Will the real Harry and Louise please stand up
www.harryandlouisereturn.com
August 20, 2008
Scene: In the kitchen, at the breakfast table
Harry: Health care costs are up again. Small companies are being forced to cut their plans.
Louise: Tell me about it. You know, Lisa’s husband just found out he has cancer.
Harry: But he’s covered. Right?
Louise: No. He just joined a start-up, and he can’t afford a plan.
Harry: Too many people are falling through the cracks.
Louise: Whoever the next president is, health care should be at the top of his agenda. Bring everyone to the table, and make it happen.
(This ad campaign is sponsored by the American Cancer Society Cancer Action Network (ACS CAN), the American Hospital Association (AHA), the Catholic Health Association (CHA), Families USA, and the National Federation of Independent Business (NFIB).)
2008 Harry and Louise ad:
http://harryandlouisereturn.com/
1994 Harry and Louise ad:
http://www.youtube.com/watch?v=Dt31nhleeCg&NR=1
Comment:
By Don McCanne, MD
What a refreshing change. In fourteen years, Harry and Louise’s breakfast table conversation has changed from, “If we let the government choose, we lose,” to “Bring everyone to the table and make it happen.” But what does this mean?
At today’s press conference inaugurating this ad campaign, it was clear from the diverse groups involved that the message is that we must all join together to make reform happen. But before the press conference was even over, red flags were raised.
Most disconcerting was the fact that AHIP’s Karen Ignagni was invited to express the support of the private insurance industry in this effort, even though AHIP is not a sponsor of this campaign. During the Q&A, she indicated that AHIP was prepared to support its specific proposal for reform (a model that uses private plans to insure the low-cost healthy, while shifting those with higher-cost needs to taxpayer-funded programs).
When Teddy Davis of ABC News asked about the problem of guaranteed issue without a mandate, Ron Pollack (Families USA) responded, “I don’t think that we’re prepared to answer hypothetical questions.” But really, are crucial fundamental policy issues to be dismissed as mere hypotheticals?
Sadly, this is merely another chapter in the saga of the strange bedfellow coalitions. The policy opinions supported by the participants are mutually incompatible and can only lead to a result that Ron Pollack has described repeatedly: everyone walks away, supporting their second favorite choice - the status quo (even though no one actually supports the status quo). This process is yet another recipe for political inertia.
There are some very fundamental principles which should garner broad support if we are truly serious about reform.
Costs must be contained. Projections that health care will soon consume maybe half of our GDP are totally unrealistic. Essential spending in other sectors of our economy will create a barrier beyond which no further funds would be available for health care. Tragically, the uninsured and under-insured have already crashed into that solid wall, and that includes many middle-income Americans. Cost increases will only move that barrier in front of more and more of us.
There are two fundamental approaches to controlling costs. We can withhold essential health care from people who cannot afford it, an option for the heartless, or we can demand a reduction in wasteful spending such as our profound administrative excesses and our non-beneficial high-tech services. The market has been and always will be incapable of controlling these costs since markets function to sell us more, not fewer, products and services. A monopsony operating in the public interest will be required to bring us greater value and affordability in our health care purchasing, and that can be accomplished only by enacting enabling government policies.
We can no longer accept the suffering and death that occurs amongst us merely because many individuals don’t have the resources to pay for care. Everyone must be included under the umbrella of a comprehensive financing system.
Since average-income individuals can no longer afford their pro rata share of health care financing, a transfer must be enabled through progressive tax policies. Rejection of this fundamental principle would equate with the tacit acceptance for too many of us of financial hardship and bankruptcy as a consequence of ill health.
Louise is right. We need to bring everyone to the table. That includes everyone who needs health care or may need it at some time in the future. That is everyone. Everyone.
Libertarian ideologues and moneygrubbers stand aside. Make room for the people.