John Hockenberry: Politics have apparently brought some parts of the healthcare industry under the tent. As the President, as I mentioned, is expected to announce today, he has gathered the age-old enemies in the healthcare debate: drug-makers, hospitals and insurance companies, and gotten them all to agree to play nice as the big healthcare debate begins in Washington. President will make the announcement at about 12:30 today. Todd Zwillich, the Washington correspondent for the Takeaway, joins us from DC. He’s a veteran in covering healthcare debates in the past. This is a twist. Too good to be true Todd?
Todd Zwillich: It might be too good to be true. It could be too good to be true. But the problem is we won’t have any way of really knowing if it’s too good to be true because this is a voluntary effort. There’s really no way to enforce it, except to use the power of the Presidency to make people feel bad if they don’t. This is not under federal rules, this is not under federal law yet, so all of these players like you mentioned, and they’re the big, heavy, lobbying hitters coming here, are trying to get on the winning team. It looks like there’s so much political muscle behind health reform this year, there’s a broad cross-section of everyone in politics who knows the system is a mess and has to be reformed that nakedly trying to kill it just like they did in ’93/’94 under Bill Clinton, and these, by the way, are many of the same groups that killed it last time.
John Hockenberry: Hm. Interesting
Todd Zwillich: Just killing it is probably not an option this time. Better to be on the winning team that seems to be what they’re doing here.
John Hockenberry: Well, two alarming implications. And again, two trillion dollars over the next ten years. That’s according to the reports. We’ll see what President Obama says at 12:30 today, but are they motivated by fear, and if they are or not why didn’t they come up with these cost-savings five years ago? Ten years ago?
Todd Zwillich: That’s a great question. And a lot of what they’re volunteering to do is stuff that has been debated for many, many years, John, they could have done ten years ago. But if they’re going to do it now, that’s great. So there’s a couple of things they’re saying we can do. The insurance companies say we can streamline administrative costs: forms, overhead, administration. The private insurance industry has administration costs that are much, much higher than even Medicare, the federally run healthcare program for elderly and disabled people. Their overhead is about twice as high as what Medicare is. So they say we can cut that, we can cut duplication of forms, a lot of things to make that cheaper. We can promote prevention, primary care wellness, weight loss, all of these things that keep people healthier on the front-end. You were just talking about care on the back-end, at the end of life. Well, most of the money really is in prevention: prevent diabetes, heart disease in the first place, no smoking, less overweight people. That could go a long, long way. Insurance companies say we can save the system billions, hundreds of billions, by doing that. They can do things like, instead of paying for every little test, every little treatment you get in the hospital, pay for the entire episode of care. Somebody comes in with a heart attack, instead of paying for every little medication, every little test, every little treatment, and then the follow-up care, say “We’ll pay you one set amount for this patient’s disease”
John Hockenberry: A flat rate for the visit. You got a heart attack, there’s a price for that.
Todd Zwillich: There’s a heart attack for the whole episode of care that may last six months, and then the hospital and the doctor and the insurance company is motivated to keep you better longer ‘cause they’re not going to get paid for every single little test. So your question was, why didn’t they do this ten years ago? Because nobody forced them. And when they killed healthcare back in ‘93/’94 they bought themselves another thirteen years of the current system that we have. Well, that seems to be coming to an end. I think all these powerful lobbyist and very intelligence people in these industries, you’re talking about pharma, the drug industry, the Association of Health Plans, the insurance industry, the AMA, the American Hospital Association, all the heavy hitters. I think they realize that being just against is not an option.
John Hockenberry: We shall see.
Farai Chideya: Todd, you know, the catch phrase, the political third rail here is the phrase “socialized medicine” and people compare us often to Canada, which does have overall cost savings but some Canadians come here to get treatments they can’t get in Canada, at the same time you had Americans buying drugs from Canada because they couldn’t have their insurance pay for their drugs. It’s been kind of a comparison. What about this whole specter, the political specter, of the term socialized medicine and could that just derail this.
Todd Zwillich: ..Of the public plan. Well, the President has said that he wants quote “a public plan” to be an option under the health reform plan. And what that would mean is some kind of plan that’s sponsored by the government, paid for by the taxpayers, that would be either a backup or one of the choices that individuals or employers or states could use to provide insurance. The White House says the best part of that is that it provides a check and a balance on the insurance industry. That if the insurance industry goes back to its old ways of skimming a lot of profit, providing inefficient care, and denying services there’s a tax payer sponsored public plan that will keep them honest as competition. So that’s why the White House wants it. Nobody’s really defined what a public plan is. We don’t know exactly what it’s going to look like. And some of the speculation about why is the insurance company and the pharmaceutical industry all of a sudden playing nice, you start to wonder, have they bought themselves a promise or a little bit of good-will on what the public plan will look like.
John Hockenberry: Well, it’s expensive good-will in the sense that there’s no real business model for a lot of preventative medicine if they’re going to subsidize that. I guess the administration is really hoping that most of America sounds like Kendell from Morristown, New Jersey, who had this suggestion for healthcare:
Kendell [on-tape]: We have to have a national healthcare system. We have to have Medicare for all. Healthcare should not be a profit-making industry and that’s where most of the money goes. It goes to administration. It goes to so-called managed care. And that’s what’s costing so much.
John Hockenberry: So Todd give us the last word in the last couple of seconds. We’ve got to get to Femi here.
Todd Zwillich: We’re not going to get national healthcare in the sense that he wants, but I do know this, the United States spends twice as much as any other country and we have worse outcomes. So we need to look at where our money is going and what we’re getting for it and that’s what a lot of the debate, hopefully, will be about.
John Hockenberry: And the debate begins at 12:30 when the President speaks to the Nation about this cost-savings plan. Two trillion over ten years, we shall see. Todd Zwillich, Washington Correspondent for the Takeaway,
