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Bernard Madoff, convicted of running an $65 billion Ponzi scheme, was sentenced to 150 years in jail. What’s your take on his punishment?
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Drew Altman is president and chief executive officer of the Henry J. Kaiser Family Foundation, a nonprofit foundation that develops and conducts its own research and communications programs, often in partnership with outside organizations. It is one of the nation's largest private foundations devoted to health and health care issues. The foundation is not associated with Kaiser Permanente or Kaiser IndustriesPolicy debates are almost always about different ways of achieving similar results -- and which approach has the best odds of succeeding. They rarely take into account the changes in thinking and habits that people will have to make to accommodate those changes. Nowhere else is this more true than the debate in health care reform, where all the various proposals are being sold to the public on the promise of cheaper, more widely available health insurance. Little emphasis is put on what achieving those goals will mean in terms of changing how people obtain that insurance.
That's a huge mistake, one that could ultimately prove fatal to health care reform efforts yet again, warns Drew Altman, president of the Henry J. Kaiser Family Foundation, one of the nation's most prominent health policy think tanks. He says Americans simply aren't prepared to move away from the employer-based system. How does he know? The Kaiser Foundation did what few politicians have done so far -- ask. A Kaiser Foundation poll shows that by huge margins most Americans believe buying policies on their own will make getting health insurance more difficult for them in a variety of ways.
Altman says that doesn't mean reform policies that would move away from an employer-based system are doomed. Rather, the poll shows illustrates "some initial nervousness people have about purchasing health insurance on their own," he writes. "And this unease -- which opponents will undoubtedly exploit -- is a challenge for proposals .. that would abruptly switch from employment-based insurance."
POSTED BY: JD (July 15, 2008 02:52 PM)
I agree that historic policies have allowed a lot of people to remain ignorant in areas where they shouldn't be (thus the fear of being "on their own" when it comes to managing their health care). But we must also ask if such a model is sustainable. Refusing to make people responsible for themselves may be easier, but is it prolonging a problem? Typical government. I wish we had a candidate who told us we need to "bite the bullet" on a few things, because we do, no matter how much we want to live in denial.
POSTED BY: JCH (July 16, 2008 01:34 AM)
I wish I had an answer, but I don’t. Mr. Altman’s questionnaire questions seem to be almost irrelevant in that they largely ask for an emotional opinion about simplistic questions. The intelligent answers to each of those questions would require knowledge and considered assumptions about both the resulting legislated mechanics and the government regulated and corporate customized implementation of any such proposal.
I appreciate the light shed on the crucial problem of public acceptance. I must note that the "public" had virtually no say on accepting or rejecting the disastrous "insurancizing" of our health care system during the last bit of health care reform. I say this as a client member (since 1950) and staunch defender of the Kaiser Permanente (NorCal) system.
The problem, as I see it, is that of allocating the cost of maintaining individuals’ health and the cost of diagnosis and treatment to those who benefit from a healthy population in an equitable way. The "players," at least, include the medical professionals and institutions, the individual, the employer, the individual’s community, and the economy at the various levels affected. This is a problem for which the parsing of risk is a daunting intellectual challenge. It is an area of research where I would expect the KFF to be in the fore-front of trying to solve and to articulate possible solutions to the public.
POSTED BY: Bull (July 16, 2008 12:14 PM)
Not once does the article mention the BIGGEST reason employees do NOT want to shift from employer-based healh coverage ..... the (often) very substantial subsidy from the employer. Major corporations generally pay 75% of the cost of the plan. The pre-tax value of the remaining 25% contribution from the employee is VERY minor in comparison. Add to this the fact that "Group" medical rates are MUCH lower than for individually purchased policies (for the SAME benefit level), and even if coverage is "available", the chronically ill will pay a VERY high price to get it in the Individual market.
Be assured, absolutely no REAL change can take place until the public is properly educated that RATIONING of care MUST be a part of ANY solution .... since the country simply cannot afford to provide rolls Royce coverage to all (at an "affordable" cost). I foresee the ONLY solution as a single-payer (low expense Medicare-type) system, taking ALL current private-insurer profit and a large portion of the current Big Phama profit back into the system as HEALTH CARE services, together with a CAP on care FOR EVERYONE .... e.g., we WILL NO LONGER PAY $100,000 or $200,000, or $500,000 for ridiculous end-of-life exercises in futility or to extend the life of those terminally ill for a few more months. Yes, it does seem somewhat heartless, but we (as a country) cannot afford to do otherwise if we are to provide a "reasonable" level of "affordable" care to the masses.
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