Monthly Archives: July 2009

Health care Germanophilia

I’ll admit. I had to look that word up. It is not a disease.

From the reading I’ve done about other country’s health care systems so far, I’m sure about this – it’s incredibly difficult to understand exactly what they’re like without having lived there. Acknowledging that right up front, I’ll say this:

Canada’s health care system gets plenty of mentions in our national health care debate – positive and negative. I don’t think I would want a Canadian system.

I like the German system better. In it you get national health insurance, but you also get to choose from a couple hundred “sickness funds” so you can tailor your health care plan to your needs.

France also has an excellent system, and I could very easily have been persuaded to write a Francophilia blog post instead. But I’ll go with Germany for now.

Why? I love Canada. I think it’s a great country. But maybe if conservative are going to throw around a national bogeyman in Canada, progressives and liberals could respond not by defending Canada, but instead looking to Germany. First of all, it gets you around all of that nutty anti-French business here in the U.S., and hey, everybody loves German engineering, right? Think BMW, Mercedes…beer.

Now for some links:

NPR had a great series on European health care system a while back.

Here’s Germany, with a bonus story from the New York Times.

Here’s France, with a bonus op-ed about the French system from the Boston Globe.

Health care ironies

Nobody – not even medical personnel – are immune to our screwball health care system.

First of all, we have the story from the Peoria Journal Star about how OSF Healthcare is cutting compensation for its employees because of the swelling ranks of unemployed – and therefore uninsured – patients using its emergency room.

And then a different story on a more personal note – I’ve talked to a local doctor who was essentially laid off from a local health care system. The biggest concern for this doctor is finding a new job with health insurance coverage for the doctor and the family. Our employer-based health care system strikes again.

Financial crisis narratives

Stories matter. We tell ourselves and one another stories all the time. They are the lenses through which we see the world.

So, along that line, I found this post from libertarian Arnold Kling interesting. He lays out a breakdown of the big stories – narratives – that are being told about the economic crisis.

As for me, I’m definitely in the outsider camp, but I fall somewhere in the middle on Kling’s left-right scale. I want firms to be able to fail, but I want there to be appropriate regulation so that the entire economy doesn’t crash as a result. I don’t think we should focus so much on housing policy (instead we should focus on wages), but I also want banks to carry their risks more directly.

Also, I don’t think he accurately represents what Simon Johnson and James Kwak say over at the Baseline Scenario. I don’t think they’re interested in simply resuscitating the old system, but with more regulation.

More on economic liberty

Building on my post yesterday, I want to stress that my vision of economic liberty is aimed at individuals and families. I think if we had this framework for thinking about economic matters, the financial bailouts of the last year or so might have looked completely different.

We’ve spent a great deal of money and energy saving financial and automotive firms from failure. In a sense, the thought was that we can only help individuals and families in the economy by making sure that critical companies remained intact. We’ve developed a system – or at least a way of thinking about the economy – in which we can only help people by helping out firms.

What if we instead had made sure that the people that were part of those firms had what they needed in the economic downturn and allowed the firms, which are really just particular groupings of people, to go out of business? We could have spent trillions of dollars helping people get new skills in college, developed and funded programs that would have a genuine impact on the housing crisis, provided people with funding to move to the places where there are jobs and away from depressed areas, etc. These kind of initiatives, combined with some of the so-called automatic stabilizers like unemployment and welfare benefits, could have led to a bottom-up recovery, instead of a top-down one like is trying to be fostered now. And, of course, universal health care insurance is key in all of this, because more people might be tempted to move to new jobs, try new things, and ultimately be more productive if they knew they wouldn’t lose their health care coverage and could get proper care in the first place.

As for our current firm-centered approach, in the case of the financial sector, this appears to have been only choice in the short-term. (Sadly, the Obama administration seems committed to continuing keeping some firms too big to fail, instead of whittling them down to size.) In the cases of the U.S. automakers, I think this was much less true.

Either way, it would be great if we could come out of this current economic crisis with a different approach to our economy – one centered on true economic liberty for individuals and families.

You are “the government”

Here’s a great post on OpenLeft making a point I’ve thought of many times.

Whenever you hear a conservative going on about how “the government” is going to do this or that, it’s important to remember that, in America, we are the government! “The government” is all of us, working together, to achieve common purposes through a democratic system.

But, of course, that system can become corrupted, hence the need for campaign finance and lobbying reform.

Two more links on health care

A lot of us on the left focus on the public health insurance option as an essential part of health care reform. But it’s equally, if not more, important to focus on the development of insurance exchanges.

Also, it’s always nice to see an article putting the U.S. health care system in the same league as the systems in Russia, China, and Turkmenistan. (h/t Ezra Klein)

What’s in it for Peoria in health care reform?

So, President Obama spent his press conference the other night trying to convince America that health care reform is essential and important for everyone. The New York Times reports that he had mixed results. I don’t think that’s too unexpected. It just illustrates how critical health care is to people’s lives and sense of security and well-being. Nobody wants to lose what they have.

But it’s important to keep in mind the alternative to health care reform. Steven Pearlstein from the other day in the Washington Post:

Among the range of options for health-care reform, there’s one that is sure to raise your taxes, increase your out-of-pocket medical expenses, swell the federal deficit, leave more Americans without insurance and guarantee that wages will remain stagnant.

That’s the option of doing nothing, letting things continue to drift as they have for the past two decades as we continue to search in vain for the perfect plan that would let everyone have everything they want and preserve everything they already have while getting someone else to pay for it.

By the way, President Obama seemed to lift these words straight into his presentation, or Pearlstein got it from talking to the administration. From a CBS transcript:

Just a broader point — if somebody told you that there is a plan out there that is guaranteed to double your health care costs over the next 10 years, that’s guaranteed to result in more Americans losing their health care, and that is by far the biggest contributor to our federal deficit. I think most people would be opposed to that. Well, that’s the status quo. That’s what we have right now.

But even that’s a bit abstract. Now, we have a concrete example of what can happen to people in Peoria without expanded health insurance, and from a medical system no less. From the Peoria Journal Star we learn that OSF Healthcare System is freezing wages and cutting compensation. Spokesperson Jim Farrell tells us why:

Farrell said the changes are in response to a dramatic increase in uninsured patients being served at the hospital amid high unemployment and a struggling economy.

So, at least in this case, a lack of universal health insurance means that OSF employees go without raises, lose bonuses, and lose paid vacation days.

As for everybody else, take a look at David Leonhardt’s great piece in the New York Times the other day trying to come up with numbers for how much everyone is overpaying for American medical care.

And to finish on a Peoria note, a (supposed) native son is featured in an article in the Onion!