Healthy, Wealthy, and Wise. Or at Least One of Those Three.

Oregon's Ron Wyden, one of those rare senators who prefers legislative brainstorming to running for president, is launching a muscular effort for national health care.

The Healthy Americans Act will match insurers with health care consumers in an environment designed for competition. Each state, with financial support from the Federal government and insurance companies, will establish a Health Help Agency. Health Help Agencies will lower administrative costs by coordinating payments from employers, individuals and government. These agencies will also provide consumers with unbiased information about competing private health plans and determine premim reductions that will ensure every American can afford their health plan. With the resources to compare plans based on quality, cost and service, individuals—rather than their employers—will be empowered to choose the health plan that works best for them and their families.

OK, I'll cry uncle; I'm not enough of a health care wonk to dismiss this outright. Wyden has maintained a pretty good record on privacy rights, a pragmatic approach to health care modernization, and in 2005 he proposed tax reform far more compelling than the usual "Bush tax cuts are teh suXX0r" approach favored by Democrats (even if the Flat Fair Tax wasn't exactly a brilliant plan). The senator's obviously going to fight for the plan , so we'll see if the next year's debates about health care reform are fought on his turf.

Editor's Note: We invite comments and request that they be civil and on-topic. We do not moderate or assume any responsibility for comments, which are owned by the readers who post them. Comments do not represent the views of Reason.com or Reason Foundation. We reserve the right to delete any comment for any reason at any time. Report abuses.

  • ||

    I am not much of a wonk on this issue, either, but words like "Help" and "Agency" together make me break out in hives.

    Plus, I don't know if I can name a government agency know for "providing unbiased information to consumers."

  • ||

    Yea David that's what we need, another government agency. I mean that is so great because all the government agencies are so efficient and helpful and never, ever go over budget and waste taxpayer money.

    I think Reason should consider giving drug tests to employees before they get near a keyboard, either that or start a search for David's head beginning with up his ass.
    What a fucking jerk.

  • Robert||

    I think Weigel's perplexity is genuine. It's hard to tell whether some of these proposals are steps in the socializ'n of medicine, or bulwarks against it. In this case I'm afraid it would operate as a bulwark against further socializ'n, but only at the point it moves us to, which is far to the "left" (or "right", depending how you look at it) of where we are now. (Like building a fort far to the rear of where we are, and then retreating to it.) It disconnects liability from most forms of risk; looks like smoking would be the only common risk-based criterion allowed. It remains to be seen whether it really would leave us with more after-tax $.

  • dhex||

    "Yea David that's what we need, another government agency. I mean that is so great because all the government agencies are so efficient and helpful and never, ever go over budget and waste taxpayer money."

    i can't tell if you're being serious or sarcastic!

    in light of this fact, i can only recommend that you reach for the pill marked "chill" and follow the instructions on the bottle.

  • ||

    Just trying to understand this whole thing here.

    We're supposed to trust a statist senator trying to expand the influence of the feds into health care even further because why?

    And David's new-found fetish for the Dems is starting to really creep me out.

  • Dan T.||

    David writes:

    OK, I'll cry uncle; I'm not enough of a health care wonk to dismiss this outright.

    I agree that he needs to turn in his Reason card - libertarians don't need to understand anything about health care policy to dismiss a health care plan. Just remember government = bad.

    And if some nanny-statist points out that many countries have national health care systems that are more effective and efficent that our for-profit system, repeat some anecdote about how if you have a heart attack in Canada you can't get CPR for six months.

  • ||

    From the linky:
    The Healthy Americans Act will match insurers with health care consumers in an environment designed for competition. Each state, with financial support from the Federal government and insurance companies, will establish a Health Help Agency.

    This is not mandating healthcare for all, it is mandating healthcare insurance for all. It is an attempt to divorce the healthcare insurance companies from employeer driven packages. In otherwords, you pick the insurance pool you want to join, not your employeer. It still isn't doing a damn thing for the common man though. No offence to those big-corporation ass-kissers out there but this will do nothing except raise the profits of companies like Blue Cross by funneling tax recipts into thier coffers. Just because insurance has "affordable" premiums doesn't mean you can afford the deductible, nor that the insurance will cover all of your medical needs (look at HMO track records).

    This is nothing more than further corporate welfare disguised in a way that even "libruls" would buy it. Expect this to have great feedback from the AMA and Republican stalwarts as well.

  • ||

    I think the folks getting twitchy need to appreciate where Dave is coming from.

    Dems are poised to ram socialized medicine as an issue. An aging population leery of chucking social security and fiercely focused on the Medicare issue aren't going to make it easy to scale back that promise.

    Add to that increasing premium costs hitting workers and insurance companies increasingly poor reputation for covering what they've been contracted to cover are making consumers pissed and wanting a new system of care.

    Like it or not, something is going to happen - and soon - to push paying for medical care into the socialized direction.

    I think Dave's point is that this program - something akin to a USDA for health care crossed with a referral agency - might be better that some of the scarier options out there.

    You can either realize where things are heading and try to influence them or you can tilt at windmills.

  • ||

    Yep. Another government agency. Sure worked last time.

  • ||

    As someone who deals with government agencies a lot (as an attorney), I can tell you the difference between the hated (by Dan T.) "for profit" world and the government benevolence world is quite distinct.

    For Profit Service Provider, 5:30: Certainly, Sir. Come right in, we'll take your money.

    Government Agency Employee 4:10: Are you kidding? We close at 4:30. Come back tomorrow. What do you expect - our service is free. Well, except for the fee that subsidizes my impossible-to-be-fired job.

  • ||

    What is Stand Tall for America?
    Stand Tall for America is a website in progress - and we're just getting started.

    When it's fully launched in 2007, it will be the online organizing center for Americans who care about progressive policy change that tackles the tough problems facing our country -- including health care, tax reform, net neutrality, and more.

    It's sponsored by Senator Ron Wyden (D-Oregon) and Wyden for Senate, but it's really about you.


    Ooooo. I can't wait until the "under construction" signs come down. Then we can find out how he and the rest of the usual suspects are going to save us from the [insert fear here] peril, one of the gravest threats to working Americans today.

  • Dan T.||

    For Profit Service Provider, 5:30: Certainly, Sir. Come right in, we'll take your money.


    Continued: "...you do have money, right?"

  • Chris||

    Do I rely upon my employer or government to purchase my food? My water? Health insurance should be like groceries: either I can go to a store or order it online.

  • ||

    Wyden's idea sounds great, except for the fact that I don't believe for a moment that it would do any of the things he claims. I like Wyden as much as any sitting senator, and I live in Oregon, and I'm sure he means well. But it hasn't been my experience that vast governmental agency = efficient, helpful service that actually treats all citizens equally.

    And I can't WAIT until the same entity monitors my income and expenditures, taps my phones, tracks my health, and believes it can tell me what to eat, drink and inhale, and who to screw. (To the small extent this is not already the case.)

  • ||

    Nothing says "good for personal liberty!" like increasing the government's financial stake in your health.

  • ||

    Dan T.

    Government Service Provider: "Don't forget your filing fees."

    The issue isn't whether we pay for things we get - the issue is whether we realize we pay for it. Libertarians tend to realize that there is no free lunch, it just comes out of our taxes.

    The Dan T's of the world fall into two categories: 1) some believe the money to pay for government services comes out of a magical box guarded by the King of the Leprechauns, 2) others know that someone else is paying for it, but don't care because they (the payers) are rich (probably trust fund kids who never worked a day in their lives) and the poor schlub who needs the government service is poor.

  • ||

    FROM THE 'EARMARKS' THREAD Dec 12/06

    "Aresen | December 12, 2006, 11:54am | #

    joe

    I can't vote in the 2008 US Presidential election. Little problem with citizenship. I'm Canadian.

    For bragging rights, however, this is what I would insist on:

    1) A decrease in the deficit WITHOUT a tax increase.
    2) Non-military spending must decrease as a percentage of GDP.
    3) No new spending initiatives - whether or not vetoed by President Bush.
    4) Passage of any free trade agreement WITHOUT strings attached. [I.E. no "environmental" or "working conditions" requirements tacked on.]

    If the Dems give you 3 out of 4 by Nov 3/08, you win bragging rights."

    There goes #3.

  • ||

    The health care system that receives the highest scores on patient service is the Veterans Administration.

    The health care system that makes the most efficient use of its operating budget is Medicare.

    I'll tell you, it's getting to point where your feelings about things you don't know anything about have ceased to be reliable means of determining how well it would work.

  • ||

    Arensen,

    You're bringing outside issues into the debate. The issue was about the Democrats' capacity to improve the budget process.

    The fact that you won't make any bets on that specific issue tells me you aren't very confident that they'll do a terrible job on it.

    Free Trade Deals? Military spending doesn't count? "New Spending Iniatives" give you a win, even if they are made up for cutting other programs?

    What do any of these have to do with whether the Democrats are going to reform the budget process?

  • ||

    In other news, the Senate Democrats may not end up pushing much legislation after all; Tim Johnson (D-SD) just had a stroke and may be incapacitated. A shame, too; he's a nice, moderate fellow, and despite my policy disagreements with him, he's one of the few senators I have much respect for. I hope he gets well soon:

    http://www.argusleader.com/apps/pbcs.dll/article?AID=/20061213/NEWS/61213029

  • ||

    Shelby wrote, "I like Wyden as much as any sitting senator, and I live in Oregon, and I'm sure he means well."
    Oh, since he "means well." that makes it okay?
    Hitler meant well. Germany was aggrieved by the armstice and it had a growing population, so it was right to renounce the treaty and get some more land, only Hitler went about it the wrong way. Is that it?
    What does that mean "he means well."?
    And how do you know? Hint: He maybe lying.

  • Gimme Back My Dog||

    The health care system that receives the highest scores on patient service is the Veterans Administration.

    The health care system that makes the most efficient use of its operating budget is Medicare.


    It's not that I don't believe you, but these are pretty broad statements to make without anything backing them up.

  • ||

    "I think the folks getting twitchy need to appreciate where Dave is coming from."

    The 'let's try and siphon off some votes from libertarians' wing of the Democratic party?

  • ||

    Didn't that mormon dude running for president pass something very similar in Massachusetts?

    Anyone know how that is working out?

  • Kari Chisholm||

    Thanks for the post. I'm helping Senator Wyden with his netroots site on this - Stand Tall for America.

    Obviously, there are going to be a lot of questions. Anything this big is going to be pretty complex.

    I'd encourage everyone to actually head on over to the site and read about the plan.

    As you can imagine, there's definitely a lot of misunderstanding already appearing on the net...

    For starters, this is NOT some massive new government-run health program. Instead, you'd get your health coverage through private insurance companies. You'd have much broader choice than you currently do with your employer.

    The Lewin Group - which is a nonpartisan, independent, private health care actuarial analysis firm - said it would cover over 99% of Americans and save $1.48 trillion over 10 years.

    How? Through cost containment, reduction of adminstrative expenses, and reducing the number of uninsured people who DO get care -- but in the emergency room, and paid for by taxpayers.

    Keep those questions coming!

  • ||

    So now we are banking on a government organization to lower administrative costs!! This sounds like the millionth push that if we only had one program, without all that messy competition, then things would finally be organized... While I do appreciate separating employment and insurance as the next step to freedom and advancement in both arenas, this plan is about the worst possible way to accomplish such an end.

  • ||

    joe

    "Reform the budget process" is bafflegab. It is meaningless if the results are no different. I'm looking at the bottom line.

    I'm assuming that the Dems will aim to cut the military budget, particularly as they try to push President Bush to pull out of Iraq. The hard part is controlling the rest of the spending.

    Show me a result that makes me think the Dems are more fiscally responsible than the Republicans or more open on trade.

    I'll even throw in one more chance for the Dems: 5)Take steps to end the stupid drug war.

    Give me objective criteria to say that they are the better party from a libertarian point of view.

  • RSDavis||

    Someone asked me a question on this I honestly can't answer - namely, why are we ranked lower on the WHO's World Health Report if our system is so superior? I know the economic principles of why Single-Payer won't work, but I don't know the specifics of why this report might be flawed. Can anyone help? Here are the rankings:


    Source: WHO World Health Report - (top 50) ~

    Rank Country

    1 France
    2 Italy
    3 San Marino
    4 Andorra
    5 Malta
    6 Singapore
    7 Spain
    8 Oman
    9 Austria
    10 Japan
    11 Norway
    12 Portugal
    13 Monaco
    14 Greece
    15 Iceland
    16 Luxembourg
    17 Netherlands
    18 United Kingdom
    19 Ireland
    20 Switzerland
    21 Belgium
    22 Colombia
    23 Sweden
    24 Cyprus
    25 Germany
    26 Saudi Arabia
    27 United Arab Emirates
    28 Israel
    29 Morocco
    30 Canada
    31 Finland
    32 Australia
    33 Chile
    34 Denmark
    35 Dominica
    36 Costa Rica
    37 United States of America
    38 Slovenia
    39 Cuba
    40 Brunei
    41 New Zealand
    42 Bahrain
    43 Croatia
    44 Qatar
    45 Kuwait
    46 Barbados
    47 Thailand
    48 Czech Republic
    49 Malaysia
    50 Poland

  • elGaboGringo||

    Coordinate payments and compare coverages?

    Why do we need a new government agency?

    Sounds like we could get by with Google and Paypal.

  • ||

    I'm not a policy wonk, either, therefore I can recognize meaningless gobbledygook when I see it.

  • Sadie||

    Some explanations for Medicre's supposed superior efficiency. Basically, its an accounting illusion.

    http://www.managedcaremag.com/archives/0602/0602.news_medicare_eff.html

  • Sadie||

    Please tell us where the VA claim comes from, because I can't find such a statement, even on the VA's website. I'd be happy to know that vets are getting top-notch care.

  • D.A. Ridgely||

    joe, I would also like cites for your claims regarding patient service and efficiency. Not that I doubt you have them but I'd like to see the context. So, for example, are we talking VA administered hospitals here or the wider Tricare system, etc.?

  • ||

    Joe:
    "The health care system that makes the most efficient use of its operating budget is Medicare."

    Yes if you believe their numbers.

    In reality the cost of Medicare administration is almost 30%. The government does a good job hiding costs through fund accounting so their numbers don't include minor items like retirement costs, depreciation, and much of their infrastructure.

    Most for profit healthcare plans run about 15%, (profit tends to run on average 3%)except for the non-profit plans I deal with that run 20 - 22%, for those who would hate to see what the effect of profits would be on healthcare, it is clearly apparent that it does lead to a much more efficient health plan.

  • ||

    Obviously, there are going to be a lot of questions. Anything this big is going to be pretty complex.

    But yet, one man thinks he has it all figured out. How much is the honorable senator paying you to pimp this?

    I'd encourage everyone to actually head on over to the site and read about the plan.

    As you can imagine, there's definitely a lot of misunderstanding already appearing on the net...


    The only misunderstanding is that some tool thinks by introducing a govt. bureaucracy that things will get simpler and cheaper.

    For starters, this is NOT some massive new government-run health program.

    Yet.

    The Lewin Group - which is a nonpartisan, independent, private health care actuarial analysis firm - said it would cover over 99% of Americans and save $1.48 trillion over 10 years.

    I know how we can save even more: by every congesscritter getting a real job.

    How? Through cost containment, reduction of adminstrative expenses, and reducing the number of uninsured people who DO get care -- but in the emergency room, and paid for by taxpayers.

    Well, at least he didn't claim they'd do it through volume, volume, volume.

    Keep those questions coming!

    Perkiness this extreme is usually terminal.

  • ||

    Wyden should learn how to use spellcheck first.

    Every time an individual interacts with state, local and federal government-registering their car, enrolling their children in school, applying for a driver's license or paying their taxes-they can be required to verify their enrollment in a private health insurance plan.

    Not in love with this, but it's at least arguable that not having insurance is an externality imposed on hospitals and other consumers (as people without insurance can get into catastrophic situations and still receive medical care without ever having any intention of paying it back). That said, it's got more teeth than the Massachusetts plan. There's probably going to be a helluva lot more compliance if you can't get, ya know, your car registered for want of health insurance.

    Make individually purchased insurance tax-deductible like employer-based insurance currently is under federal law; repeal the federal ban on interstate trade and competition in health insurance; then let the states decide whether they want "health help agencies" or not. If they do, great: pass state laws creating them, and then pay for them. I live in New York, so I'll scream and yell about what a terrible idea they are, and then they'll pass and I'll be pissed but I won't move and that'll be the end of that. Sure as hell preferable to Leviathan, especially if things do get especially bad in New York.

  • Offended||

    I think Reason should consider giving drug tests to employees before they get near a keyboard, either that or start a search for David's head beginning with up his ass.
    What a fucking jerk.

    Seems that Terry has a limited set of phrases to use when commenting.

    Terry Josiah Says:
    August 8th, 2004 at 9:06 am
    "Total crime in England and Wales is up 9.3 per cent.
    But the Government shrugged off the shock figures and blamed new police methods of recording crime where incidents seen by officers are logged even if they have not been reported."
    Crime is up. If gun bans work why is crime up?
    As usual, Lambert, who is fucking nuts, sticks his head up his ass, and denies the obvious.
    That is why Lambert works for a university, a state institution. He would be fired in a private company because his is mentally disturbed and an asshole to boot.

  • ||

    If you are in a car accident, an industrial accident, a private property accident, an at work accident or on private property accident then you do not get to use your expensive monthly health care insurance. The law allows every business and every automobile operator and every worker a separate insurance contract policy so you get confused and have to fight it out in court. You do not always get what you pay for or get to use what you pay for regarding insurance contracts approved by the government legislators with idealistic profitable laws to force you to pay for.

    People want health care not health plans.

  • ||

    The health care system that receives the highest scores on patient service is the Veterans Administration.

    As a disabled veteran, I am absolutely gobsmacked at this breathtakingly bold assertion. Highest scores compared to what, exactly? The British Navy circa 1660? Please, please, please, joe, post a link to your source for this.

  • ||

    I try to stay away, but I can't.

    David, you've seen the comments, and I haven't seen a response. Obviously you've shown some intelligence to have graduated Northwestern, but when you make posts like this one has to wonder if you've actually learned anything. You're link to the "pragmatic approach to health care modernization" was interesting, even though you seem to have missed the statement "Rumor has it that Wyden's newly found free market principles also coincide with his possible plans to challenge incumbent Republican Sen. Mark Hatfield next year".

    Why don't you enlighten us with one government plan to help us make our own decisions that has actually worked, so we have a basis for comparison? Considering the groundswell of people who are beginning to believe that you are a statist liberal in libertarian skin (and I'm not yet one of them, despite that link you put to my comment in a previous post).

    I don't care that you have attempted to cultivate a following at DailyKos, if you are making a case for libertarian principles. When you do nothing but act as a cheerleader for Democratic candidates, it's disappointing at best. If you believe in the cult of the libertarian Democrat, that's fine, be you need to remember that it's the "libertarian" that should come first, because at best our party allegiances are transitory, at least until a third party can begin making inroads on the two-party bastardization of our Constitution.

  • Andrew II||

    Andrew,

    The plan, as I understand it from the Los Angeles Times summary, has people directly buying their own insurance in years 1 and 2. It's only after year 2 that some kind of payroll-tax system gets implemented.

    What if the plan kept with its year-1-and-2 format and let people spend their own healthcare dollars (perhaps through a HSA) in perpetuity? Wouldn't that be a pretty good plan?


    Also, how about including a modification of the community rating system, where people who take advantage of preventative care and routine check-ups get lower rates. If there is really merit to these programs, individuals who make the effort utilize these programs should incur lower future costs, and should be charged less, right?

GET REASON MAGAZINE

Get Reason's print or digital edition before it’s posted online

  • Progressive Puritans: From e-cigs to sex classifieds, the once transgressive left wants to criminalize fun.
  • Port Authoritarians: Chris Christie’s Bridgegate scandal
  • The Menace of Secret Government: Obama’s proposed intelligence reforms don’t safeguard civil liberties

SUBSCRIBE

advertisement