Some introductory notes on healthcare, Pt. 1

As the President cranks up the heat on the issue of healthcare, we’re going to be hearing/reading/seeing more and more discussion on the current and potential options for Americans to receive healthcare coverage.

Over the next few days, we’ll post a few basic things to keep in mind whilst the gears of our discourse pulverize the topic.

“Healthcare” is a big term like “climate change”, it means a bunch of different things all at once.

And what it means changes with whoever is talking. Primarily, though, “healthcare” is different than “health insurance”; the former is a huge systematic term, the latter is how health care providers get paid. Changes to all of “healthcare” means changes to private health insurance plans (like Blue Cross and HealthPartners), AND changes to subsidized public health insurance plans (like Medicaid and Medicare), AND changes to the health of our overall population, and even changes to the very way our doctor-patient systems work.  Health Insurance is a subset of healtcare that gets payments to providers through a lot of paperwork.

“Single payer healthcare” and a “public plan option” can also mean a lot of different things.

A lot of folks, including the very excellent Robert Reich, would like the U.S. to get to a point where we have a single health insurance plan that covers payments to healthcare providers. There’s a lot of mixed feelings on single payer (because, again, it means different things), but for the time being, having any form of single payer system isn’t realistic because there isn’t enough political will to make that happen.

That’s why President Obama is trying to usher through a public plan option.  To get a good grip on the environment that President Obama is dealin with, read this op-ed by former Bush advisor N. Gregory Mankiw—it’s a text book example of the politics surrounding our current flawed healthcare system.

Here’s a key graph:

A dominant government insurer, however, could potentially keep costs down by squeezing the suppliers of health care. This cost control works not by fostering honest competition but by tbihwarting it.

Actually, the U.S. is broken into different markets, and these markets are today squeezed by near-monopolies of health insurances.  President Obama’s plan, which is more like a solid first step than an extensive overhaul, is trying to create a basic option for health insurance that would try to open up these monopolies by providing an accessible, basic health insurance plan.

The details of the plan are still being hammered out in negotiations with and in Congress, and these changes should include considerations for existing local and national health insurance plans, which we’ll talk about tomorrow.