Wednesday, September 9, 2009

In my dreams

Here's what I'd like to hear from our president tonight.

My fellow Americans, we are in the beginning stages of a strangling economic crisis driven by the rising costs of health insurance. As has been noted by the GOP, small businesses are the job creators and economic powerhouse driven by American ingenuity and our penchant for risk taking.  But the cost of health insurance is making it harder for enterprising people to justify leaving the security of a large corporation to branch out on their own or join a start-up venture.  The high costs of health insurance and its linkage to corporate employment will, in the long run, strangle our economic growth by reducing the mobility of our workforce and entrepreneurs.  Americans have always risen to a challenge, but we are better at answering acute challenges, such as the collapse of Collateralized Debt Obligations developed by unregulated bankers, than we are at addressing the creeping, yet serious distortion of our economy that is driven by health insurance costs.

We cannot afford to wait until the problem is acute.  We must take action to make sure that our entrepreneurs start businesses and our workers change  jobs to use their talents efficiently in the world marketplace.  We cannot afford the stagnation that comes with people working where they are not their most productive.  We need to address this now, not later.  The longer we wait, the more entrenched will become the attitude that health benefits are more important than the job itself.

It is unfortunate that the debate has devolved into shouting matches over death panels, death books and nationalization.  I take responsibility for having set the process off on the wrong foot - from the very start we should have been clearly talking about health "insurance" reform, rather than health "care" reform.  We don't need the government or  insurance companies getting between patients and doctors. We aren't talking about changing the health care that American's receive, nationalizing it, or subsidizing it for all Americans.  What we are talking about is changing how health insurance is paid for and who profits from it and how to make sure everyone has access. What we need is a level playing field and true competition in the insurance market.

At the moment, the market is dominated by a few large players who have little or no incentive to compete with each other in providing real health insurance.  Most of their efforts are spent in finding new and better ways to deny benefits.  We know that we cannot regulate efficiency.  The government cannot force insurance companies to be more efficient or reduce costs.  We know that the best way to develop market efficiency is by competition.  Only when corporations are threatened by real competition will they invest in and develop new ideas that will bring efficiency and cost reductions to the marketplace. The beauty of competition is that it releases creative energies that sit lethargic when money can be made by operating the same old system in the same old way.  We believe that for-profit health insurance corporations are presently so inefficient that a government-run health insurance program will be able to undercut their price structure.  This will make the insurance companies get competitive or get out of the business.  We know these companies can be more efficient than a government-run program, but only if the are forced to compete.

Make no mistake - if we do not have a public health insurance option, we will not have real competition and we will not see any significant reduction in health insurance rates.  If we are going to keep entrepreneurial start-up businesses going and workers moving to productive new companies, then we must have real health insurance reform.

To remove the appearance of conflicts of interest, I call on all Senators and Members of Congress to sign a pledge to not take any money from health insurance companies for the next two election cycles. Now let's get down to work.

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