelligent enough to recognize a good proposal when he sees it, without trying to recreate the wheel. He’s supporting measures by both Ron Wyden and John Edwards which call for reasoned, incremental implementation of universal health care. By doing so, he’s playing good, smart politics. He’s not grandstanding, packaging an old proposal in Novick wrapping. He’s just quietly, efficiently doing what’s right.
It’s big picture politics. After all of these years of small brain, small heart Bush/Smith ways, I can’t wait for someone to be elected who is looking out of a bigger window.
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connect with blueoregon
Nov 3, '07
What does Steve Novick think of the work that Sen. Dr. Bates and Sen. Westlund have been doing at the state level on health care?
9:19 p.m.
Nov 3, '07
Right on Kristin!
I think I may have told this story before, but it Steve making that "big picture" connection between the cost of individual school districts having to provide health care and the importance of Universal coverage that really drew me to support his candidacy.
The fact that individual states, including Oregon, are making efforts to insure everyone is good, but it will take action at the national level to really make a difference. Here's to hoping for a President John Edwards and a Senator Steve Novick!
Nov 3, '07
I am so seriously put off by the "Novick sees/Novick is..." refrain... unless Kristin is an official spokesperson for the campaign she's in no position to state what "Novick sees or is." And I'm a freakin' Novick supporter.
Nov 3, '07
For the first time in the history of America. The life expectancy of today's children is less than that of their parents. This is catastrophic. And our infant mortality is equal to that of a third world country. Current U.S. adult life expectancy is down from #1 to #42. And dropping fast. These facts are what is known as EXTINCTION! indicators. These are the early signs of the final phase of the EXTINCTION of the American people.
You have to take the profit motive out of health care delivery. The profit motive does not work with health care. Or any other essential public service like police, and fire. The sooner everyone faces this truth. The sooner you will be able to adopt a real solution to the problem. The days of paying for health care out of pocket are at an end. Just like the mob days of paying for protection out of pocket came to an end.
HR 676 is the way to go. Single payer Universal National Health Care For All. Medicare for all. Accept no substitutes. The sooner you face this. The sooner you begin to heal the Cancer of private for profit medicine that is destroying this entire society. Other developed countries realized this years ago. It's a no-brainer now. See sickocure.org
Money, greed, and the profit motive has just decimated health care in America. And killed, and injured millions needlessly. Just for profit. But that is what large amounts of money, greed, and a lust for power always does. No one is immune from this corrupting power. The smart ones know this. And avoid letting them-self be put in compromising positions. But that is easier said. Than done. And very few succeed.
Most in the US go into medicine primarily to become wealthy. That is who the medical schools mostly choose. Most of the medical schools faculty are in bed with the drug companies, and others. And like the story of Dr. Faustus. They end up selling their soles. One compromise at a time. Until Lucifer owns them.
In medicine. Compromised care means. Injury, disability, and death. It's sad really. But HR 676 can fix this disgrace. Like it has in other developed countries. The only question is. How many more millions will be hurt, injured, and killed. And how many more of your children will die before their time. Before we fix this disgrace of private for profit health care in America.
I realize there will be a few people that have what they believe is good health care coverage. Who will want to opt out of a single payer system like HR 676. But let me remind you we rank # 37 in quality of health care for all. Down from #1. Never the less. A few opting out is not a problem. As long as all other Americans are automatically covered at birth through life. Unless they choose to opt out of HR 676. The government takes out 1.4% from your paycheck now for Medicare. All they have to do is substitute for HR 676 what they now take out of your paychecks for private health insurance. Remember, we already spend more on health care than any other country in the world. Right Now. We are being ripped off. And raped.
The SCHIP program is a desperately needed program for Americas children. But with the impending EXTINCTION of Americas children. And their current catastrophic health care condition. SCHIP needs to be extended to cover all of Americas children, immediately. Parents should have no hesitations, or financial worries about seeking medical care for their children. Whenever they have any concerns about their children's health. Especially in the richest country in the world. I would submit that any President, or politician that fails to do this for the children. Betrays their most solemn oath to protect the American people. Especially when you consider that all other developed countries have done this. And that we are the richest country in the world.
So get on it America. Get it done. You have been doing great over the past several months. Keep it up. And step it up. You have to force it, and take it. It's the right fight, and the right thing to do. Now is the time... Take no prisoners.
Nov 3, '07
Novick looks like kissed Teigen's ass and she wrote so nice about Novick. Health care vs huge salaries. When Governor Kulongoski / Democratic Party raised salaries of directors of state agencies to $160,000 , Novick said no one word against it. So many government employees, yours should be servants, have so huge salaries, and for what? They do NOT care about who has no health insurance. And so many children have no health insurance, so many parents of our troopers in Iraq have no health insurance. Cutting these salaries will generate a lot of money for many children and adults. Where they are Novick and Merkley?
Pavel Goberman - Candidate for US Senator. www.getenergized.com
Nov 3, '07
At the Oregon Summit, Steve Novick declared himself in support of Hillary Clinton's health care plan, Barak Obama's health care plan, John Edward's health care plan, Ron Wyden's health care plan, and Universal health care through a single payer system. That is impossible as they are mutually exclusive. So which one is it? They all have remarkably different roles for individuals, employers, government, and HMO's. Those different roles have profound a effect on how our society views the health care crisis and what values we associate with it. Steve Novick doesn't have a health care plan, he has a bunch of prominent Democrats that he wants to associate himself with. He is doing exactly what you say he is not: grandstanding.
10:28 p.m.
Nov 3, '07
Bdunn:
"Because every one of them will be an improvement over what we have now."
That's a quote from Novick from the Oregon Summit right after he listed that he'd sign onto Hillary's health care plan, Edwards' health care plan, Obama's health care plan, Wyden's health care plan, and a single-payer health care bill if someone has one.
And let me tell you, at the Summit he got a huge amount of applause from the crowd on this topic. Since I was at the Summit, I haven't watched the videos people have recorded. So I don't know much/little of the audience applause came through. But I just cued up the video I shot myself. I was taking pictures, but my camera allows me to shoot video as well. So I shot a few short videos. It happened to be that I caught this exact topic as one of the three videos I shot. So I copied his quote from the video. And I heard the applause only grow as he spoke on this topic.
It's not grandstanding to say you'll sign onto a program that would drastically improve the situation we have now. And the reaction of the crowd there wouldn't have been what it was had the comment been grandstanding.
I do web site work for the Novick for Senate campaign, but I only speak for myself.
10:33 p.m.
Nov 3, '07
Pavel, oh articulate man,
Oh, and Larry, too...
I've never met Novick personally, so no ass kissing involved. I've seen him speak and I've read what he's wrote and I've read many articles about him. What I've written is based upon what I've learned, based upon what we all have access to.
Enjoy your day!!!
Nov 3, '07
Thank you bdunn.
It is all well and good to say someone else has a good health care plan.
But to the pregnant woman using her husband's health care insurance because it is better than what she gets from work, to the veteran who gets appointments postponed 6 months and then 6 months more only to be seen by a doctor who says "you should have been seen a year ago--we will schedule surgery as soon as we can", to the working uninsured person, to the person who lost coverage after leaving a job and discovers COBRA works better for some people than others, to the person having trouble getting insurance because of a pre-existing condition, it is time for details.
For those families encountering such situations or knowing someone who is, are they going to vote for a candidate whose supporters say "He’s supporting measures by both Ron Wyden and John Edwards which call for reasoned, incremental implementation of universal health care."? Or will they wait until they hear the level of detail discussed by politicians who have really studied the issue and show that knowledge when they speak?
This is why I have not chosen a US Senate candidate yet. Why the allergy to details?
Why not "Steve especially likes --- from the Wyden health care plan and ___from the Edwards health care plan because he believes that =========== is important"? Is it too much work to talk about details?
Seems to me I have heard more discussion of health care details from St. Sens. Dr. Alan Bates and Ben Westlund (along with presidential candidate Mike Huckabee) than from anyone running for US Senate from Oregon.
And how does talking about Gordon and SCHIP help the people with the specific health care problems mentioned above?
So far, it seems like both candidates are playing inside baseball--pictures of visits to various places, generalities about issues as if this is a debating society, talk of endorsements.
Is there any reason that these candidates can't just leave Gordon out of it for once and talk about health care details the way people who seriously care about the issue do?
10:38 p.m.
Nov 3, '07
Bradley,
Seriously. What Novick said at Sunriver is that any of the plans that the Democrats are proposing are better than what we've got now. Novick has said that a single payer plan is the ideal, but that there are logistical problems in making the transition to such a plan. In the meantime, whichever plan makes it to the floor of the Senate would have his vote.
BTW, it's not necessary for every Senator/Senatorial candidate to "reinvent the wheel" in terms of developing a comprehensive plan. Novick has said that he likes Wyden's plan on a number of occasions, and I've also heard him mention John Edwards' plan on more than one occasion. Is that clear enough?
Larry McD,
I believe that Kristin is summarizing arguments that Novick has made while out campaigning. I've heard him make these arguments himself, so I guess I'm comfortable with people putting them in print for a wider audience to read.
Nov 3, '07
Both the Novick and Merkley campaigns should prepare for their common foe to co-sponsor a bi-partisan "big issue" bill, with Wyden which will evoke a massive public response. Health Care, The Sub-prime Problem, Global Warming - you know the ones. Mark my words. Better yet, be prepared. Gordo certainly cannot rest on his laurels therefore, he's about to create some.
11:11 p.m.
Nov 3, '07
LT,
Having just written my Master's thesis, I guess I was a bit too tired to write another for BlueO. The details of which you speak are very interesting and I am learning more about them each day -- I'll work on sharing some here as time goes by. For this piece, I just wanted to shed a little light on a candidate I like very much.
In the meantime, BlueO seems very kind, it seems, about considering guest columns. You feel like writing one? Add some more substance to the discussion? Or maybe just writing a long comment with the details you've referenced included?
11:50 p.m.
Nov 3, '07
"Steve Novick doesn't have a health care plan, he has a bunch of prominent Democrats that he wants to associate himself with."
This one pins the unintentional irony meter...
Nov 4, '07
Kristin,
The federal/statewide campaigns I have worked on stretch from Tom McCall's re-election as Gov. to John B. Anderson for President in 1980 to Gary Hart for President in 1984 to Gray and McFarland and Hooley for 5th Dist. Congress, to Lonsdale and Wyden for US Senate and Kitzhaber for Gov. (I am leaving some out).
The candidates mentioned found a way to talk about issues important to them in ways which drew in other than "the usual suspects". I was local Volunteer Coordinator for Hart because the evening the local campaign was formed (volunteer committee in that corner, fundraising over there by the couch... etc.) I was the only person who chose the volunteer committee who had ever been involved in a campaign before. We were lucky to have a candidate willing to talk about issues in detail (and who had a long record of legislation proposed, public statements, votes cast, etc.).
This might work as an introduction to a speech on health care,
Novick sees health care as a labor issue. Imagine the day when people have the freedom to leave an oppressive workplace without fear of losing their health insurance. Imagine the day when a parent, caregiver or a student can work part-time and still have health care.
but where are the details? You did a great job of writing, but it is the candidate whose name is on the ballot. The ol' policy analyst himself has to know that the first sentence is a topic sentence to a paragraph without much detail. Imagining a better future is easy--the logistics are hard. If Steve is saying "imagine a better day" rather than discussing how well the COBRA system works and whether the private sector part of it needs more oversight and regulation, I know he is capable of better (I've known Steve for years).
If we had universal health care, part time employees and those who have been laid off wouldn't have to worry about health coverage. But does Steve favor an interventionist model or a prevention model? As I understand it, many policies don't pay for inexpensive screening but do pay if a problem diagnosed in the ER leads to hospitalization.
When I heard Steve speak a few months ago, the Q & A was more intelligent than the prepared speech. In the prepared speech, when talking about health care, Steve would say "Kitzhaber says..." as if everyone in the room was supposed to know Kitzhaber was a State Senator who authored the Oregon Health Plan and did a lot of work on health care as Governor. There were 2 people under the age of 25 at our table. Why should they have known that?
Kristin, congratulations on completing a Masters thesis--what was the subject? Will you have to defend it orally to a panel of professors?
That is the sort of intellectual rigor we deserve from Steve--and to hear it from Steve himself. Of the 2 main primary candidates, Steve has the better speaking voice, but some of his rhetoric makes clear he hasn't run for elective office before. He has the intelligence and background, but can he translate that to explaining issues to a general audience? The last time I looked at his website, he only had the paragraphs on some issues, nothing in depth. And care for veterans under "prioritized defense spending" instead of a Veterans category or at least under health care?
Just because Steve inspires some people doesn't mean the rest of us need to take him on faith. Part of his biography is his work on policy papers for Bruggere--but when newspapers did long profiles "the candidates on the issue of...", the articles generally ended with "Bruggere had no detailed position on the issue". I am being a nag now because I don't want that to happen again, and in 2007 it is still early enough to prod the candidates to be more specific.
Call me a skeptic or a cynic, but it has been a long time since I have been inspired along the lines of John Lennon's "Imagine"---which is what your post sounds like.
This can be a philosophical debate among friends--I know people who pose a hypothetical and then wonder why I am asking for details. (Often I use the domestic analogy of the difference between "we must clean the house" and "first we will clean off the kitchen counters, then we will mop the floor, then we will dust and vacuum the living room and dining room...".)
I am very happy that Steve and Jeff have inspired people who haven't been around politics for decades to get involved in politics. But I have heard more specifics about health care from John Edwards, Mike Huckabee, Howard Dean, John Kitzhaber, Alan Bates and Ben Westlund than I have from either Steve or Jeff.
And "imagine a future where..." or any other post by a candidate's supporter does not substitute for a candidate (or a campaign website) discussing such important issues in more detail.
A friend of mine likes the phrase "a vision for the future and a plan to carry it out". I have yet to see that from any US Senate candidate.
1:37 a.m.
Nov 4, '07
FWIW, the John Edwards plan and the Ron Wyden are very, very similar. There are a couple of key differences, but they're basically the same idea.
But a single-payer plan is fundamentally a different thing.
Given the massive outcry from the public for health care, with a Democratic President, it's likely that the question will be WHICH health care plan -- not WHETHER a health care plan.
While both Medicare-For-All (single-payer) and the Healthy Americans Act (wyden) would both be an improvement over the present situation - it's somewhat disingenuous to for a candidate to suggest they'd support anything.
It's pretty much a cop-out.
It's one thing for an advocate like you, me, or anyone else on this thread to say, "hey, man, I'd support anything - it's all better than the status quo" or "I'm for single-payer, but I could live with edwards/wyden."
But that's not an appropriate place for a U.S. Senate candidate, because it's not an appropriate place for a Senator. A Senator will have to put his marker down on one or the other: Are you for abolishing the insurance industry? Or are you for keeping the private insurance industry but reshaping it into a fair universal health care system?
(And one note about Obama's plan: It ain't universal. To me, that disqualifies it. His number isn't zero. He simply says that he wants to make it affordable and help those who "wish" to purchase insurance. Only children would be mandatory.)
Nov 4, '07
Do any of them get it? The government caused the problem with health care in America by over socializing medicine to the extent it is not completive, and we want to exacerbate the problem? U.S. Capitalism refers to an economic system in which the means of production are all owned and operated for profit, and in which investments, distribution, income, production and pricing of goods and services are determined through the operation of a market economy. It is the right of individuals and groups of individuals acting as "legal persons" or corporations to trade capital goods, labor, land and money (see finance and credit). See http://www.InteliOrg.com/
7:46 a.m.
Nov 4, '07
LT,
Take a breath, it's ok. Please recognize this post for what it was -- shedding a bit of light on a candidate. The campaign has a long ways to go -- there will be many more posts on Novick's positions and the details. If no one else writes them, I will. Breathe. I respect what you're trying to say -- we need to know more -- I agree. I was not attempting to write the ultimate tome on Steve Novick, esq.
I wrote this because Novick does inspire some of that John Lennon Imagine kind of stuff for me. Hopefully you will feel this again one day.
8:44 a.m.
Nov 4, '07
Unless I missed something, Dr. Coles is the only one in this entire thread (including the post) talking about the root issue with healthcare - CO$T$.
Rather than fighting over how to pay for healthcare why aren't these candidates talking about how to control the costs in the first place?
Kristin's nice post just underscores this problem. Yes, healthcare costs impact all of those things and more. But where's Novick's proposal for addressing those costs?
Nov 4, '07
Finally a thought provoking blog about the inerconectivity (did I make up a word?) of economics, healthcare, politics and our social strata. Not so much Novick, or Westlund or Bates count here as the discussion of how it is all connected.
Interestingly enough I just finished watching "Crash" so perhaps that influences myy thoughts.
Our society is becoming more complex and weaved together. It is a tapestry. What you do to one sector (or fail to do) affects others.
9:30 a.m.
Nov 4, '07
Colin
You cant claim that Novick has a fundamental understanding of health care as a fundamentally synergistic issue if he doesn't define which values his plan(s) support.
And Kari's post pegged this one right.
Nov 4, '07
Meanwhile Workers are competing with 20-38 Million Illegal aliens who have no care about Medical insurance, the E.R. works fine for them. American workers forced to compete with people that do not want the companies Health insurance as that would reduce their remittances they can Western Union to home.
Therefore Hospitals & DR.s charge extra to compensate for the huge increases in un paid bills via those that should not be here. example - Salem Hospital charges 15% MORE if you have insurance. Double digit premium increases for the last 15 years are not because so many are getting sick after all.
So why does Jeff Merkley do nothing to stop the magnet of Oregon Jobs & social services to Illegal aliens? Will those hundreds of thousands of Illegals now fleeing Oklahoma & Arizona & North Carolina & New Jersey come here and further burden our workers and our insurance needs?
Meanwhile Clinton & Obama want millions more to sneak in as they approve of the DREAM Act and Licenses to Illegals & Voting by illegals.
Attrition thru enforcement DOES work & as Democrats continue to pander to socio-ethnic special insterest groups and forget Americans and make US pay for the education, medication & incarceration of tens of millions, Democrats will lose support and Votes.
Solution? 20-38 Million Illegal aliens leave on their own because they cannot take someones job or Gov't services, ONE HALF to 2/3 on Non insureds are gone! WAGES rise and there will be many many many LESS without insurance here and insurance rates will go down(auto also). Capitolism, beyond your understanding, is about supply & demand, reduce demand and un paid bills and rates go down, silly commies.
10:21 a.m.
Nov 4, '07
Go away, Rick. Your brand of uninformed nativism isn't welcome here, not to mention your attempt at hijacking thread with yet another rant on immigration. Take it back to the Marion County Republican Party. Since you're their vice-chair, they apparently welcome your views. Buh-bye.
10:30 a.m.
Nov 4, '07
Bradley,
Not sure what you're talking about when you mentioned the "values" that a health care plan supports. I think Steve has explained, through the examples that Kristin mentioned in her original post, the utility of having Universal coverage because of the secondary consequences that lacking health care creates.
Kari,
Given the problems we had passing through a Universal coverage plan last time, I think that it's responsible for a Senator to keep their eyes on the goal, rather than being wedded to any specific means of reaching it. There are lots of "interests" that are going to try to kill any proposal when/if it actually reaches the Senate floor.
Steve has said on many occasions that Edwards' plan is the most preferable alternative to a single payer system. It addresses issues of costs, fragmentation, and stops insurers from denying access to care due to "preexisting conditions."
I think Steve has been plenty specific about why providing health care access for everyone is vital for our economic and social wellbeing without saying, "I'll only support plan X." That would not be "Senatorial."
10:55 a.m.
Nov 4, '07
Kari,
While we may not be voting for the same candidate, I truly appreciate your comment to Rick, and your standards in general around hate speech. Way to go.
Nov 4, '07
Go away? Are you serious? Uninformed? DR. Madeline Cosman PHD., ESQ. was Published in the Journal of Physicians & Surgeons referring to the huge impact illegal aliens are having on health care costs and expensive diseases, the Journal does not Publish liars.
Your hit piece on Gordon Smith voting against the DREAM Act had most comments against the dream act and awareness that these illegal job competitors are hurting Americans.
CNN latest Poll shows 2 out of 3 Democrats do not support License for Illegals. 72% of New Yorkers do not either.
Discussing Health care without discussing causes for the dilemma are ignorant.
Kari, you are uninformed and I will go away if you only want this to be a propaganda machine for your narrow minded immature buddies.
I was not writing as a Republican anything, just as a concerned American, and yes I am a Native American.
Even if you disagree you will post this as freedom of speech is important to all of us, isn't it?
11:07 a.m.
Nov 4, '07
This is me ignoring Rick. It's fun. Anybody else want to join me?
11:09 a.m.
Nov 4, '07
I will go away if you only want this to be a propaganda machine for your narrow minded immature buddies.
Yes, please. Thanks, Rick. Goodbye.
11:12 a.m.
Nov 4, '07
Steve has said on many occasions that Edwards' plan is the most preferable alternative to a single payer system.
Thanks, Colin. I hadn't heard that, but it's a good thing, if true. Could you provide a link to a source?
This post doesn't reflect that clarity (suggesting instead, what I had heard, that Steve was equally in favor of all plans - eve contradictory ones.)
It'd be good to get Steve's support of the Edwards plan on the record.
11:19 a.m.
Nov 4, '07
Kari,
If by "this post doesn't reflect that clarity" you mean what I wrote, I did in fact write that Novick specifically supported the Wyden and Edwards plans (see, up there), prioritizing their approach over the others.
Steve's support of the Edwards plan is on the record. It's on his website, under issues, in health care. It's right there. On the record. He wrote "I would support either Senator Wyden's or Senator Edwards' plan and as your Senator would work to get one of them passed and put into action."
11:31 a.m.
Nov 4, '07
"Unless I missed something, Dr. Coles is the only one in this entire thread (including the post) talking about the root issue with healthcare - CO$T$."
He's also the only one who thinks government healthcare is not a better solution than private healthcare, as we've seen proven around the world.
11:38 a.m.
Nov 4, '07
"It's one thing for an advocate like you, me, or anyone else on this thread to say, "hey, man, I'd support anything - it's all better than the status quo" or "I'm for single-payer, but I could live with edwards/wyden."
But that's not an appropriate place for a U.S. Senate candidate, because it's not an appropriate place for a Senator. A Senator will have to put his marker down on one or the other: Are you for abolishing the insurance industry? Or are you for keeping the private insurance industry but reshaping it into a fair universal health care system?"
Horsenuts, Kari. First of all, he didn't say "I'll support anything"--he listed a number of health care plans that vastly improve upon what we have now. I also disagree that a Senator will have to put his marker down on one or the other; the leadership will do that. And there's nothing wrong with being a yes vote for either option, because both plans (presumably) would increase coverage.
11:41 a.m.
Nov 4, '07
Oh, and I should say I recall Steve saying that single payer is preferable, but he doubts it's politically viable. Which doesn't mean he wouldn't vote for it (seems he would), but--like Wyden and others--obviously seeks something that both strongly improves the system...and that can be passed.
Nov 4, '07
To support Steve's position on the effects of poor health throughout society, let me remind you that two of Europe's most conservative statesmen - Otto von Bismarck and Winston Churchill - promoted national health plans because they recognized their respective nations needed healthy citizens for a strong military and growing economy. So much for socialized medicine.
12:01 p.m.
Nov 4, '07
And in terms of costs, the Wyden and Edwards plans will ensure that employers pay some amount into the plan and therefore it will not rest entirely on individual taxpayers. Also, both plans propose reforms that will dramatically improve the efficiency of the way health care is provided. Finally, both plans will nearly eliminate perhaps the most expensive form of care, emergency room services for the poor.
It's really possible, folks, to fix this health care quagmire, with the right leaders in Washington.
Nov 4, '07
However, since there are legitimate concerns that switching to a single payer system immediately would be disruptive (for one thing, it would throw an awful lot of insurance company employees out of work), I would favor an interim approach to getting health care to more people, such as those proposed by Senator Ron Wyden and former Senator, and presidential candidate, John Edwards.
is a quote from Steve's website. It is followed by itemized reasons why this is a good idea.
There was also a comment "every employer has to pay something" and a comment about how the uninsured going to the ER can be costly and that cost is spread around to everyone.
That is true, but what about really small businesses--the gift shop with 2 employees, the tiny restaurant or farmers market that hires a few people extra people during the busy season? The "mom and pop" businesses of all sorts? The entrepreneur who has invented something and has enough business to hire 3 employees?
There are good Democrats who have run small (or larger) businesses who will tell you that the jump from, say, a sole proprietor to hiring some employees can be a headache. There are people who hire independent contractors (from sales to tutoring to a business whose star employee needs a personal assistant due to a recent disability, etc.) and thus don't deal with Soc. Security, workers comp, unemployment. How would they be required to pay "something" as employers? Would it require re-writing the independent contractor laws, the business tax laws?
Dealing with those situations would require more than just imposing an employer mandate. Often such debates center around whether "all employers paying something" means the employer of at least one employee or at least 5 employees or more than 10 or what number? And who provides health insurance for the business owner?
Sorry Rick, even if every illegal were rounded up and sent home (talk about a logistical nightmare!) there would still be the question of who insures the business owner and the 3 employees of a small business. Not to mention situations where there is a 2 earner couple and perhaps the husband's insurance has better benefits than the wife's insurance, so the couple is both insured under the husband's insurance. What if the husband's company decided in an economic downturn to change their employees' insurance?
Big picture is fine, but good legislation is eventually passed after the details have been debated and enough votes gained for the final legislation.
1:06 p.m.
Nov 4, '07
LT,
All of those people are already paying something, they just don't realize it. Even if they don't provide health insurance, they pay with taxes, they pay with sick days for their employees, they pay with high insurance premiums for themselves. They pay and pay and pay.
And ya know, I can write on and on about Wyden and Edwards and the health care situation as can a lot of people who have commented on this post, but how about you stop whining about how we are not spoon feeding this to you and find out on your own? You seem reasonably intelligent. Time to take some responsibility of your own. Go do some research.
1:15 p.m.
Nov 4, '07
Kari,
Here's the link to what Steve has on his website.
Also, he's elaborated (a number of times) at some of the events that I've attended regarding his preference(s) regarding health care reform. Drawing from what I've heard, I would suspect that his personal preferences are probably: 1st) A "Medicare-for-all" type program, 2nd) The plan that Edwards has articulated, and 3rd) Senator Wyden's plan (though that might have something to do with the fact that they'd both be representing the same state).
The Kennedy/Dingell plan is probably the most aggressive proposal out there right now, but its prospects for passing through the House and Senate (even with D majorities) are probably low.
Novick has a vision of all Americans being covered, but realizes (very astutely) that there's a lot of institutional resistance to such a plan. I'd like to see employers relieved of the burden of providing health insurance and achieving the kind of cost savings that come from a single-payer system, but it's going to take a mass movement to make it happen. We might not be there yet, but Edwards' plan is the best out there that's (likely) "viable." I see it as a step in the right direction.
Nov 4, '07
I am not whining. I just read a Washington Post poll which said that the top 3 issues people care about are Iraq and Economy/ Jobs (one point apart in latest poll) and Health Care.
If you think that when campaigning for Steve Novick, people will decide to vote for him because "All of those people are already paying something, they just don't realize it. Even if they don't provide health insurance, they pay with taxes, they pay with sick days for their employees, they pay with high insurance premiums for themselves. They pay and pay and pay." then fine, go to it. Use that approach when campaigning for Steve among friends, at events, etc.
But does any registered Democrat who owns a small business really like being described as "all the people are already paying something"?
Are all potential voters well versed in the Wyden and Edwards health plans?
If you think trying to give a heads up to political insiders about what it may take to win over the 95% of the population who vote but aren't political junkies is "whining", then you and I see the art of campaigning for office differently. I know a pregnant woman who has health insurance from work but is relying on the better benefits of her husband's health insurance. I know someone who took over a small property ownership business and is turning customers away because "we don't want the business to get too big".
One of those people is registered NAV and the other is a former Democratic activist who I met on the 1992 Clinton campaign. Each are now very busy with their own lives and not as politically active as many folks here.
If saying a US Senate campaign should reach out to those folks, and that the campaign should not assume everyone in Steve's target audience could already tell you any component of either the Wyden or Edwards health plan, is "whining", then you and I are definitely not on the same wave length!
I will wait until 2008 to decide which campaign better reflects the sort of candidate I want to see running against Gordon and hopefully serving in the US Senate. Neither Steve nor Jeff has yet inspired me to join their campaign.
1:35 p.m.
Nov 4, '07
Yep, we're not on the same wavelength. That's great with me. Feels fine. As I don't even know where to start with what you just wrote (I mean, wow! Some of it doesn't even make sense as written English!), I'm just gonna agree to disagree with you and wish you a fine day.
So, yeah, have an absolutely great day! Seriously!
Nov 4, '07
Sorry, Kristin, but my complaint holds.
There is (or should be) a bold bright line between what you really know and what you think you know... between what "Novick sees" and what "Novick says." I'd be a lot more comfortable if you had said in your introduction something to the effect that "Based on considerable research and reading, I believe that Novick sees" or "Novick has stated that..".
I believe from reading your piece that you're a very bright and sincere person, but I don't know that.
And by the way, I didn't accuse you of flacking for Novick, I was simply pointing out that you wrote as if you know these things to be true when, in fact, you believe them to be true... and almost certainly with good cause.
1:39 p.m.
Nov 4, '07
Larry,
Point taken -- I'll be sure to include that detail on my next post.
2:50 p.m.
Nov 4, '07
TJ: I also disagree that a Senator will have to put his marker down on one or the other; the leadership will do that.
You're saying that Steve would acquiesce to the wishes of the leadership? This would be the same leadership which you charge with wanting to keep Novick out by backing Merkley...
That aside... Kari is right. Not only will each Senator have to put their marker down on a given approach but it is highly appropriate for each and every one of us to expect them to do so.
3:09 p.m.
Nov 4, '07
Thanks, Kristin, LT, and Colin for the clarity on Steve's position on which health care plan he supports.
Looks like TJ didn't hear him right. TJ wrote: Oh, and I should say I recall Steve saying that single payer is preferable, but he doubts it's politically viable.
Not the first or the last time for that, I'm sure.
6:04 p.m.
Nov 4, '07
I can't wait to attend a Health care Debate to hear Jeff and Steve talk what they feel we should be doing as a nation to address this problem.
Nov 5, '07
kristin, thanks for taking the time to write your post. your larger point seems to have gotten lost in the details, but i think it's a good one worth reiterating - steve novick has made statements concerning the fact that the healthcare issue is inextricably linked to many other issues of concern facing our country today.
and i guess it's a valid complaint that,in his speeches, he doesn't imagine every single possible demographic that might be represented in his audience (small business owners, veterans, college students, stay-at-home moms, rodeo cowboys, &c) and tailor his speech to provide details that would be of specific concern to those individuals.
i hope this is the worst complaint we hear about him throughout the upcoming election, though.
12:01 p.m.
Nov 5, '07
Kristin,
Thanks for the big picture take. Evaluation of specific plans needs to use those linkages as criteria.
Novick's website says specifically that he would work to get either Wyden's or Edwards' plan passed -- presumably depending on whether Edwards, whom he supports, gets elected president.
LT,
Wyden's plan (has links to examples and pdf full text) places a quality floor on all private plans eligible to receive federal funding under the act, that they must provide benefits at least equal to the standard BC/BS plan offered to federal government employees in 2007, with some further specifications regarding prevention and pain and disease management benefits, for which there can be no out-of-pocket expenses to individuals. The private plans are given the unfortunate cutesy name of Healthy American Private Insurance Plans or HAPI Plans. There is also provision for "actuarially equivalent" plans offered through HHAs that provide the same minimum benefits plus others, provided that they don't compete unfairly with the private plans by cherry-picking healthier clients, which presumably means higher premiums or co-payments ("individual responsibility payments").
This seems as if it would address the issue faced by your pregnant friend and her family. As I understand the proposal, the family would buy a family plan that would not be tied to any specific employer, offered through an insurance exchange mechanism allowing comparisons. There would be some degree of subsidy, from complete subsidy of the basic HAPI plan rate for poverty level or below, getting progressively smaller, up to 400% of official poverty level. Subsidies for actuarially equivalent higher-benefit plans would only cover the basic plan rate portion of premiums on the same basis. Currently insured employees would have their current benefit converted into a pay increase; companies would benefit ultimately because pay rises much slower than healthcare costs; benefits negotiated under collective bargaining agreements could continue on such a negotiated basis if workers and management so desired.
The plan has a detailed specification of different levels of employer contribution, which are progressive by revenue per employee, broken out by quintiles, with different schedules for "large" employers (above 200 fte employees) and "small" employers (50 fte employees and under) and a sliding schedule per employee fte from 51-200 fte employees. For your two fte small business, the employer contribution would be 2% of the geographically weighted average cost of providing the basic plan in a given state if it were in the lowest revenue per employee fte quintile, up to 12% of the basic cost for the highest quintile. For employers with more than 200 employee fte the range would be 17% to 25% of the basic plan cost, with a sliding range in between.
Wyden offers two small business "employer examples." The one closer to your case reads:
Doug's Diner has 3 full-time and 9 part-time employees who work an average of 30 hours per week. Doug cannot currently afford to offer health care to his employees. He often loses his best staff to chain restaurants that offer health insurance and is unable to afford insurance for himself and his family on the individual market. This family small business falls into the lowest rate tier under revenue by employee, paying a 2% rate. Under the Healthy Americans act Doug will pay $1,513 per year and he, his family, and all of his employees will [have] access to affordable health insurance.
The $1513 is the employer annual contribution. Doug's family would still have to pay the individual/family premium, possibly with partial subsidy, plus co-payments if any. Because they would be part of a statewide risk pool, those premiums would be much less than current individual market plans even without subsidy and it seems likely that the family costs plus the employer share costs would still be less than just an individual market family plan now. This example has either a bit more than 10 fte or 9 fte (the grammar isn't quite clear), so the underlying estimated cost per fte is either about $150 or $167 per year, so your two fte case would be looking at annual costs of about $300-350 as an employer, possibly varying a bit by state.
In basic structure of this scheme is single collector (federal government), two-tiered multiple payer (feds pay to 50 state Health Help Agencies plus HHAs for various non-state territories, who pay insurers). States are required to ensure at least two qualifying HAPI plans are offered in each state; it does not appear that states are required to recognize more than two such plans as eligible for subsidies under the scheme though I'm not sure on that point. The scheme preserves the separate existence of Medicare, health care provided by the Defense Department and the Department of Veterans Affairs, the Indian Health Service, extant employer-provided retirement health benefits, and the possibility of employer-provided benefits under qualified collective bargaining agreements, as well as supplemental Medicaid benefits for children and elders, and allows religious exceptions. Supplemental plans may be offered by insurers and subsidized by states but will not enjoy federal subsidies; abortion services must to be offered as a supplemental benefit by all HAPI plans except for those offered by religious organizations that object.
<hr/>There are provisions to pay primary providers for case management and disease management under Medicare (underfunding of which is a serious problem now). There does not appear to be any similar benefit to the V.A. system. Medicaid and SCHIP would gradually cease to exist except that states that provide supplemental benefits under them will be required to continue to do so (this is not entirely clear to me).
Potential problems: punitive charges for failing to enroll in a timely manner might be abused & might be particularly problematic for homeless people. Illegally resident non-citizens are not eligible for subsidies and a requirement to repay such subsidies illegally obtained placed on insurers raises the prospect of getting the health system involved in immigration law enforcement, though the exact implications aren't clear. It appears that a state HHA could designate only religious organization-based HAPI plan providers with religious objections to abortion as approved providers in that state, and thus force abortion service coverage into an individual supplemental plan market that would be much more expensive.
The act is not transparent with respect to handling of pre-existing conditions, I think partly because relevant sections refer to the Public Health Act, but it does look as if an individual who has trouble coping with the obligatory enrollment requirement might end up being penalized with pre-existing condition charges on top of fines.
Above all, the scheme only goes a little way toward reducing the fragmentation of the system and related costs. It looks as if it will reduce some of the administrative complexities and differential billing practices in the current system and thus reduce some costs, but it will remain administratively costly and cumbersome and will subsidize the profits of private insurers. It appears that providers of HAPI plans will become something like privately-owned public utilities from a regulatory perspective, in terms of rating and premium negotiations with HHAs, except that there may be potential for political favoritism in designating qualified HAPI plans.
In addition to the link to the PDF full-text on Wyden's website, the text of the bill can be accessed in web-page form by sections linked to the table of contents by going to the Library of Congress website and searching under S. 334 or Health Americans Act.
As far as Steve Novick's position goes, my impression is that Wyden's bill is more thoroughly thought-through, streamlined, and addresses more problems than Edwards' plan, but that's just an impression. Both are much better in my view than either Clinton's plan or Obama's. Neither is as good as a government funded national health insurance plan.
12:22 p.m.
Nov 5, '07
Chris,
Thanks so much for this information! It's a very valuable contribution to the discussion. Clearly, the ideas have been thought through and heavily researched, and tailored to some very specific needs.
Thanks again!
1:43 p.m.
Nov 5, '07
Kristin, my pleasure. Thank you again for drawing attention to the wide implications of healthcare reform. To me, even without having heard him speak, the materials Steve Novick supplies on his website make your reading of what he "sees" persuasive. He also seems to have provoked you to thinking through your own excellent expression of the relationships and sharing them with us, which I personally found helpful and quite relevant to the concerns about persuasive expression that LT rightly raises.
To me that speaks well of Steve's leadership & ability to engage followers. Healthy (so to speak) and constructive primary debate can benefit everybody. I hope some of the savvy Merkley supporters around here follow your example in talking about the thinking his ideas provoke for them, along with other Novick supporters joining you, of course.
Nov 9, '07
This is for Stephanie.
I just posted a compliment to Jeff on another topic, then saw the link to this from Steve's site on the list of blogs on the right side of Blue Oregon.
I said I would compliment the first candidate who did something like this. About time someone did.
Good for Novick for adding this to his website!
http://www.novickforsenate.com/novick_vows_stand_men_and_women_who_defend_our_nation
But you partisans for one candidate or another need to remember there are those of us who have not decided on a candidate yet and reserve the right to praise or criticize any and all campaigns.