Benny's World

Thursday, September 18, 2008

Updated: Elizabeth Edwards and the Three Headed Dragon

I did a search today on to get information about the testimony Elizabeth Edwards was presenting to the House Committee on Energy and Commerce. One would think that is newsworthy.

Instead, this is what you see first:

It's more about Elizabeth Edwards "trust" in her marriage than about expansion of health care. She says "I don't want to feed the monster." Well, I guess there is a three-headed dragon here. Her cancer, health insurance companies, and the dirty laundry (the media). Finally two down from the list I just posted, there is a headline from the News & Observer that she is testifying at Capitol Hill.

Because I'm more interested in what she had to say about this important issue (something neither campaign is talking about much these days since the Financial crisis is overshadowing everything), I'm posting parts of her six page testimony. They are succinct and very much Elizabeth's voice:

We are in the middle of a great debate on health care in the United States. We see it in the major debates led by Massachusetts and California. We see it discussed in more than a dozen states from Maine to New Mexico. We see the health reform debate in the many bipartisan and strange bedfellow efforts that have developed. We see the debate in the reform collations that have formed, such as HCAN and Better Health Care Together. And lest we forget, the debate is happening at every kitchen table in the country, since health costs are part of our economic meltdown. Of course, some on this committee have been a part of the fight for better health care for a long time, and I’d like to thank Mr. Dingell in particular for his leadership.

But for the first time in 15 years, there promises to be a major health care debate here in Congress. Both the Republican and Democratic nominees for president have engaged in a serious health care discussion. Everyone here knows the twin problems of our broken status quo:

* 45 million uninsured. Health insurance is how we access care in the United States today. It is virtually the first question you are asked when you call a physician’s office or go to the hospital.

* Skyrocketing costs. The cost of our health care system is astronomical and constantly growing. Total health care spending in the United States doubled between 1996 and 2006, and without reform it is expected to double again in the coming decade.

Given the limited time and the impressiveness of the panel, I want to use my time to talk about the importance of health reform to:

* Address health care for all and cost-containment simultaneously. Effective cost containment requires that everyone have coverage, and covering all requires that coverage must be affordable.

* Strengthen the role of the group market. Grouping health risk in the marketplace through employer-based benefits is one of the few things we do well in the U.S. health system. Use of the individual market will undeniably weaken care delivery as more Americans become subject to pre-existing exclusions, higher cost sharing, and absent benefits.

* Use care in exploring tax credits. Reforming the tax treatment of health insurance may be an important part of health reform. However, done poorly, it could actually diminish Americans’ access to coverage. For a health insurance tax credit to work properly to expand coverage, it must make meaningful insurance coverage affordable, reflecting both family size and the rate of medical inflation. And it must not threaten employer-sponsored health insurance, which most Americans have and want to keep.

She gets to the heart of the matter here:

Much of the disagreement between the role of the individual market and the group market rests on the belief of free-market economists that buying health care is akin to buying any consumer good, like a car. Of course, individuals have a role to pay in the health care system, and we need greater transparency in pricing, quality-of-care data, and comparative effectiveness information to help them play that greater role. But the reality is that deciding between the costs and benefits of various cancer treatments like chemotherapy, radiation, and surgery will simply never be the
same as choosing between purchasing a Dodge, Pontiac, and Lincoln.

We have extreme market failures in health care that require government intervention, including:

• Incentives for insurance companies to cherry-pick (or later drop those from coverage who are sick). Private insurance companies will always try to limit their losses by avoiding giving care to those who need it.

• The moral hazard faced by individuals who may choose to not get coverage for themselves or their children. Because of the cost of insurance, some individuals and their families will gamble that they can avoid getting sick to avoid paying premiums.

• Fee-for-service incentives for providers instead of incentives that reward prevention and wellness. We continue to fail to put sufficient emphasis on chronic care and disease management in our health care system.

In short, it is a dangerous mistake to overstate the role that consumerism can play in health care that will cost lives if we get it wrong.

Here's a link to the rest of the testimony.

Tomorrow, I will provide a link to the archived web cast from the House site. I can guarantee she wore lipstick when she testified. But I'll take a pit bull on the issues any day of the week over an underqualified hockey mom who's more of a shiny object for the McPalin McCain-Palin ticket.

Update: as promised, here is the entirety of the hearing online. Elizabeth's portion starts around 1:03.

Otherwise, if you want to see a part of it, here's a link to the ABC News, which has about 3/8 of her testimony.

In both instances, she rips McCain's health care plans and calls him out on them.

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