Coburn Gets A Good Start

Senator Tom Coburn (R-OK) is one of the most intelligent congressional Republicans on health care. During the crock “summit” a few weeks ago, he hammered the fact that one-third of America’s health care costs are wasted, and that anti-fraud (10% of Medicare’s costs) and tort reform ($54 billion dollars over ten years, according to the Congressional Budget Office) efforts are good places to start reforming the system. Today Yahoo! News has published a column by Coburn, where he lays out some specific failures of the Senate bill.

This is not Coburn’s best work- he did better in his two Huffington Post pieces, and as I said above was a great conservative representative in the summit. He does, however, name the number one issue with American health care and health insurance: cost. Since cost is directly related to access, lowering cost would increases access. Unfortunately, as Coburn points out, the Senate/House/garbage bill increases coverage (access) to health insurance without lowering cost, and in fact increases cost. Thus, we will have a failure on multiple levels if the Senate bill passes the House.

I think Coburn missed a couple of key points in his column, though this is not entirely his fault- he covered a great deal, and it’s not as if he could tackle everything in a 600 or 800-word opinion piece. The key things he did not address were: why he as a conservative opposes cutting Medicare, when Medicare is a single-payer health care system; why he thinks tort reform is such a big deal, when the CBO director said it would save only .5% in our health care costs (he addresses this in my first link above, though I think he overstates the case); and how lowering health care costs would lower the cost of insurance, something liberals seem not to understand.

When it comes down to it, major health care reform is simple and- surprisingly- probably bipartisan. We have to lower costs, increase patient choice and awareness of costs, lessen government control and incentivize consumer wisdom. I believe the following would do this:

1. Tort reform. It would lower health care costs, which in turn lowers health insurance rates and helps improve the quality of care in America. It would not lower costs as much as Coburn says it would (with respect, of course, to his experience as a doctor), but it would help more than the CBO says it would, since less defensive medicine lowers costs of tests/procedures; allows doctors to worry less about being sued and more about doing their work well; and allows better health because fewer invasive tests will be done unnecessarily.

2. Modify the employer exclusion tax. This would treat individual insurance the same as employer insurance is treated, thus incentivizing insurance policy holders to have their own insurance. Since there would be more direct control and knowledge of insurance, people would watch what they spend more, and when jobs are lost insurance would not necessarily be. It also would give consumers more money, since their individual insurance would now have the same tax treatment as employer-based insurance. Lastly, it would lower the costs on businesses, allowing them to grow.

3. Change our Medicare payment reform system in the style of the Dartmouth Atlas Program. It would lower costs, increase the quality of care and put something of a brake on the overutilization of resources America currently has.

4. Get rid of the insurance monopoly exemption. This will kick in market competition for both the numbers of insurance providers and the prices they charge.

5. Allow the purchase of insurance across state lines, for the same reasons as number four above.

6. Put government efforts towards going after waste, fraud and abuse in Medicare and private health care insurers and providers. Even if we only cut out half of the waste/fraud/abuse in Medicare, that is $30 billion saved every year. That’s $300 in ten years.

7. By doing the above, we would put effort towards a culture that does not insure for every little paper cut, but instead treats insurance as it should be looked upon- as a backup in case of catastrophic illness or unfortunate circumstances.

I know Coburn didn’t have the room to attack all of these angles, especially since he had to go after the House/Senate/garbage bill in-depth. I do think, however, that Democrats, all of whom allegedly hate insurance companies; want to increase competition; insist on lowering costs and increasing coverage; and want a better Medicare system, could easily support the above ideas, with the exception of tort reform. This is mostly because trial lawyers are absurdly influential in Democratic circles, but also because there is a legitimate argument against the lawsuit limitations referenced by the CBO- after all, in some cases, half a million dollars won’t be enough to pay for a doctor’s mistake.

Oh, and this answers one of my concerns with Coburn’s piece- if we institute tort reform, payment reform and combat Medicare fraud/waste/abuse, we will save many tens of billions of dollars a year in Medicare costs. THIS is where cuts should be made, not arbitrarily, as Democrats want. Though I dislike Medicare, government has forced two generations of Americans to pay into the system, and the older ones deserve to get something out of it.

Real News Left Behind

It was 10:10 on Sunday evening, and I decided to see what the leading?news stories were on CNN?s and Fox?s respective websites. Having seen Yahoo News? top story being about Tiger Woods? car accident the other day, I suspected I knew what the answer was. Turns out, I was right. The stories were in spots designed to get major, first–or-second-glance attention.

Now, to be fair, Fox and CNN also had big stories about the police shooting (both), a woman who is helping women get mammograms (CNN), a story about AIDS guidelines (Fox) and Fox had its required “Support a Republican” story about Senator Lugar (R-IN) and his?thoughts about delaying health care reform until?”next year, the same way we put cap and trade and climate change, and talk now about the essentials: the war and money.” However, Fox had the Woods “story” on its top four list on its site, and CNN had it first on its “Latest News” list. (Oddly enough, MSNBC had the Woods “story” listed as third in its Sports section, and I actually missed it the first two times I scanned the page. MSNBC’s main section covered the police shootings, the economy, Afghanistan, Detroit’s economic needs, where investors are focusing this week and the Steelers-Ravens game. Not too bad for a liberal rag of a “news” source.)

Money drives news, as it should- news needs money to survive, after all- but once again our news is showing just how misplaced American priorities and dollars are. Stories that cover Honduras, Afghanistan, Iraq, Russia, China, the recession, the police shootings, health care reform efforts and other important news should be at the top of the list the vast majority of the time. Instead, they are pushed aside by non-news and entertainment.

This is an old rant, and says nothing new (except that MSNBC actually did a good job at something). Should those of us who care keep hammering at America’s lack of real world knowledge and news awareness, or are we wasting our time? Will we as a nation pull our heads out of *the clouds* and at least try to be aware of the world around us? Please?