Next steps for Oregon in health care reform
By Alan Moore of Portland, Oregon. Alan describes himself thusly: "Unemployed after 11 years working for health care unions, he spends his days applying for jobs, doing home remodeling and wondering if the right wing really does want to return to the middle ages."
Now that the Congress has passed the Reconciliation Bill, it’s time for progressives to take stock of what has been achieved through the passage of the two health care reform laws (HCR). Is HCR, as Vice President Biden so artfully noted, “a big fucking deal”? Or is the passage of the HCR essentially a defeat for progressives as the reforms that were achieved “are borderline pathetic”.
The vehemence of the right wing in opposing HCR can tell us much about the degree to which HCR is a major progressive advance for the USA and a defeat for conservatives. But to fully take advantage of this opportunity for progressive change, we need to think through the moment strategically. For all its complexity and flaws, the United States, and thereby Oregon, now has a health care system that will push aside the non-system that has vexed us since the end of World War II. This healthcare system is based on the new understanding that receiving medical care is now a right in the United States – not just for emergencies, but meaningful ongoing care. Recognizing that right and the extension of health insurance coverage to the vast majority of Americans means that HCR is the largest progressive gain in a generation.
What has been missing is a discussion of how HCR will transform progressive politics in Oregon and the United States and what we should do to take advantage of this moment. To defend the HCR from the inevitable Right Wing attacks and to expand on the achievements gained so far, we need to both believe in the health care reform and understand it as a vehicle through which we can achieve further progressive gains both nationally and at the state level. By creating a right to medical care and having the success of the overall healthcare system now a responsibility the federal government has taken on, and shared with the states ongoing health system reform, is now a serious part of our politics and will be for years to come. Further, the HCR expands what can be achieved and changes the landscape of healthcare politics at the state level. Both aspects are significant opportunities for progressives.
Oregon has had a dynamic state level health care reform process since the late 1980s when the movement to create the Oregon Health Plan took form. As successful as we have been in Oregon, our efforts have been repeatedly stymied by the lack of a coherent foundational health care system and the resulting difficulty in achieving comprehensive reform at the state level (the cases of Hawaii and Massachusetts being the examples of states able to overcome the obstacles to achieving close to universal health care). Despite over 20 years of sustained efforts, close to one in three Oregonians under the age of 65 remains uninsured despite major gains in 2009 covering uninsured children. Now we have a national healthcare “system,” which will achieve near universal coverage even without further reforms. We have both an expanded opportunity for further innovation in ways that were not realistically achievable prior to and the ability to work towards truly universal coverage. That effort can go on simultaneously with a continued national reform effort. What can progressives in Oregon try to achieve?
One obvious place where organizing is already taking place is around the public option. Rep. Grayson has introduced H.R.4789, the Public Option Act. So far only Rep. Wu has co-sponsored this bill from the Oregon delegation. By transforming the public option from an obscure policy proposal to essentially the holy grail of progressive organizing for HCR, the progressive movement has bought into the conservative notion that the only way to influence events is through market forces (here through a public insurance plan operating very much like a private insurance plan). It is not so much that a powerfully conceived pubic option competing with private insurers would not be a step forward, but the structure of that market has not received the attention that it needs for health care reform to succeed, public option or no public option. Given the national prominence of the public option and the momentum behind this idea, we should start now to get firm commitments to actually move the public option bill through Congress from the rest of the Democrats in the Oregon congressional delegation. But we cannot stop there.
Many European and Asian countries achieved universal healthcare without either single payer nor through the use of publicly owned insurance plans (e.g. Public Option). They have done so in part by serious regulation of health insurance. The HCR is a good first step in a potentially progressive regulatory regime, but we can go much further here in Oregon. The two highest profile examples are: 1) outlawing rescissions – the removal of health insurance retroactively, frequently as a means to avoid the expenses of caring for the ill, and 2) denying coverage based on preexisting conditions (this year for children, in 2014 for everyone).
Oregon has taken important first steps to seriously regulate the health care industry already, thanks to the passage last year of HB 2009 by the legislature which has uniquely prepared to take advantage of the HCR. If we do not pay attention to how that reform is implemented, corporate interests can turn that reform to their advantage. The Oregon Health Authority will be the institutional mechanism to implement the policies of the appointed Oregon Health Policy Board. Oregon also has very organized public purchasing pools that have tremendous leverage in the market. What is the progressive agenda for these institutions in light of our success in national healthcare reform?
There are many more opportunities progressives could take action on. We could start by not accepting the projected 95% coverage by health insurance that the HCR is projected to achieve as enough. We could get closer to 100% coverage by revisiting an Oregon based employer mandate. The subsidy of up to 35% of the premiums for the employees of small businesses is being implemented immediately. This cushioning of the smallest companies will make it easier to hold corporations more accountable generally and takes away one of the commonest arguments against an employer mandate. Other ideas? Strong regulations to insure health corporations do not overbuild which leads to spiraling costs. Further efforts to ensure pharmaceutical affordability. Bringing much needed transparency to all aspects of the health care industry. This list could go on and on.
Cynical of the potential? That cynicism is a right wing victory in undermining the belief in government action for public good even amongst core progressive activists. While I’m no fan of Ralph Nader’s electoral adventurism – he hit the nail on the head when he noted how constrained we are after years of conservative ascendancy as we all now “grow up corporate” which “means we curtail our imagination. We don't even dream of what is possible.” We can regain our belief in collective action through a progressive government and placed all of our faith in competition in the marketplace. Thanks to the HCR, so much more is possible. Let’s start dreaming and organizing now and figure out how Oregon can take advantage of the moment, because a change is only going to come if we fight for it.
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March 31, 2010
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Mar 31, '10
Very interesting Washington Post column:
http://www.washingtonpost.com/wp-dyn/content/article/2010/03/31/AR2010033101663.html?hpid=opinionsbox1
When a party discovers that core aspects of its political identity no longer offer meaningful answers to the nation's problems, the torment is acute. Yet what else can we say of the GOP now that "rugged individualism" won't suffice to save American workers from competition from China and India, and when taxes are sure to rise, no matter how many Republicans we elect?
The signposts in the Republican universe have been abruptly altered. <<
Some of us are old enough to remember how disorienting it was for some folks when minorities got the right to vote. That changed everything, and I think this author's point is that HCR did the same thing.
Mar 31, '10
T. R. Reid in his excellent book "The Healing of America" explains the different health care systems in the industrialized nations. The two most prominent are the Bismarck and Beveridge systems.
The "Bismarck healthcare systems: Systems based on social insurance, where there is a multitude of insurance organizations, Krankenkassen etc, who are organizationally independent of healthcare providers" is predominant in Germany and Austria.
The Beveridge systems: "Systems where financing and provision are handled within one organizational system, i.e. financing bodies and providers are wholly or partially within one organisation, such as the NHS of the UK, countries of Nordic states etc."
The Euro Health Consumer Index of 2007 says: Bismarck Beats Beveridge!
Mar 31, '10
"By creating a right to medical care..."
You are confusing a "right" with an "obligation". I have the right to speech, but I can choose not to if I wish. I won't be able to do that with Healthcare, if I'm forced to participate. We had the right to Healthcare before, just like if I had the money, I could purchase a gun. The government doesn't force me to buy one and thus I have a "right" to own a firearm if I so choose, not an obligation.
I can't imagine anyone enjoyed hearing that this bill would be bringing 16,500 new IRS agents into employment. We've basically allow them to take what they want from us in taxes and give us in return whatever they call Healthcare. Don't any of you feel like the government is on it's way to controlling more and more aspects of our lives?
I challenge any and all of you to read the Constitution (and if you have already, re-read it) and define for yourselves where you draw the line when it comes to the government taking your rights? When do you stand up and fight back? Will you ever fight back?
Mar 31, '10
So, would you change your mind if one of the first effects of the leg were to kill off Medical Marijuana in the 15 states that have it?
May be a moot point when Measure 73 passes.
Apr 1, '10
I read stuff from the left like this and get very disheartened. There really are two worlds in this country. One side believes in the America that became the greatest country on Earth. The other, reflected in this essay, simply rejects the values and principles that made this country what it is.
Sure, you have other values and principles, and they are in a sense legitimate. They just are not what this country is about.
Right to health care? Wrong country. Sorry.
And the battle we are in is quite simply a battle for whose view of what this country should be will win out. The view of the left: collectivism, not America.
Go ahead and scream at me. Fine. Your vision for America has nothing to do with what America is. You are un-American in that you openly reject the founding principles of this country.
Apr 1, '10
"Right to health care? Wrong country. Sorry."
People can't enjoy their right to life, etc. without good health and that almost always requires good health care, a quality that the American system has abjectly failed.
"One side believes in the America that became the greatest country on Earth."
There are two sides to America's alleged greatness, and the one you seem to prefer to ignore, SwamiSam, is that slavery and aggression and oppression have been part of the mix.
Suggested reading for "conservatives" related to health care: How to Talk About Single Payer to a Conservative
Apr 1, '10
Talodus,
HRC does NOT require or "obligate" you to receive any health care from anyone. What it does require of you, based on your income, is to pay into the new health care system, just like you would pay your federal income tax. If you don't have any income, you don't pay (you would be eligible for Medicaid). If you are of limited income your contribution would be subsidized. And that "16,500 IRS agents" factoid is totally bogus: http://mediamattersaction.org/factcheck/201003310001
Apr 1, '10
Bill Bodden commented: 'There are two sides to America's alleged greatness, and the one you seem to prefer to ignore, SwamiSam, is that slavery and aggression and oppression have been part of the mix.'
Not condoning American instances of any... but name for me ANY country where slavery, aggression, and oppression have not been part of the mix at one time or another. If your sole qualification for the 'greatness' of a country is it be 100% virginally pure of slavery, aggression, and oppression, then there are no 'great' countries... nor have there ever been or will there likely ever be.
Apr 1, '10
"If your sole qualification for the 'greatness' of a country is it be 100% virginally pure of slavery, aggression, and oppression, then there are no 'great' countries... nor have there ever been or will there likely ever be."
Alcatross: Go back and read my comment. I said there were two sides to America's "greatness." As for your challenge I believe you can find a rise to "greatness" in American history if you go back to the end of World War II when the United States agreed to be magnanimous towards the defeated enemies and went so far as to institute the Marshall Plan to rebuild Western Europe. Admittedly, there was enlightened self-interest, but there was no slavery, aggression or oppression in that shining hour. Something similar can be said for the Peace Corps. Unfortunately, there is something of Jekyll and Hyde in Uncle Sam so that we should press for doing more good and less harm.
If you believe that abuse of human rights in its various forms is essential for "greatness" I would be interested in what you mean by that term.
10:34 a.m.
Apr 1, '10
Not condoning American instances of any... but name for me ANY country where slavery, aggression, and oppression have not been part of the mix at one time or another
When founded, the US was a tiny and fragmented nation residing on the shores of the Atlantic. There were millions of acres of land and minerals to the west that they were able to exploit during the next 150 years at very little cost in lives and blood to the dominant ethnic group.
This allowed the hyper-individualism that is unique to Amreican culture to flourish, kinda like the Mad Hatter's Tea Party, where you completely trash your place setting and then move on to another one.
By the '50s we were pretty much out of new place settings, and it was only the new fascination with Ayn Rand's social socipathology that kept the cancer spreading until the wheels finally came off in the Bush administration.
If you are still an Objectivist at this point, you're just another religious believer.
Apr 1, '10
People who equate and confuse "greatness" with military power and empire would do well to check a few instances in history where those led to decline and fall.
This article by Lewis Lapham - The Road to Babylon - is but one example of many supporting my point.
Apr 1, '10
I gotta go with Pat Ryan on this one. European-Americans ran out of space and cheap natural resources generations ago. Now in the US everyone outside of the tiny owning class faces control by the corporate oligarchy and possibly the corporate state (yes, defined by Mussolini as fascism) on one hand, or the possibility of social democracy on the other, in which citizens can still turn to the state for legal regulation of the oligarchy. I can't understand the lingering sentimentality about rugged individualism, Ayn Randism, libertarianism, etc. There is simply no space left in the global economy for all that.
Apr 1, '10
Pat,
At the earliest stages of European settlement on this continent the colonists realized the importance of the WITT (We're In This Together) philosophy and rejected the YOYO (You're On Your Own). The Mayflower Compact, a social contract for the good of the whole, dates to November, 1620.
Apr 1, '10
"I can't understand the lingering sentimentality about rugged individualism, Ayn Randism, libertarianism, etc. There is simply no space left in the global economy for all that."
It has been a long time since I read Ayn Rand, but if I recall correctly her focus was on the hero without any regard whatsoever for other people who made the hero's achievements possible. The Nazis had their version of Randism with Aryanism, and we know where that got them. Ayn Rand informed much of Alan Greenspan's concepts and we now know where that got us.
3:54 p.m.
Apr 1, '10
So the great virtue for Oregon is that we can have something worth having if we can regulate it properly? That's disappointing, because there's no way Oregon can regulate the health care industry properly, unless someone doubled our oversight budget while we weren't looking. State-based enforcement is an unfunded joke, and the insurers know it--which is why they killed federal enforcement in the first place.
Apr 1, '10
On April 10th “ROP”, the Rural Organizing Project of Oregon (http://www.rop.org/) is having their annual “Caucus. I will be attending this meeting of rural Oregon activists and would like to speak there about Oregon Healthcare – a topic not presently on the agenda (http://www.rop.org/2010-caucus-agenda).
I understand that the new National Health Care Law allows states to create their own Single Payer systems in lieu of their state-run insurance exchange. I also understand that Democrats, in power these days in Oregon, are interested in developing a bill to accomplish this. The ROP meeting will present an excellent opportunity to notify the grassroots about how to support Single Payer in Oregon.
Can you tell me who, in our legislature, is interested in constructing an Oregon Single Payer Health Care bill? Who’s office can I point Oregon activists to? I will contact this Oregon legislator for more details and instructions.
Is your organization in gear to get this boat away from the dock? (The Website doesn't appear to be.) What materials can you get to me in time for April 10???
Eager to hear from you...
6:17 p.m.
Apr 1, '10
maybe in your circle, but plenty of people have been talking about this for a very long time. ramifications of various outcomes have been under discussion for months. and almost no one things anything is finished. the very best part of the bill is that for the first time ever, we finally got Step 1 done. but as long as health care is a source of huge profits for some, nothing is done. it's going to take a while, but we will find a way to make health care a functioning right and not just a conceptual one.
Apr 1, '10
LT – You got it, achieving the establishment of a right to health care and a social insurance system (however complex and flawed at present) to implement that right changes politics irrevocably. The article I cited by David Frum that cost him his job at the American Enterprise Institute (http://www.frumforum.com/waterloo) analyzes the situation well from a thoughtful conservative viewpoint (such an endangered species these days). Bill Bodden – There are multiple paths to high quality, low cost, universal access healthcare. The Euro Health Consumer Index does a good job each year of summarizing the strengths and weaknesses of the European systems. Here is the 2009 report - http://www.healthpowerhouse.com/files/Report-EHCI-2009-090925-final-with-cover.pdf For those wondering about these odd terms (Bismarck, Beveridge, etc.), the Physicians for a National Health Program have a wonderful short primer on the different types of health care systems (http://www.pnhp.org/single_payer_resources/health_care_systems_four_basic_models.php) Given the historical development of healthcare in the U.S., it seems to me it would be easier for us to transition into a “Bismarck” style system with well regulated health insurers fostering quality care by care delivery organizations. Talodus – It is naïve to think that the uninsured have access to high quality on-going health care in this country. It just isn’t so (unless you are independently wealthy – most of us aren’t and we don’t develop public policy dreaming that we are). Currently the uninsured get healthcare in Emergency Departments and the like and we all pay the costs as the price of this care that hospitals are required to provide and then hospitals raise the cost of their care for the rest of us to cover the cost of caring for the uninsured. It is nuts. For those who want to get into the nitty gritty go here (http://www.kff.org/uninsured/20030212-index.cfm) Unfortunately the Republican Senators and Representatives didn’t take on healthcare in an intellectually honest fashion so there wasn’t a real debate between those who believe healthcare should be a right and those who believe healthcare should be a privilege. As your side of the debate didn’t engage honestly (instead making up facts as you have done with the untruth about 16,500 IRS agents) and ultimately lost the battle, healthcare is now a right. You can continue to go uninsured, that will be your choice, but you will pay a tax to defray some of the costs to society when you inevitably become ill or injured. The vast majority of the uninsured in Oregon and the U.S. are not uninsured by choice but because they are “uninsurable”. That sad category will end as soon as the healthcare reform is implemented.
Kurt Hagadakis – What makes you think that the HCR will negatively affect Medical Marijuana? The federal government already (foolishly) proscribes it, which has not stopped Oregon and other states from allowing the practice. The legislation is silent on this issue and I can’t see how it would change the game (which is slowly but surely changing to the benefit of the medical marijuana proponents). SwamiSam – I think you are mistaken as our Congress and President just created a law that if you think about it, establishes the right to receive high quality healthcare. I think that fits fine under the Declaration of Independence’s framing of the issue, that there are unalienable Rights including life, liberty and the pursuit of happiness. Healthcare fits nicely under life let alone the pursuit of happiness. Irregardless, those in Congress who share your views decided that the proper way to deal with healthcare was to take their marbles and go home, so we won without the grand debate between the two ideologies you identify. I think I’m just as American as when I swore and oath to defend the Constitution back in my youth, but you’re welcome to your opinion – that’s freedom of expression, another of our core values. Jim Houser – Thanks. Torridjoe – I think if you paid attention to what has been happening in health policy in Oregon you would see that the state government has been doing a better job of late. I highly recommend the Lund Report (www.thelundreport.org) for ongoing coverage of the details. Here are two examples – fighting fraud (http://www.thelundreport.org/resource/oregon_department_of_justice_expands_health_fraud_unit) and requiring transparency by the health insurers (http://www.thelundreport.org/resource/oregon_regulators_stand_up_to_insurers) Bruce DeLoria – There are many health issues facing rural Oregon (high among them being access to care) – I’m not up on efforts for single payer in Oregon but I would hope that the ROP would take on the healthcare challenges that rural Oregonians face. Their voice would be a valuable contribution. T.A. Barnhart – I completely agree with your larger points, what I was referring to in the passage you cited was the period just before and just after passage of the HCR when so many progressive voices were wringing their hands as if we had lost! But we won and as you noted “we will find a way to make health care a functioning right and not just a conceptual one.”
Apr 1, '10
An excellent commentary, Alan. Wish more progressives spent time actually looking at this bill. I get the feeling many just write it off without even bothering to read about it because it is not single payer - which is short-sighted of some, immature of others. "Cynical of the potential? That cynicism is a right wing victory in undermining the belief in government action for public good even amongst core progressive activists." You hit the nail on the head. We have been given something to work with here and we need to be involved to take the best advantage of it, pushing it further and further ahead.
Apr 1, '10
Alan: Thank you for the link to the Euro Health Index for 2009. Very interesting data.
"We have been given something to work with here and we need to be involved to take the best advantage of it, pushing it further and further ahead."
The question now is "Will enough people rise to the occasion?" One cause for optimism is that there is a lot of talk - sensible and nonsense - that is getting a lot of attention. If the sensible prevails, then we can hope for better days - and health care.
Apr 2, '10
Health care is not a right. The alleged 'right' to health care means that someone else must be forced by the government to provide it. No right requires for its implementation the unwilling contributions of others. Rights are not compatible with slavery. We have rights because of our nature as rational beings possessing free will and the fact that reason is our basic means of survival. Governments cannot create rights, only entitlements. When governments use their legal monopoly on the retaliatory use of force (which monopoly they have solely for the purpose of securing the rights of their citizens) they act without legitimacy.
Some of the comments here spew venom at Ayn Rand. Progressives had little intellectual opposition prior to Ayn Rand. The degree of 'progressives' misrepresentations and slander of Ayn Rand and Objectivism are but a measure of their mendacity. But they are right about two things--she is their most dangerous enemy and they are unable to engage her intellectually. Thus slander and misrepresentation are their only means to defend themselves from her.
Apr 2, '10
"The alleged 'right' to health care means that someone else must be forced by the government to provide it."
Whether people want to debate health care as a right or not is an option; however, there is another reason for providing health care to all. Otto von Bismarck, one of Europe's most conservative statesmen, recognized it was in his nation's security and economic interests to have all of its citizens provided with good health services. It makes just as much sense today for all nations to have similar policies. The part of the American system operated by corporations beholden to investors is clearly a failure and needs to be restructured, something along the lines of the Bismarckian or Beveridge models that the vast majority of western Europeans are happy with and benefit from.
Apr 2, '10
Meant "Initiative 73" earlier.
Posted by: John W. Bales | Apr 2, 2010 6:07:43 AM
Health care is not a right.
Then, neither is a driving license. Either society expands what is a right over time, or they are fixed, core things. Which is it? Add health care or take most the idiots of the road.
I've a formula that accounts for your "rights". How much does our having it help big business? Enough, and we might get it.
Apr 2, '10
I agree with the commenter who noted that there is no such thing as a "right" to healthcare. That's absurd. Anyone who says we have a "right" to healthcare has no concept of the origin or meaning of the term "right." They're merely throwing out words like a parrot.
As for the problems in the current system - lack of coverage, swamped ER's, inflation of costs, lack of preventative care, etc. - these are all caused directly or indirectly by government interventions in the market. This is kindergarden economics. It was proven by economists decades ago that a free market is the most efficient allocator of resources and that the best thing the gov't can do is keep its hands off. The introduction of physical force into the peaceful market creates all sorts of distortions - mostly inflation of prices.
Every gov't law, regulation, and control creates unforeseen problems. Those problems are then used as an excuse to create another layer of regulations and controls - and so on. Obamacare is going to lead to more people uninsured (the fines are still cheaper than getting insurance!) and higher prices (people will pay the fines to the IRS until they get sick and then buy insurance - and the insurance companies aren't allowed to say no anymore) and who knows what other problems. I also think there will be shortages as hospitals and doctors and medical supply companies shut down. We'll probably wind up importing most of our doctors from third world countries like they do in Canada and Europe. It's going to be a disaster!!! And what's really funny is that it'll be all the poor and dumb people who voted for Obama who don't presently have insurance who will get screwed over by the individual mandate. Idiots deserve it for voting for the "cool" candidate.
The Democrats need to realize that they are powerless over the economy. All gov't attempts to control or "manage" the economy always create more problems than they solve. In their arrogant attempts to micromanage entire industries, they've already made our political system completely unmanagable and corrupt. When will they learn? You can't control the economy; it will control you.
Apr 2, '10
"Every gov't law, regulation, and control creates unforeseen problems."
How about the laws and regulations against libel, slander, robbery, murder, etc.? Admittedly, they and many others do cause problems for criminals, but it appears they work mostly for the benefit of most citizens.
Apr 3, '10
"How about the laws and regulations against libel, slander, robbery, murder, etc.? Admittedly, they and many others do cause problems for criminals, but it appears they work mostly for the benefit of most citizens."
Nice logic chopping - but you know what my basic point was, and you didn't address it.
I should clarify that above I was speaking more of modern attempts by the gov't to control the economy. Prohibitions against libel, slander, robbery, and murder have been in place in most societies for hundreds - if not thousands, depending on the exact law - of years.
The dividing line really is this: Is the gov't protecting the individual's freedom? Protecting you from murder, assault, robbery, etc. - those traditional state common law functions - are a matter of protecting your freedom from physical coercion, i.e. protecting your individual rights from criminals. Those individual rights are the building blocks of all economic activity. Before we can create and trade things, we must be secure in our persons and our possessions.
In today's society, the gov't devotes about 1 percent of its resources to its basic, legitimate function - protecting our individual rights from violence. For the most part, the state governments (and certainly the federal gov't) aren't just trying to create the foundations for trade - but trying to manipulate the outcomes. All the laws and rules and regulations and controls - the tens of thousands of pages of new regulations issued by the federal gov't every year - that attempt to control or "manage" or manipulate the economy create more problems than they solve. Most of the current problems were created by past rules and regulations (but the left always blames the problems on "selfishness" or "greed" or some other universal aspect of human nature).
Liberals need to just chill out, worry about their own lives and quit trying to save the world. Their moral vanity is a bottomless pit - and they're going to bankrupt all of us well before they've satisfied themselves.
Apr 3, '10
The vehemence of the right wing in opposing HCR can tell us much about the degree to which HCR is a major progressive advance for the USA and a defeat for conservatives.
Alan Moore obviously represents that kind of idiocy that has come to masquerade, and destroy, the liberal, progressive cause. The fact one side won a political battle has no bearing on the whether the bill itself is progressive. In fact, as we have seen, in the last week, all of the major features of this insurance industry welfare bill actually are right-wing proposals originating in places like the Heritage Foundation. And the benefits it will actually deliver, what we see stated in over-general and misleading talking points, will be limited by costs. Even that is part of the right-wing, conservative formulation that is the very DNA of this bill.
Torridjoe – I think if you paid attention to what has been happening in health policy in Oregon you would see that the state government has been doing a better job of late.
Actually, Alan, it's pretty clear you have a pretty superficial knowledge of what has been happening in the state the last three years, and you are typically arrogant in that ignorance. Or you are being dishonest. The fact is, the Oregon Health Authority has been charged in HB2009, Section 9(L):
If The Lund Report itself were a credible information source for purposes of argument as you use it, in their political piece obviously trying to suck up to Wyden and Bates they would have reported that the law and the OHA already is progressing on a publicly owned alternative. They would have instead investigated and reported what Wyden and Bates are really up to in view of what the OHA has already been charged to do under HB2009. And in this piece as well as right next to all their supposed progressive reporting about the insurance industry, they would have provided information about the considerable campaign money Wyden and Bates receive from the insurance industry, pharma, and the health care industry. It is all available online for them to research from their computers with the same ease they picked up that story they fluffed up for their "report".
I think this comment of yours gives us some hint though about what really is going on here:
It seems to me it would be easier for us to transition into a “Bismarck” style system with well regulated health insurers fostering quality care by care delivery organizations.
One only has to cite this comment in isolation to see how while Alan's whole post demonstrates obvious skill with language and political persuasion, it doesn't demonstrate serious critical thinking ability nor an understanding others may see through it.
Alan, it would be much more useful, and obviously more within your actual area of expertise, for you to explain whether you, and the ONHFP you once represented, agree or disagree with groups like the California Nurses Association/National Nurses Organizing Committee/United American Nurses on what reform should look like. (And do you claim the CNA/NNOC/UAN would agree with your conclusion about Bismarck plan?)
Apr 3, '10
Alano - Its difficult to have a reasoned dialogue with people who share your perspective in large part because in general, those who hold perspective similar to yours are so divorced from the facts. An example? You assert the government spends only 1% on public safety - wrong by orders of magnitude at the state, local and federal levels!
"Public safety is the third biggest category (of the state budget) 15.8% goes to prisons, courts, State Police, etc" - http://www.blueoregon.com/2009/01/understanding-t.html
I'm not sure what county you live in so I'll use Multnomah county as an example "Public safety -- the Sheriff's and District Attorney offices, Department of Justice -- accounts for about 54 percent of the county's $380 million general fund." - http://www.oregonlive.com/portland/index.ssf/2010/03/post_14.html
The federal government spends about 23% on 'national defense' let alone the costs of the various federal police type agencies (FBI, DEA, etc.) and the federal courts and prisons. (http://en.wikipedia.org/wiki/United_States_federal_budget)
So putting aside your fragile connection to reality - how do you think the deregulation/non-regulation of the financial sector worked out? That seemed to not have worked out so well - time for some rational regulations?
Apr 3, '10
Wow, GH. Facts, logic, a big picture and intellectual integrity. Good luck. Everyone to date that has fit that profile has been pretty viciously savaged by mainstream Dems on here. Maybe I can help a bit. I'll promise to post less if you post more. That should get you some consideration from the flabby moderates.
Apr 3, '10
The following article [cited below] is a good example of how, if we examine the intracacies of the new legislation, we see that there is much more than meets the eye. This article gives us 1) the argument against those big businesses who complain about the loss of a tax susidy for presciption drug coverage [it's actually a double subsidy currently], and 2. how de-incentivizing corporations to be responsible for healthcare can strengthen public programs [in this case, Medicare Part D] and lead us away from our existing employer-based system [which the article provides interesting historical background on]:
Dead $14 billion loophole could sink corporate healthcare. http://money.cnn.com/2010/04/02/news/economy/health_care_taxes.fortune/index.htm
Apr 3, '10
Alano, et al.,
Say you own property next door to a hospital. You can't (in most parts of this country) build an non-emissions regulated lead smelter there. Yep, the government has restricted your personal and property rights. Get over it. Unintended consequences of such restrictions? Maybe. Intended consequences? You betcha'. If you think you have popular support for your "freedom fantasy" why not promote a ballot measure to repeal Oregon's public access Beach Bill. You could title it the "Free the Government Controlled Beaches Act". Have you really the strength of your convictions, or are you just a poseur? Be sure to let me know how that campaign goes.
Apr 3, '10
Actually, ObamaCare is as far from a progressive HCR bill as one could get and still say the word "reform" while maintaining a straight face. Tge democrats who foisted this upon the rest of us are either idiots or pure genius. You couldn't have designed a house of cards, waiting to fall in onself about 15 years down the road had you tried.
<h2>I predict that they are idiots who just happened to luck into creating something so messed up that even moderates will be pleading for full government intervention w/in a generation.</h2>