Al Franken’s Health Care Rally, 2010-Feb-21

 

Healthcare

 

Today I went to a health care rally in Minneapolis. I decided to go so I could understand what liberals seek from health care reform, and why. So, I went as an observer and not a protester. No signs, no tea bags… just plain old, middle-aged me.

Observations:

  • Liberals really, really HATE insurance companies and corporations in general. They actually believe insurance companies deny coverage and drive up the cost of health care because they’re greedy and cruel.
  • No mention was ever made of Obama’s 2009 quid pro quo with Big Pharma, Big Insurance and that Big Broker, the AARP.
  • Over, and over they chanted against Big Insurance. They were encouraged to frame all discussion points around ‘insurance companies’ when debating with normals.
  • They are still holding a torch for universal coverage. Yes, the impossible ‘46 million’ was brought up as well.

 

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  • Franken tried to sway them away from single-payer, saying, “let’s not let the perfect kill the very, very good.” He did encourage their support by adding that the latest secret plan was the path to universal coverage. Franken held aloft a manila envelope containing the secretly negotiated House-Senate plan. It was an effective but amusing prop: the real health care plan is thousands of pages. Perhaps he should have wrapped a phone book in butcher paper and held that up, instead?
  • Franken also said Democrats were easing the tax burden on the ‘Cadillac’ plans and ramping up the costs for the “very, very rich.” Thunderous applause here.
  • The crowd was juiced up by ‘organizers’ (whatever those are), MoveOn types and handsome young liberal doctors. Franken appeared late, for all of ten minutes and then left.
  • At no time did this group talk about the COST for all this. I never heard ‘deficit.’ Also surprising was how little Obama’s name was mentioned.

 

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  • There were some right-wing protesters outside, and a nervous man with a large ‘Obamacare’ sign appeared in the back. There was just a bit of yelling, but to the progressives’ credit, they calmed him down and engaged him in quiet discussion.

 

Conclusions:

  • Keep. The. Message. Simple. It’s all the insurance companies’ fault! I don’t think the audience understands that it’s state and federal tinkering that causes problems for insurance companies, which must pass inefficiency and cost on to the insured.
  • It was obvious the Left was trying to drum up flagging support in the face of potential failure.
  • Rally attendees look exactly like the tea party people. Really. The audience was 95% white, well-off and 50ish. The also sound like tea party people, too. Not the things they said, of course, but the chanting and head shaking. Oh, there were a few more ponytails and the t-shirts had very different sayings. Believe it or not, here were actual ‘Wellstone!’ shirts.
  • Al Franken is really just a tired, short, fat man. Not a messiah. And not a person I can demonize.
  • I left with mixed feelings. This group’s passion equals the tea partiers’.  I just cannot see either finding a common cause. One side will lose the health care debate. The smaller side. I wish it wouldn’t be that way.
  • It’s sad this group is not willing to start over and let other Americans help frame the solution. “It’s our time!” really means “now or never.” Pity.
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7 comments

  1. John,

    I thought that you wrote a very thoughtful piece here. I think your kind of listening is what will make this country a better place.

    I’m curious. How do you feel about the insurance companies? Do you think they should exist? Do you like the way other countries, that pay about 1/2 per capita for medical care, do what they do?

    I was watching on ted.com the other day, a guy with some revolutionary medical device ideas… he was printing blood tests onto paper, taking the cost per test down to pennies… http://www.ted.com/talks/george_whitesides_a_lab_the_size_of_a_postage_stamp.html

    Insurance companies won’t cover any tests made with that kind of tech. but neither will something like medicare (they’d call it ‘experimental’)… so what is the answer? how do we get to innovate? after all, i believe innovation is the only way to get costs way down… orders of magnitude down… for us to be healthy…

    Please share your thoughts.

  2. Remember that insurance companies are really just brokers for a service between providers (hospitals and doctors for care, companies for medicine and devices), so the only innovation they can deliver will be around what they own: the service. I can’t see any innovation from insurance companies other than efficiency- or cost-based ideas. They have no manufacturing, no engineers, no scientists and no warehouses.

    In capitalist societies, innovation is usually market-driven; if there’s a willing market, and an entity has the resources and risk aversion to take the plunge, they will make take a creative idea into a product like your device, above.

    But health care is in a no-man’s land where capitalism is constrained by government regulation, as it should be. If regulation raises cost or lowers price to the point that there’s no profit, or it raises the risk so there’s no chance of making money, then there will be no innovation.

    I’m flattered that you think I can answer this question — I’m no expert. Perhaps someone, better qualified will find your question and answer here.

  3. That’s a very good point about the insurance companies. I often hear that when listening to thomhartmann.com. He also notes that primary for-profit medical insurance is illegal in just about all other countries except for ours.

    If currency is a fiction invented by the government and the central bank to create an economy with costs and rewards, then I think it should be possible to invent a different kind of currency that would encourage the healthiest possible population.

    I would want to see a type of system where doing what is best for patients is alos what is the most financially rewarding, even if in the current system, it would not be the most profitable thing to do.

    For example, it should be more rewarding to invent an MRI type device that cost $20 than to invent a military contractor style $1.5M system that does the same thing. The way it is set up right now, there is obviously more financial incentive to make a huge expensive monstrosity, with the patient as the afterthought, later.

  4. Interesting reading this from a viewpoint I don’t normally see. I found it linked from http://www.dailykos.com/story/2010/2/23/839808/-observed:-a-tea-partier-sneaks-into-a-Franken-Rally, so not surprisingly I’m on the liberal side of the spectrum. Don’t take this the wrong way, but if the Republicans in Congress were like you I think things would be a lot quieter and more productive 🙂

    Some specific thoughts here:

    * I’m not surprised the cost issue wasn’t discussed to any great extent. To me, the cost (at least in, say, the next 5-10 years) simply isn’t that big of an issue compared to having health care financially accessible to everyone. Or, to look at it another way, if my taxes were to go up to pay for it I would accept it with equanimity. However, the fact that every other industrialized country does have universal health care for much less money than we’re paying — and has much better outcomes — suggests that a good universal health care scheme shouldn’t raise costs in the long term.

    * The quid pro quo with PhRMA is actually very unpopular in the progressive community. I don’t know why it didn’t come up — I wasn’t at that rally — but it most certainly hasn’t been ignored!

    * I would agree that we generally take a dim view of health care insurance companies. I think enough has come out about insurance company practices (see e. g. http://www.time.com/time/politics/article/0,8599,1920893,00.html) about Wendell Potter that there’s justification for this. I think practices such as recission (or “post-claim underwriting”) doesn’t merely border on fraud — taking someone’s money and then trying to find a way out of providing a contracted service doesn’t strike me as terribly honest.

    * It’s not irrational for insurance companies to want to minimize their costs. The problem is whether it’s good public policy to allow people with risk factors such as genetic problems to be charged exorbitant rates such that they’re effectively uninsurable. I don’t think so — that’s simply my basic world-view — and if it reduces the efficiency of insurance companies, I think that’s a cost that should be borne by society. A lot of the conservative arguments focus on behavioral issues (poor eating habits, lack of exercise), but a lot of people at high risk can do everything right and still be extremely high risks.

    * I don’t agree about starting over. The “Gang of 6” — three of each party on the Senate Finance Committee — negotiated all summer fruitlessly, and Mike Enzi all but admitted that he wasn’t negotiating in good faith (see http://www.billingsgazette.com/news/state-and-regional/wyoming/article_db4d1146-91f9-11de-bf23-001cc4c002e0.html).

    * Finally, I think there is room to find common cause, but it’s going to require more radical thinking than I’ve seen much of. I think that progressives and free market conservatives could find common ground in breaking the link between employment and health insurance. From a free market standpoint, it can’t be efficient for people to make decisions about employment or starting a company based on health insurance, and it can’t be efficient (or fair) for companies to bear the cost of medical issues that have nothing to do with their business. It’s particularly tough for small businesses without a large pool of employees to share costs around. From either a progressive or a free market standpoint, having someone tied to their job for fear of losing health insurance isn’t right. John McCain did bring this up during the 2008 campaign (to his credit), but unfortunately his proposal simply was too small. But I think down the road this is something we could work together on.

    Again, a very interesting piece that I’m glad I stumbled across.

  5. Dave and Robert, thank you for the long, thoughtful responses.

    Dave, I can’t agree that private insurance is illegal in most countries, but I’ll just say that a person may be penalized if they use it. The penalty may be fines, higher taxes or permanent removal from the government sanctioned plan. The Swiss have an interesting hybrid I wish Americans would consider.
    Your innovation idea sounds good, but I can’t figure a way to make it happen.

    The Daily Kos… Wow. I’m tickled, really I’m mentioned there. I let all my left-leaning friends know. 😉

    Robert, The problem with the pending heath care reform legislation is that is doesn’t register with most working people who already have some sort of insurance. The benefit of universal coverage is a ‘huh’ for people worried about what insurance costing them today. Most people don’t care about the uninsured unless they are about to become one of them. Long term projections about *government* cost savings is also a non-starter; people think about their personal savings and the diminishing value of *their* health care dollar.

    “It’s easier to sell aspirin than vitamins.” Focus on the pain of your market and sell them just what they need. When they’re feeling better, they may opt to buy some vitamins later. The White House and Congressional Democrats have been pushing some very old vitamins that don’t address the pain of insured people and retirees. So, they get angry.

    I believe the middle ground is to minimize the pain of working people today. Reducing cost of what they’re buying.

    Throwing spears ans Big Insurance bogeymen may make you feel better, but it won’t accomplish anything.

  6. Robert, I forgot to comment on your last point — I agree with “breaking the link between employment and health insurance.” Well, maybe. Giving employers tax breaks for insuring their employees is one of the causes for skyrocketing health care cost. If employers gave people cash to buy their own insurance, people would make prudent choices on how to spend it — and where to spend it.

    Of course, I would also suggest that for Medicare, too.

  7. My proposal’s a bit more radical than that: keep employers out of at least basic healthcare *altogether*. So no employer subsidies, no paying cash to employees to buy health insurance. Whether employers are buying health insurance directly or giving their employees cash to buy it, the problem of high fixed cost for employing someone remains. So get employment out of this altogether — there’s no logical connection. If employers want to offer extras as ordinary (taxable) fringe benefits, fine.

    We might disagree from here on exactly how to handle it otherwise. Obviously low and no income people won’t be able to afford market rate insurance, whether that insurance is private/profit, private/non-profit, public, or single payer. So how to subsidize that is a question — but in some ways a much simpler question. Note that we still need other reforms, such as guaranteed issue/community rating, but I think this would drastically simplify matters. It would certainly make matters easier for small businesses who face huge cost hikes if they have a sick employee or two.

    Yes, people with employer-provided health insurance probably generally feel reasonably good about it, and understandably fear change. Group plans can’t reject people or engage in other shenanigans. However, I think people realize that they’re a layoff away from losing their insurance (particularly in this economy) and would like to see a more comprehensive reform.


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