By David Lazarus
San Francisco Chronicle
February 18, 2007
(John Castellani, president of Business Roundtable, an association of chief executive officers of some of the biggest U.S. companies) was noncommittal when I asked what sort of remedy his group favors when it comes to addressing America’s health care woes.
“What we’re putting on the table is that this is something that needs to be addressed immediately,” he said. “We’re also putting on the table that there are no bad ideas here.”
So, I asked, would Business Roundtable, which includes among its members the heads of some of the country’s biggest insurers, get behind a government-run system similar to universal-coverage programs in place in every other industrialized democracy?
“Nothing is out of the question at this point,” Castellani replied. “Everything is under discussion.”
Really?
“All of our members face the same problem,” Castellani said. “Costs are going up dramatically and the quality of care is no better than in countries that pay a lot less. We recognize that we need a solution that works for everyone and we’re committed to finding it.”
While none of the private-sector forces advocating change is prepared yet to back a specific plan, much less acknowledge that a government-run (or single-payer) system presents considerable advantages from a cost-saving perspective, it’s important that they’re not ruling anything out.
Castellani said he’s held talks in recent days with House Speaker Nancy Pelosi and senior White House officials. So far, he said, everyone’s keeping an open mind.
“Within the next three or four months, you’re going to see some specifics about what can be done,” Castellani pledged. “These conversations are going on right now.”
http://www.sfgate.com/cgi-bin/article.cgi?f=/c/a/2007/02/18/BUGQ8O5NDE1.DTL
Comment:
By Don McCanne, MD
In spite of a flurry of new reform proposals, there are really only three basic options: (1) single payer national health insurance, (2) expansion of our public programs and private health plans, and (3) continued gridlock while tweaking the welfare programs.
The first option, single payer, is the solution that would “work for everyone” that the Business Roundtable is “committed to finding.” The second option, expanding the current system, cannot work since it dramatically increases the costs that everyone wants to control, while falling far short on the other goals of reform. The third option, gridlock, is unacceptable since the problems continue to compound.
Castellani says that the insider conversations are already in progress, and we will see specific legislative proposals within the next few months.
What will be proposed? SCHIP is due for reauthorization, and, at the moment, this seems to be the only avenue on which an agreement can be reached. So we’ll have two more years of the third model: gridlock, with minor tweaking.
But the conversations for comprehensive reform are already taking place. They should be studying the differences between the first two options: single payer and multi-payer. Instead, they are looking at several variations of the public and private multi-payer models.
They understand the clear superiority of the single payer model, but they continue to be driven by the belief that it is possible to design a multi-payer model that would please everyone, except the single payer supporters. Whereas the private insurers would never support single payer.
But aren’t the private insurers a major part of the problem? Why should they be a part of the solution?