he has offered an important preview of what universal health care's opponents will say during the presidential campaign
This time, Giuliani swings for the fences with a low-budget, recycled re-release of a Bush healthcare plan.It comes with Bush-like slogans too, like "fight them over there so we don't have to fight them here". Hey, if these ideas are so timely for America, why aren't they law already - the GOP have had years to make it a priority.
Don't wait for the candidates to take a swing at what can be assumed to be 'running interference'. If there is any chance of meaningful healthcare reform, its got to be 'netroots-ish'.
This is a key social and economic issue of a generation, barring war, perhaps, or radical energy policy. God knows, it's more important than Stem Cell research wing flapping, etc.One observer is going to get this week's personal Pulitzer for this:
For Giuliani, you get the feeling, it's all about what his plan isn't (Michael Moore, Cuba, "socialized medicine") rather than what it is. Or, to put it more bluntly, it's about stopping universal health care — not achieving it.
Which, perhaps, is a good thing. Giuliani hasn't made a meaningful contribution to the policy debate. But he has offered an important preview of what universal health care's opponents will say during the presidential campaign — and afterwards, if Congress seriously takes up the issue. - J. Cohn in TNR, who have been on the beat.
And he's got some strong propaganda. He wants people to FEAR change, not embrace it. He's calling up xenophobia ("We need an American solution").
'HEALTH CARE IS LIKE WELFARE DEPENDENCE' - NY SENATOR MOYNIHAN IS TURNING IN HIS GRAVE
The most bizarre - if there is just one - is that he's touted government action as welfare-program-like slavery and to the crazy idealism of the Great Society.
Tell that to the millions in the VA system. Shall we start calling them slaves to their healthcare? Most can understand welfare dependence, but health dependence? C'mon. What an embarrassment.
THE MYTH OF MARKETS - BEEN THERE, DONE THAT, WITH 'MANAGED CARE'
Rather than trying to solve the national health care trainwreck that is going on in slow motion, Giuliani seems intent to pay off a few people who maybe are the 'likely voter' agitators for the greater change that is needed. Surprise. It's a tax credit for the self-employed. They must have some poll that shows them the largest disgruntled group, since they already bought off seniors' silence with their last major, unfunded legislation.
What Giuliani and his economists don't want to face up to is that there is no amount of toying with private insurance and Nanny corporations that is going to work. Managed healthcare didn't work and it delivered up a long list of horror stories that are an American embarrassment, not "the best healthcare in the world". If 'managed care' couldn't work, then all these little tax fixes may just feed the monster that has demonstrated ability to bloat itself, with non-economic costs for medical devices, lab tests, claims processing (to some degree), and a seemingly unlimited spiral in patent drug prices.
FISKING RUDY
The goal:
All Americans want to increase the quality, affordability, and portability of healthcare.Sorry Rudy, but smart Americans want to move past soundbites:
- Let the pendulum swing in order to drive costs out of the system.
Get started by ending the Nanny Corporation and it's private health care corollary. If Corporations want to offer programs, let them pick up the tab for comprehensive wellness and preventive medicine, which would be a nice supplement to government financed basic health and hospital coverage. If the private health companies want to continue, let them move into the markets for catastrophic health, supplemental health, long-term disability, and end of life policies, mostly. - Bring oversight to the large pharmaceutical companies.
The temptation to raise prices, rather than accelerate innovation, is just too tempting and subject to abuse, even moreso alongside a need to drive double-digit earnings for ever larger companies. Sometimes industry-government partnership is all that is needed to stabilize 'protected markets' as best as possible (I've seen at least some good reports from Canada drug price cost containment done this way). - Make the workforce productive and make American industry highly competitive.
More healthcare has productivity advantages, that have even been measured. The end of the Nanny corporation will free companies up to focus on running businesses, since they've been so bad historically at running 'promises to employees', like pensions and, now, healthcare coverage, post-retirement or otherwise.
Reduced focus on all the nuances of the tax code will also save billions and billions (that's usually the figure heard when fending off changes to the tax code, yes?).
Besides, the items above are just the small set of what might form an eventual consensus to action. But, plenty of others would just assume add that concerned Americans would like to rate their national health care not just by their five-minute waiting line, but also by the no meaningful waiting line for scores of millions.
THE OTHER BIG EMBARRASSMENT
The idea that millions of additional consumers waving their dollars is going to lower prices that health insurance companies charge is another embarrassment. Within parameters (age, smoking, etc.), the cost to insure a life is pretty much set by the cost-structure of the out-of-wack industry. As high as the administrative costs are, the opportunity to spread fixed costs over a wider base is not going to offer the kind of price reductions that are meaningful (perhaps even material).
Besides, the cost savings could just as well end up being paid out in executive bonuses at insurance companies for all the 'hard work' of enrolling all those consumers who Giuliani just empowered to go wave their tax-mollified dollars. Not that they shouldn't get paid, but you know ... well, if my comp plan was linked to enrollment, I'd donate to the Giuliani campaign, wouldn't you?
