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Bob Bennett's Peculiar Fear of British Health Care

bennett.jpgUtah's Bob Bennett is certainly one of the GOP's most learned senators on health care reform. Which is why it's so disappointing to hear him lashing out with this kind of nonsense:

“The sticking point in this entire debate is the demand on the part of the Obama administration that the final product have a government plan as one of the options, and if that happens, I will do everything I can to say no because I am convinced we would end up with only one option that survives,” said Bennett in his speech on the Senate floor. “Right now, nearly 1.8 million Britons are waiting for hospital or outpatient treatments at any given time. Let's realize that the American voter will never stand for the kind of rationing by delay that seems to have crept into every other government-run health care system.”

I count at least three things wrong with that argument. The first is the suggestion that a public health insurance option would naturally lead to a socialized system in which the government owns the hospitals and the doctors: If it hasn't happened in France, or Germany, or the Netherlands, why would it happen here?

Second, the 1.8 million Britons waiting for treatments are waiting because Britain pays about 41 cents for every dollar we spend on health care (and yes, those are per capita numbers). To put it more starkly: Britain spends $2,760 per person, per year, on health care. America spends $6,714. According to Bennett, in this scenario, 3 percent of Britons wait for non-essential services at any given moment. If Britain spent $3,954 more per person -- which would more than double their spending -- does anyone really think waiting lists would persist? If so, why?

Third, 1.8 million Britons are waiting for treatments? That's 3 percent of the British population. Is Senator Bennett really prepared to argue that there's not 3 percent of the American population unable to afford a doctor's visit or a necessary treatment at any given time? In a country where more than 15 percent are uninsured? Really? And what about if we erased the single-payer programs of Medicare and Medicaid? How many would be without care then?

(Photo credit: http://bennett.senate.gov/)

By Ezra Klein  |  June 4, 2009; 4:06 PM ET
Categories:  Health Reform , Health of Nations  
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Comments

Yet, where the hell is another Senator to carry the president's policy forward?
I hope no one is waiting for Kennedy, as much as I admire him, is in no shape to mount a good fight.
No matter how you try to compromise, it never happens. The idiotic foolishness of thinking a public option would destroy private insurance is just more of the same, ill educated twaddle.
Enough.
I tell myself that there is a republican statesmen out there. I thought that maybe Colin Powell was going to step up.
But there isn't anyone. They're all going home.
Is the end? Will we see a Whig like dissolution and reformation?
Meanwhile, the nitwits are screwing it all for everyone.

Posted by: marcus411 | June 4, 2009 5:04 PM | Report abuse

Well said. Idiocy on the part of Bennett who is obviously just banging the scare tactic drum.

Public plan is not socialized medicine. Waiting for non-essential services is not rationing. And 3%? I bet we would kill for a number that low.

Posted by: scott1959 | June 4, 2009 5:33 PM | Report abuse

It really boils down to an issue of control. I want control over my own health care. I don't want to have to "contribute" to politicians and "embellish" the wages of bureaucrats in order to receive health care. I don't like the system of having to go through an employer to get health insurance but Government tax incentives created that system. I would prefer a consumer oriented system where individuals drive the market. I want to be able to comparison shop my best options online and then purchase what best suits my needs. If everyone had to shop for health insurance simple profit motives would gradually make that process easier. I think the Government could play a minimal role via tax credits or vouchers and charities can also help. The bottom line is the Government is not competent to play a larger role in our health care system. The influence they currently have is a large part of the problem. Why aren't you people horrified of Government solutions?

Posted by: fallsmeadjc | June 4, 2009 6:30 PM | Report abuse

Fallsmeadjc---I think we are not horrified by government solutions because we have seen Medicare work effectively, we have seen VHA work very effectively and any innovation in the private sector has been government introduced efforts that the private market eventually took advantage of....examples: DRG pricing, RBRVS pricing, even utilization review. The MedPac system is vital here.

Left to their own devices, an individual consumer oriented system you describe would have you paying 20% of your dollar for administrative expenses and little incentive to truly compete to lower costs. You have to remember we have ostensibly had competition for the last 40 years and all we have had is rapidly escalating costs.

The healthcare market is not a tradition market that responds to competitive forces like others in our economy. This is due to the third party present, shielding you from the vast majority of the costs. The presence of a public option would keep real competition alive, and would spur innovation.

Posted by: scott1959 | June 4, 2009 9:30 PM | Report abuse

I'm suggesting that we restructure the health care market so that it does act more like a traditional market. Market forces have been proven to bring down costs. Why can't this work in health care?

What do you think would happen to food prices if everyone had Government subsidized food insurance? Would you favor food insurance over food stamps even though food stamps are technically a voucher? We could create lots of Government jobs operating a food insurance agency and the profits of food suppliers would skyrocket. Even Wal-Mart could pay high wages and still be hugely profitable in such a system.

I get that some people would still need help acquiring health care but there are lots of private charities dedicated to that purpose. Just think if all the money being spent trying to reform health care were actually being spent on providing it. Would there still be such a huge need?

This whole thing reminds me of the Patrict Act and the Iraq War. The Government is basically saying "Give us more of your freedoms and we will protect you." I associate the word reform with increasing freedoms not reducing them. Nationalizing Health care would be a reduction in individual freedom. Individuals would have less control over their own health care. That is not a reform. That is a power grab. Our Health care system is screwed up because we don't have enough control of it. The best way for the Government to fix it is to pass reforms that increase the freedom of individuals to fix it.

Posted by: fallsmeadjc | June 4, 2009 10:52 PM | Report abuse

Scott had a great post, and I'll only add a very small piece. Healthcare is also not like a traditional market because it's got both a high technical information level and high costs for wrong choices. I can figure out which HDTV I should buy with relatively little information, and if I get it wrong then I'm not really hurting too badly because I've just got a TV that's not the best. Picking the wrong healthcare caries both potential negative health outcomes and huge healthcare costs.

Posted by: MosBen | June 4, 2009 10:53 PM | Report abuse

Notably, the American system rations care too. We just ration it by preventing some people from ever receiving certain kinds of care. So nobody's in line, but that doesn't mean we have better access.

Posted by: davestickler | June 5, 2009 1:59 AM | Report abuse

It really boils down to an issue of control. I want control over my own fire protection. I don't want to have to "contribute" to politicians and "embellish" the wages of bureaucrats in order to receive fire protection ... If everyone had to shop for fire protection simple profit motives would gradually make that process easier. I think the Government could play a minimal role via tax credits or vouchers and charities can also help. The bottom line is the Government is not competent to play a larger role in our fire protection system. The influence they currently have is a large part of the problem.

I am always amazed at how convinced people are that government can't do any jobs well, who also support the local police and rally for the firefighters. Let's be honest here: There -are- things government can do better than the market, just as there are things it cannot. Could we please have an intelligence debate among adults about where that line is and which side health care falls on? Or are we doomed to resurrecting tired old bogeymen until the crack of doom?

Posted by: gilroy0 | June 5, 2009 8:16 AM | Report abuse

Fallsmeadjc...

The healthcare market simply is not a traditional market (unless everyone pays for 100% of their care with no insurance present). I challenge you to find a way to restructure it to become one...

When you go buy a TV, you do the research, you go to Best Buy, you pay 100% of the cost, you get a TV. Turning this experience into one analogous to healthcare, you feel like you need a TV, it is impossible to do much research at all, you go to Best Buy, they say not to worry, for a small copay you can have any TV they got because you have insurance, you walk out with the best plasma screen TV they have.

That is not a rational market. It can't be under those circumstances. You may feel like you can rationalize it by changing who the insurer is, who you pay the copay to, but you can't.

The government is not proposing to subsidize everyone's insurance as I think you allude to. The proposal is for a public option which is not subsidized (other than for the poor--similar to today's Medicaid, only with eligibility somewhat expanded). Under the public option you would pay the cost of that insurance just like you would for a private policy under Aetna, et al. This is just one more element of competition in the system.....and an important one given the oligarchic pricing that exists today.

The insurance industry has had a cozy deal til now. This could introduce real competition which would be very good for the consumer in the end.

Posted by: scott1959 | June 5, 2009 9:49 AM | Report abuse

Pricing a product and rationing a product are not the same thing. If a good TV costs $500 I would have access to it as long as I could come up with $500. If the Government were the only supplier of TVs then I would have to wait in line for one or "contribute" to some politician in order to get one.

It is not right to restrict the freedom of individuals to pay for health care services. Any reform of the health care system should focus on improving the pricing mechanism for health care to bring prices down and better orient the system to consumers. It should not abolish any form of pricing mechanism and force us into lines and onto our knees.

Posted by: fallsmeadjc | June 5, 2009 11:20 AM | Report abuse


The government would not be the only supplier of health care providers. You are seriously confused and are assuming that what is being proposed is a UK style nationalization of health care. Nothing is farther from the truth. That is not even on the table and never has been discussed. Even under Medicare-for-all what you fear would not exist.

If you truly believed in improving the pricing mechanism to bring prices down and better orient the system to consumers you would back a public option.

Posted by: scott1959 | June 5, 2009 11:46 AM | Report abuse

Private insurance companies make about 3 cents of every dollar spent on health care. Every time you go to the doctor they lose money. It is in their financial interest for you to be healthy.

Health care and health insurance are two different industties. Consumers are insulated from the actual cost of health care by health insurance and they are insulated from the actual cost of insurance by their employers. These relationships are an obstacle to the ability of market forces to bring down prices of both services. Governmental reforms should focus on removing this insulation so that market forces can work within these two distinct industries.

The employer insulation can be removed by repealing the tax exemption on employer provided health benefits to even the playing field with the direct purchase market. As more individuals start purchasing their own policies health insurers will have to become more consumer oriented in order to be profitable. The Government could also remove some of the regulatory barriers to entry that make it difficult for new health insurance companies to enter the market. New private companies are often the best source of innovation.

Posted by: fallsmeadjc | June 5, 2009 11:48 AM | Report abuse

Any public player in the marketplace is a cheater because they are not playing with their own money. The only thing they encourage is cheating because that is the only way a private player can keep up. It's like steroids in baseball and Fannie and Freddie in the mortgage industry.

Medicare and Medicaid are the worst run health insurance companies ever. They lose 100 billion dollars a year to fraud. They do not deserve to exist. There are better ways to help poor people obtain health care.

Posted by: fallsmeadjc | June 5, 2009 11:57 AM | Report abuse

No disagreement with your post of 11:48.

But a public player is no more a cheater for not playing with their own money than an insurance company. In your system they would both be playing with the premium dollars paid in by their members.

As for the fraud that exists in Medicare, what is the cost of fraud in the private commercial market? It isn't zero. Look it up. Also, keep in mind that while private insurers can reform, Medicare is stymied in implementing MedPac recommendations by Congress (witness the DME debacle if a couple years ago). The administration is trying to change that.

Posted by: scott1959 | June 5, 2009 4:04 PM | Report abuse

I wouldn't be surprised if Bob Bennett is right: The public option will turn out to be sufficiently better than what the private insurance industry is offering that the latter will be unable to compete.

Unlike Bob Bennett, I think that that would be a good thing, not a bad thing.

Posted by: KennethAlmquist | June 7, 2009 1:19 AM | Report abuse

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