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February 22nd, 2010

Susan Estrich asks “What went wrong?” and lazily asserts, based on what is clearly little to no research, that it is because Obama and the Democrats are trying to fix health care when we can’t afford it and it really isn’t that broken anyway.

What really went wrong is Democrats sat idly by while Tea Partiers and others took over the public airwaves selling fear and misinformation. A majority of people falsely believe that health care reform will force them to change insurance. Majorities actually support the components of the plan when they hear what they actually are. The endless mantra of “government takeover” of health care resonates as a sound bite with some people. But the facts remain: if we do nothing about health care, we really will bankrupt the nation. Health care costs are rising at twice the rate of inflation. As a nation we spent roughly twice the percentage of our GDP compared to the average industrialized nation on health care, yet we have waiting times worse than many other countries which Republicans have lambasted for their nationalized programs. While we lead in a few areas, like cancer, we lag badly in others, like infant mortality, and overall our health care outcomes are no better than other countries which spend a far smaller percentage of their GDP on health care. Premiums are skyrocketing, more and more people can’t afford health care, and businesses are having to cut back on health benefits or drop it entirely. Medicare spending is going through the roof.

We have an absurd system where many insurance providers make an unconscionable amount of profit, yet at the same time we have no meaningful cost controls. Providers are paid on a fee for service basis rather than on quality of health care outcomes. Huge amounts of time and money are wasted on paperwork. We have no incentives in place to streamline health care information technology. And even those with insurance are not safe: you can have your coverage cancelled when you get seriously ill because of trumped-up fraud accusations on the part of insurers.

And no, Republican claims that we can solve this problem with “small” reforms are engaging in fantasy thinking. New York State tried to stop insurers from denying coverage to people with preexisting conditions. The result? Many people decided not to buy insurance until they got sick, which of course is the inevitable result. Insurance premiums skyrocketed, and continue to go up. The only way to solve this problem is with a comprehensive approach of some kind.

The health care proposal currently under discussion will REDUCE the deficit according to the OMB. Furthermore it has incentives and pilot programs designed to encourage experiments in alternative payment systems, such as bundled payments rather than fee for service, and other sensible cost control measures. Studies have shown that health care outcomes can in fact remain as good or better even as you reduce the number of specialists assigned to a patient and reduce excess tests and procedures.

We can’t afford to deal with health care now? We can’t afford NOT to deal with it now. Yes, it is a complex issue but it angers me when pundits bloviate out of their asses on issues of national significance without bothering to do research or carefully think through the positions they so sloppily broadcast to the world. I don’t need to know that you’ve done the extensive research of consulting your memory about a sample size of one: your personal experiences with health care, while spreading your ill-informed opinions about what ought to apply to the entire country. It’s a combination of laziness and hubris. If you have a national audience, for God’s sake take some responsibility and learn about the subjects you write about. Wake up and smell the Google: it doesn’t take much work to figure out what is going on with health care in this country, but it does take some work, work which Estrich and the many other political talking heads out there seem to be unwilling to bother themselves with. Of course, if even pundits don’t bother to do research, it’s no surprise many Americans don’t either.

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