OK, I'm trying to hold my temper, but I'm sitting here watching the Democratic debate, and I want to just smack Barack Obama. He and Hillary are debating health care. The contrast between the two is remarkable. She understands the business and the domain. He simply does not. He has a pollyanna view of health care that is consistent with his lack of experience on the national stage or in the trenches where the really big and powerful play hardball.
Let me cut to the chase: Barack's plan is right of center and far too Republican friendly. He is sacrificing principle and worse, he is violating basic business principles that make coverage work. He believes he's progressive on this issue. He's not. It is obvious he's never had to actually negotiate coverage. You cannot leave anyone out of the pool and make the thing work. It is a fundamental actuarial principle of the business. And whether Cigna or the Feds run it, you have to follow the same coverage principle. You must mandate coverage, just as Hillary and Edwards pushed for.
I have been an executive in an insurance company. I was intimately involved in managing care and helping to rate applicants. Barack says everyone who wants health care will buy it if it is affordable. Bullshit. I have seen many young adults -- working young adults -- refuse coverage because they'd rather spend their money on cars, electronics, entertainment. They do not believe they'll get sick. Wolfe Blitzer is right. Those people get sick and then the rest of us pay for it. Yes, people with little income for insurance...mostly responsible adults with families...can't afford the premiums. Subsidies are the answer, not exempting them from the system.
He also spouts that he will pay for his program by focusing on prevention. To paraphrase him: we'll pay for a dietician so we won't have to pay for a diabetic's foot amputation. Right. Has this man ever talked to someone who actually cares for patients? I do. I'm a nurse practitioner. I work with people who have heart problems and many of the illnesses that go with them, like diabetes. Even if you can get people to get control of their health and lifestyle (and let me tell you, this is a rare feat), this takes an enormous amount of time and MONEY. The payback is not in a premium year. Ever. He is totally nuts and clueless to think he's going to pay for his programs with this as a core strategy. It just won't work. And I think what distresses me the most is that this guy thinks he has answers when he is so clearly misinformed.
Hillary covers her program with new taxes and savings from negotiating pricing and instituting administrative cost savings. That may still not be enough, but it is much more realistic.
You know, I keep saying that I'll support Obama but the truth is, while he's charismatic, he just isn't a heavy hitter in the policy department. Worse, he has top advisors guiding him and they aren't pointing him in the right direction. Why would anyone think that would substantially change if he were elected?
I'm sorry, too much of this story feels like 2000, when the Republicans fell all over themselves lining up behind a guy who was charismatic and seemed like a whole new animal. He was an empty suit. I'm still not sure how full Mr. Obama's suit is either.
You write very well.
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