Herzlinger and McCanne on "choice" in candidates' proposals
Who will fix America’s broken health care system?
The Real News Network
May 8, 2008
Prof. Regina E. Herzlinger is the Nancy R. McPherson Professor of Business Administration Chair at the Harvard Business School. She is the author of bestselling books “Who Killed Health Care?” and “Consumer-Driven Health Care: Implications for Providers, Payers, and Policymakers”.
Dr. Don McCanne is a Senior Health Policy Fellow with Physicians for a National Health Program, a widely recognized organization that represents over 15,000 doctors across the US that advocate for a single-payer national health insurance plan.
Transcript
VOICEOVER: Professor Regina Herzlinger of the Harvard School of Business and Dr. Don McCanne of Physicians for a National Health Program each evaluated the health care platforms of all three candidates.
PROF. REGINA HERZLINGER, HARVARD SCHOOL OF BUSINESS: I like all three platforms that the presidential candidates are offering. All three of them offer choice to the American consumer, although Senator McCain has put that much more front and center. Choice is very important. It is very important not to be at the mercy of a single payer, whether that single payer for your health insurance is your employer or your government, because they may not give you what you want.
DR. DON MCCANNE, PHYSICIANS FOR A NATIONAL HEALTH PROGRAM: The three proposals of the presidential candidates all fall short of what we think needs to be done. They all build on the private health insurance model. That’s a highly defective model, which is wasting a tremendous amount of resources and failing to provide the coverage that we need. Private plans compete based on the premium they charge. What we really want is competition between health care providers, physicians and hospitals competing based on quality. And that requires that patients have freedom to choose their doctors. Private plans take away that freedom.
VOICEOVER: Both experts took a look at how close Obama and Clinton’s proposals will get to achieving universal coverage.
MCCANNE: The Clinton model mandates individuals to purchase health insurance, whereas Obama does not. He says that we need to make plans affordable so people can purchase them. Neither approach is going to get everyone insured. Obama’s approach is flawed because the private health plans are not going to be able to have enough benefits if they’re going to have affordable premiums. So people will still go without health care in his model. In Hillary Clinton’s model, the plans will not be affordable. So requiring individuals to purchase a plan they can’t pay for is unrealistic. The flaw of their proposal is that the private health insurance plan has become an obsolete model of financing health care.
The Real News video (3 minutes):
http://www.therealnews.com/web/index.php?thisdataswitch=0&thisid=1457&thisview=item&renewx=2008-05-08+09%3A36%3A45
Same video also accessible at:
http://www.pnhp.org/news/2008/may/video_who_will_fix_.php
Comment:
By Don McCanne, MD
Anyone following the national dialogue on reform is certainly aware of the rhetoric over “choice.” Those supporting reform that builds on private health plans use “choice” to mean choice of health plans. Those supporting a publicly financed and publicly administered national health program use “choice” to mean choice of physicians and hospitals and other health care professionals and institutions.
People do like to have choice. The three remaining presidential candidates understand that and tout the choice that their heath care proposals offer. Of course, that is only the choice of health plans, a choice that usually takes away your freedom to choose your health care professionals. But they never mention this latter point since they would be admitting to a serious flaw in their proposals. Even libertarians should be concerned about loss of freedom to choose your own health care.
One irony here is that Regina Herzlinger, who has been referred to as the Godmother of consumer-driven health care and who is an outspoken opponent of single payer, states that she likes “all three platforms that the presidential candidates are offering.” You would think that the Democratic candidates would support a progressive model of reform. Instead, they are supporting a neoliberal model based on the conservative framing of private market health plans.
When you fully understand Herzlinger’s concepts of reform, you recognize what a disaster they would be for access, equity and affordability. You really must ask yourself why she likes the proposals of Senators Obama and Clinton. When you figure that out, speak up!