A Critque of the Republican Response to Obama’s Health Care Speech

Today, I will review the Republican Response to President Obama’s health care reform speech. To sum up, Republicans propse:

• malpractice reform (likely damage caps)
• allowing individuals to buy health insurance across state lines,
• allowing small businesses and individuals to pool together (not the same as creating a health insurance exchange),
• refundable tax credits for low- and modest-income Americans, and
• no public option/co-op.

Below are some highlights from the speech [with my comments in brackets].

“Good evening. I’m Dr. Charles Boustany…” [read: Because I’m a doctor, you can trust me…right? Here’s a profile on Boustany.]

it’s time to start over on a common-sense, bipartisan plan focused on lowering the cost of health care while improving quality. [Who doesn’t want high quality at lower cost? The difficulty is to actually implement a plan that will accomplish this.]

Replacing your family’s current health care with government-run health care is not the answer. In fact, it will make health care much more expensive. [Generally, the government has not done a good job of containing costs. On the other hand, neither has private health insurance. ]

And it cuts Medicare by $500 billion, while doing virtually nothing to make the program better for our seniors. The president had a chance, tonight, to take the government-run health care off the table. Unfortunately, he didn’t do it. [Obama says, “I will protect Medicare,” with exception of cuts where waste and fraud occur. The Republicans claim Obama will decrease Medicare funding significantly. I am not sure which is the truth. However, these two sentences make the Republican stance confusing. They say don’t cut Medicare, but “take government-run health care off the table.” Medicare is government-run health care! If Republicans were truly against government health care, they would oppose Medicare and try to replace it with vouchers or some other system. ]

One, all individuals should have access to coverage regardless of pre-existing conditions. [This is one area where Obama and the Republicans agree.]

Two, individuals, small businesses and other groups should be able to join together to get health insurance at lower prices, the same way large businesses and labor unions do. [I don’t see much of a proposal here. Currently, small businesses and individuals can group together to buy insurance. However, these pools often don’t work well because the sickest individuals and small businesses with sick employees are the ones who most want to join these groups. This is known as the problem of adverse selection. If premiums rise in these pools as healthier individuals drop out, this results in a death spiral. Republicans do not seem to be advocating a health insurance exchange as Obama proposed, only not to make it illegal for individuals and small business to group together–which they can do already.]

Three, we can provide assistance to those who still cannot access a doctor. [According to a recent Republican proposal, this would entail making health insurance tax-deductible even if it is purchased through a nongroup plan and creating refundable tax credits for low- and modest-income Americans. ]

And four, insurers should be able to offer incentives for wellness care and prevention. [This is not a real proposal; insurers currently are able to offer incentives for wellness care and prevention.]

We need to establish tough liability reform standards, encourage speedy resolution of claims, and deter junk lawsuits that drive up the cost of care. [As I mentioned in my previous post, the claims won in malpractice suits are not the cause of high health care costs; many patients are seriously injured by medical errors and deserve compensation. However, the defensive medicine many doctors practice to avoid lawsuits, does lead to unnecessary tests and drives up costs]

Let’s also talk about letting families and businesses buy insurance across state lines. [This sounds like a good idea. Individuals should be able to purchase whatever type of health insurance they please. However, this basically would mean that the federal government, and not states, would be the regulator of health insurance. This may increase industry-wide consolidation, but may increase competition in areas with a single dominant insurer. Still, if distant insurance companies do not have contracts with local doctors, this legislation will have little impact on the quality of care.]