Here's What Some Experts Had to Say about Health Care Reform

This was originaly published in the UMass Lowell Student Newspaper The Connector on April 27, 2010.




Professors Offer Opinions about Health Reform

The debate about health reform, which has gripped this nation for the last year, has been filled with issues that probably seem perplexing to many. Even after the passage of the final bill several weeks ago, there still appears to be a lack of understanding about what the bill actually means for many across the country.

After talking to three professors from the community health and sustainability department along with Monica Galizzi of the economics department, it is clear that the university’s faculty can cast some light on this complex topic.

These professors have been spending their entire careers looking into issues that politicians in Washington, and pundits across the country, have been heatedly debating for months.

Particulary there seemed to be a general agreement between all four professors that while the reform is historic, it does not go far enough to address some of the most fundamental issues within the present system.

For example, A. James Lee, an economist who has held various positions within the government, private and non-profit sectors analyzing health care’s cost effectiveness, offered an observation of how money is spent on health insurance when he said, “As much as thirty percent or more of health care services being provided today are either unnecessary or possibly dangerous…with the current financial relationship providers get paid more for doing more.”

His assessment is related to a growing, but rarely discussed, consensus amongst health economists that the current methods of reimbursement for health services are unsustainable.

Prof. Craig Slatin, whose primary area of research is public, environmental and occupational health policy, sees this issue and other financial inefficiencies within the system as a result of the negative influence of those who profit from it. Discussing the insurance, pharmaceutical, hospital and high-tech medical equipment industries, he said “the system’s designed to support the financial needs of those sectors… what the bill barely did was to remove their clout.”

Despite this criticism, he did see the bill as a step in the right direction. “It’s a major shift in how we’re thinking about health care. It says that running a system that neglects 50 million people outright… that’s unacceptable,” said Prof. Slatin.

Prof. Slatin sees a single-payer system, like in most other western countries, as the only solution that will begin to effectively address this issue of the uninsured along with cost control issues. This type of system features everyone in country being provided with health insurance paid for by the government through tax revenues.

He noted that single-payer would do the most to reverse what he sees as the most fundamental problem with the current system; namely too much focus on individual choices and not enough focus on environmental and financial issues, which have been shown to have a statistically high effect on one’s health.

However as Prof. Carlos Eduardo Siqueira, who is also an advocate for a single-payer system, explains this solution was “off the table” from the beginning of the debate about health reform.

He added that even a public option, a non-profit government run insurance alternative, did not make its way to the final bill, despite wide public support.

Prof. Siqueria suggested that a public option may have been an effective method of cost control. Prof. Lee was slightly more skeptical casting it as a “red herring” in the debate unlikely to have much of an effect.

Additionally, while discussing about a portion of the bill which mandates everyone in the country be insured, Siqueira said “We should provide [health insurance] as a right to people; I would prefer that you had rights instead of mandates.”

Prof. Siqueira, who was a practicing physician in Brazil for years, was hesitant to compare the two country’s health systems due to the enormous gaps in wealth between them. He did say that Brazil, which has a single-payer system, does a very good job insuring its citizens despite rampant poverty.

Nevertheless there have been numerous arguments made that single-payer or any more government involvement in health care would bankrupt the nation.

Prof. Monica Galizzi, an economist who specializes in labor economics, has some doubts about a congressional budget office study which determined that the bill would reduce the federal deficit over the next decade.

However she noted that when deciding how to allot money for health care, the question of how much value a society puts on health must be dealt confronted. She added that personally she viewed health care as “a basic need.”

Yet Galizzi who comes from Italy, another single-payer country, understood that there was not wide acceptance of the notion that health care is a basic need in the United States.

While thinking that single-payer is an effective method of insuring a country, she doubted whether implementing a similar system would be possible in the United States. She views this as a result of “[ideological] resistance about government intervention as well as a traditional reliance on the free market. It would be something very difficult to sell here.”

Offering a slightly different opinion about the reason that the fight for health care for all Americans, an almost century old fight, has not succeeded Prof. Siqueria suggested it was due to the power and influence of private insurance companies, “They are becoming oligopolies… They are not allowing the country to have options that many other developed countries have.”

Some Thoughts About the Tea Party Movement

In a video I just watched on YouTube taped during a talk Noam Chomsky gave in October (Part 1 & Part 2), he briefly discusses the Tea Party Movement and offers a unique perspective regarding it. (Also, read here for another unique perspective.)

Too often the Tea Party movement has been treated with derision by the elite liberal community (most notably their frequent labeling as "tea baggers"), but this strikes me as counter productive and often elitist. This is likely because the movement has mostly come out in opposition to policies supported by the Democracts, something that was most clearly evident during this summer's town hall meetings. Frequently liberal commentators simply wrote these individuals off as results of 'astroturfing,' meaning that they were payed by some special-interest to protest. Although there was some truth to this argument, the fact remains that these are real people with, as Chomsky say, "legitimate grievances."


These are people who see the massive bailout of the financial industry, the power of lobbyist in Washington and the lack of choice presented by the two-party system and are angered and frightened. But unlike most with similar views they have chosen not to be cynical, but instead have decided to speak up using their inalienable right as citizens. Unfortunately most organization of these people has been precipitated by right-wing groups, who I feel have twisted this massive mobilization of people in order to support position which run contrary to most of these people's self-interest. I don't mean that the protesters are stupid, but I do believe that they haven't been presented with any viable alternatives to those presented by the right.


This lead to Chomsky's most important question, "Why isn't the left organizing these people?" It seems that most of the individuals at these protests are working-class individuals who resent the unholy relationship between government and corporate interests. Oddly, during the health care debate the protests at town hall meetings (not the same thing as the Tea Party protests, but having a similar sentiment) suggested that the status-quo was working. This is understandable. The Democrats, who were the main outlet for the venom of the protesters, only proposed minor adjustments to the system; some of which serve to strengthen the corporate bureaucracy that controls the system.


One can only imagine if the Democrats has proposed true reform in the form of some sort of single-payer system, or Medicare-For-All (as Sen. Bernie Sanders heroically defends here). Certainly the attack could not be any worse than those used over the summer (i.e. death-panels) and at least real fundamental change would be occurring. The Democrats would have more arguments on their side (universal coverage, ending bureaucracy, lower costs), but instead the Democrats proposed a tepid bill; the senate version even lacking a public option which polls continuously showed was supported by the majority of the country.


Maybe it is fanciful to think that the Tea Party protesters would come over to the the other side if these proposals were made, but it certainly could have activated a progressive groundswell in support of reform rather than the opposition most progressives have engaged in. Regardless, it is time for the elites to stop degrading the Tea Party movement and progressives to start organizing in a similar fashion.