I think a recent article by Michael Kinglsey (http://comments.realclearpolitics.com/read/42323/432370.html) illuminates perfectly what elitists on the left (we've got them on the right, too) don't get about the average guy's resistance to the healthcare plans being promoted by Congress and the Administration. Liberal elites just think the average guy is dumb, and that because he is dumb he resists change.
That is not it.
I have impeccable elitist credentials, Princeton undergrad, got a PhD in Materials Engineering, rose through the ranks, became the boss, did the IPO, all that stuff. And I did it in manufacturing, working with the average guy. Here is the news: he's not dumb. He is also not afraid if you can say something to him that adds up. I've sold lots of change to organizations (union and non) and it works if, and only if, it makes sense to the average guy and he sees it to be in his (and his family's) best interest.
Here is what I think the average guy has figured out about what has been proposed: 85% of the people are supposed to put what they have (health insurance) at risk so that 15% of the people can get something they don't have. And, they are told that costs will go down long term.
More coverage and less cost. What has to give? When the average guy hears detractors say that the government will impose rules to control cost and access (rationing), I'll bet that makes sense to him. More coverage and less cost does not make sense to him (me neither!).
The problem isn't the audience, it's not the forum, and it is not the speaker (well, the Speaker, for sure), it is the message. If you want the majority to buy into change then you need to propose something that is in the majority's interest.
Hags
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6 comments:
Hags:
I think you illustrate a great point, but reach the wrong conclusion. You think "something has to give", which is understandable and intuitive, except it is incorrect. I suggest you read George Halvorson's new book "Heath Care Will Not Reform Itself". The author is the CEO of Kaiser Permanente and he shows how screwed up the status quo is. He explains why we are paying 50% more of GDP to cover only 85% of our population when compared to Europe. He says we can have much better health care delivery, for all, at less cost.
It is 139 pages and a very quick read. He explains how we need to cover EVERYONE in order to require insurance companies to insure EVERYONE. It is the dual mandate - we all must buy insurance and insurance companies can't exclude pre-existing conditions. If we don't have the former, we can't have the latter. If we simply prohibit excluding pre-existing conditions, why buy health insurance while healthy? We will all just wait until we're sick to buy in.
Obama is not advocating "government run health care" per se. He is promoting a much needed change in the rules of the road. The free enterprise system will continue to deliver the care - with many perverse incentives removed. Hopefully, they will have a government run option to compete with.
Final point - he advocates virtual physician groups that deliver all of the health services one might need and paying for same on a flat rate, per person basis. Reinsurance can be used to mitigate the effect of a group that uses health care above the norm. This way, we aren't paying fees for every little procedure - an accounting nightmare as well as a prescription to load up patients with unnecessary procedures. If a doctor buys an expensive new piece of equipment, he will run every patient through it where he can possibly justify the cost, no? Under the current system, why wouldn't they? Well - they do - it doesn't materially improve health care yet it costs a great deal. It is one small example of our perverse incentive structure.
The Democrats remember 1994. We will have a health care bill this year. The only question is how wide or narrow will the changes be?
Bax,
I like talking to you. Your arguments always (well, almost always) come from a reasoned position.
But, here's the deal. From my perspective you are writing about the anticipated success of Central Planning. I haven't that happen so far, meaning ever. (Please don't cite warfare examples.)
There is no doubt that a system that requires all to enroll and requires all to pay makes for a better deal for sick people. But, that is a judgment that young healthy people have an irrefutable obligation to pay for the care of sick people, even if the sick people brought it on themselves.
You also accept the proposition that our government will intervene and bring costs down. It is a lovely thought, but I don't think you can cite a meaningful precedent.
I am not an expert in the demographics and the statistics regarding other countries, but I dont think any country in Europe represents a fair model of the US from a healthcare standpoint.
Is low cost really the goal, or is it the best care? Do many people flock to Europe or Canada for the best care. I understand that drugs may be cheaper, but who goes there for access to care? I think they come our way because of defects in their systems.
You'll have to work harder to convince me that my life is going to be better with Obamacare. Do you really think yours will be? If your motive is purely altruistic I respect that, and I would suggest that is a more promising message to push if you want the healthcare legislation passed. But, so far, neither the average guy nor I believe it is good for us.
All the best,
Hags
The books was fundamentally flawed.
His premise is that covering everyone will save money. Bull. His plan is to "prevent disease" a laudable goal, but he is doing on the basis of bean counting. Disease prevention is just cost shifting to a later time.
He has the bias of a...wait...central planner.
Your average guys are right Hags, first of all this is obviously a power grab by the left in their pursuit of central control. Second, it is not necessary, there are free market solutions to these problems.
And lastly and most importantly, these folks know bullshit when they see it...yes, there potentially be "death panels", not in a week but at some point. Yes we will ultimately lose our health insurance...same deal. We have an innovative system which is the envy of the world and its expensive. Currently it is mostly paid, voluntarily.
The central planners, Rich(i.e.) and his ilk can't keep their hands off our freedom.
The just don't get it, never will.
You'll be surprised, I'm sure, that I come down differently than Hags or Jim. I respect both of their resumes - genuinely - and know that they bring a certain perspective. However, I do not agree with the complete lack of confidence in government or the suggestion that everything is okay (mostly) right now.
The fact is, health care costs are squeezing out country and it is only going to get worse. We pay 50% more in GDP than other western industrialized countries, which puts us at a significant disadvantage in global trade.
Neither Hags, nor Jim, nor any reform skeptics will answer one simple question: Why are other nations so happy with their health systems? How come no major parties want to ditch their system and adopt ours? Answers?
Hags - you say Europe isn't a fair comparison. I disagree. If anything, we should be more efficient, not less through our extensive reliance on the private sector and our economies of scale.
Statistically, Europeans do very well - superior in many health measures - than we do. They have oppressed minorities and they have inefficient bureaucrats, why do they cover everyone at 67% the cost? Why can't we do what they do?
"Central Planning" beats the hell out of our current disorganized, perversely incented mess. I am the first to agree that the private sector is much more efficient than the public sector. However, it is up to government to set the rules to optimize the game for consumers, not the doctors, insurance and drug companies. We are all consumers.
Ahhh...a blog.
However, it is up to government to set the rules to optimize the game for consumers, not the doctors, insurance and drug companies.
Where in that sentence does it talk about, "government take over of health care", because that is what is being proposed.
And in that sentence it does not seem to acknowledge that it IS their business to optimize, not the government; who's job it is to regulate, the lighter the better.
No, Jim. You describe it as a "government takeover of health care." Proponents certainly do not agree with that description. You are one who knows the importance of framing an issue.
It is doctors, drug and insurance companies primary responsibility to look out for themselves. To make profits. That is their job. That is their very legitimate role. No one should count on them for anything else. Right now, they all have it very, very good. They make far more than do their peers overseas.
Again - it is government's role to set up the playing field to efficiently operate within the capitalist system (because of it's efficiency) to provide the BEST health care possible to consumers, while providing a safety net for the least fortunate among us. The most efficient system will not involve massive cost shifting and billions of dollars dedicated to cherry picking customers, as insurance companies currently do out of necessity.
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