Tuesday, March 3, 2009

Responding to Bob Rosenblatt, LA Times, March 2009

Responding to Bob Rosenblatt, LA Times. http://tinyurl.com/b5yo2n

Are Americans really happy with the status quo, and fearful of change?

Sen. Max Baucus' health proposal notes,

More than 70 percent of Americans rate our health care system as “fair” or “poor.”41 When asked whether our health system needs a complete overhaul, major repairs, or minor tinkering, 90 percent of Americans respond that the system should be “completely rebuilt” or that “fundamental changes” are needed.4.

He continues:

At the same time, those who currently have health coverage do not want to lose those benefits. Many people are satisfied with their personal providers or their current coverage and do not want to jeopardize those connections to the system.

Do people really care about their health plan? Avoiding disruption, yes, as Medicare could do. Warm and fuzzy about UnitedHealth? He doesn't provide evidence (or a citation - though I'm sure there is one; Celinda Lake's latest comes close).

Americans do not necessarily agree on how to achieve it (see Figure 1.5). Although a majority of respondents would support a mandate on employers to provide coverage, a “Medicare-for-all” single-payer option, or a mandate that all individuals purchase coverage, opposition to each of these options is also somewhat substantial. Moreover,some of this support erodes when respondents are asked whether they would be willing to have more government responsibility or higher taxes — though half of all surveyed in 2007 said they would support reform even under these circumstances.46 (2007 survey figures)


These are pretty close odds and the numbers are 2 years old. Given that a Medicare for all option would undoubtedly work, and the other 2 options are iffy at best, does it make sense to just abandon the one that's workable? Conventional wisdom says yes; as it has in the many states that have tried it and failed. Admittedly, the federal government has greater authority to mandate employer contributions than do states, because of ERISA. Maybe this can work. Beats me how.

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