Leavitt Tilts At Health Care Windmills

(The post title refers to the Netherlands, of course.)

As reported here in last Tuesday’s New York Times, Health And Human Services director Mike Leavitt will travel to Switzerland on Nov. 7 and then fly to The Hague in The Netherlands for two days to look at how those two countries provide health care for their citizens.

As noted in the story…

In Switzerland and the Netherlands, all people have to obtain health insurance or pay a penalty. Employers are exempt from the mandates, and private insurers and hospitals provide care.

“We have been hearing a lot of people in the health policy community talk about how those two countries had been doing new things in health access, and the secretary wanted to get a closer look at what they’re doing,” a department official said.

The trip is not a sign, however, that the Bush administration is considering major health initiatives, officials said.

“We don’t have anything cooking that we haven’t announced,” the department official said. “We would not endorse a system like the Netherlands or Switzerland’s. But if there’s something we could learn about their system, we should learn about it.”

(As a side note here, I’m wondering why on earth no name would be attached to this “department official.” What this person is saying is hardly controversial, but then again, we’re talking about the delusional and paranoid Bushco regime where they no doubt see enemies everywhere, even in their nightmares.)

While I would normally be somewhat enthused over the fact that our ruling cabal is at least pretending to be interested in learning how to solve a problem, I should note the following from this link…

(America’s Health Insurance Plans) President Karen Ignagni said that "there is confusion between 'universal coverage' and 'government-run,'" adding that "we are fully committed to the concept of universal coverage" (Reichard, CQ HealthBeat, 10/31). Willem van Duin -- executive board member of Eureko, a health insurer in the Netherlands -- said that the nation had the ability to implement health care reform because "politicians, providers, insurers" reached a consensus on the issue (Appleby, USA Today, 11/1).

Daniel Schmutz -- CFO of Helsana, the largest health insurer in Switzerland -- said that divisions in the U.S. might not allow for such a consensus. Van Duin added that residents in the Netherlands and Switzerland have more willingness than those in the U.S. to pay the taxes necessary to finance government subsidies for health insurance (CQ HealthBeat, 10/31). In addition, according to Schmutz, enforcement of a requirement that all residents obtain health insurance might prove difficult in the U.S. He said, "To Swiss people ... it's highly accepted that the state has a central role in private life."

And to get an idea of how these countries deal with health care issues (and other matters also), here is a link to an article written by world traveler Rick Steves that may prove to be illuminating…

We Americans have plenty to be proud about, but we need to remember the risk of finding too many truths to be "self-evident and God-given." Because when you travel, you learn that other people find their own solutions to challenges that confront us all. On my recent trip, my Swiss… and Dutch friends impressed me with some creative thinking.

The Swiss government deals with its social problems with pragmatism and innovation. Do you have too many cars clogging up downtown or too many hard-to-employ people struggling to get by on welfare? In Switzerland, big cities provide free loaner bikes to those who leave their cars at home. And people who would otherwise be collecting unemployment benefits run the bike system.

Like the United States, Switzerland is dealing with a persistent drug abuse problem. The Swiss believe the purpose of a nation's drug policy should be to reduce the harm that drugs cause their society. Like many Europeans, they treat substance abuse more as a health issue than as a crime. Rather than fill their jails, the Swiss employ more compassionate and pragmatic methods.

To help fight the spread of diseases like HIV and AIDS, street-side vending machines cheaply dispense government-subsidized syringes. The government even tries to control where junkies shoot up. To keep them out of public restrooms, the interiors are lit with blue light. Why? Because if junkies can't see their veins, they'll shoot up elsewhere. The government hopes they'll use heroin-maintenance clinics, which provide counseling, clean needles and a safe alternative to shooting up on the streets.

In Switzerland, the casual use of marijuana is tolerated. In Bern, locals pass joints with no worries in the shadow of the cathedral, ignored by passersby. It seems the Swiss simply enjoy life in a country that believes tolerating alternative lifestyles makes more sense than building more prisons.

…

In the Netherlands, where prostitution is legal, prostitutes pay taxes, get regular medical checkups, and even have a union. When a prostitute pushes her help button, it's the police -- not an abusive pimp -- that come to her aid. The pragmatic Dutch know that prostitution will happen no matter what, so they might as well make it as crime- and disease-free as possible.

My point here is that we can’t just pick and choose elements of what the Swiss and Dutch have to offer in the way of private health care without modifying our society to resemble theirs so our health insurance “solution” will actually work.

Let’s consider this; does anyone think any politician in this country will tolerate the recreational use of marijuana, particularly a Repug? Or making syringes available from vending machines? Or advocate for prostitutes to form a union?

Neither do I. And can you imagine any right-wing media loudmouth remaining silent if we reach a point one day in this country where “it's highly accepted that the state has a central role in private life"?

I think you know the answer.

Am I saying Leavitt should stay home? No. All I’m saying is that, when he returns, he and his boss should either decide to get serious about forming partnerships among business, government, unions, and all of the players on this issue or just let Dubya do what he does best: leave the mess for someone else.

And by the way, though there’s an element of truth in the statement that the Edwards health care plan is modeled somewhat after the European plans, it’s more accurate to say that the Edwards plan encourages participation, cooperation and (ultimately) cost savings through the use of incentives, tax credits, and insurance “reform” (nice to see that industry targeted in this way, since they have no problem giving us that treatment; that’s why a John Edwards presidency is their worst nightmare).

Update: Oh, and by the way, while Rudy! trumpets the virtues of private insurance over oh-so-baaaad government coverage (oh, excuse me – I mean “socialized medicine”), please consider the following from this linked story written by Joe Conason (a nod here to Ezra Klein and a h/t to Paul Krugman; hope that takes care of all the kudos)…

…Giuliani was serving as mayor and participating in a city of New York health plan when his doctor informed him that his prostate biopsy had come up positive. The coverage he enjoyed -- which resembles the Federal Employees Health Benefits Plan -- permits all city employees, from trash haulers and subway clerks up to the mayor himself, to select from a variety of insurance providers, and it is not much different from the reform proposals adopted by his nemesis Hillary Clinton.

In the spring of 2000, when Giuliani learned that he had cancer and abruptly dropped out of the Senate race against Sen. Clinton, he was enrolled as a member of GHI, one of the two gigantic HMO groups that provide care for most city workers (the other is known as HIP). He underwent surgery and radiation at Mount Sinai Hospital, a prestigious institution that participates in the GHI plan, which means that his costs were largely underwritten by city taxpayers.

But I guess this is par for the course for the “Ape Man” presidential candidate (and I think Cowen’s theory is one of the stupidest things I’ve ever heard, though partly true I guess, sadly enough).