White House health summit 11:53 a.m.
  –Some brighter moments a few minutes ago, but same-old same-old from Rep. Paul Ryan of Wisc. To wit: “WashingtonWashingtonWashingtonWashington.”

Ryan is using the GOP talking point, of course: We’re all in favor of health care. We’re all in favor of reducing waste, fraud and abuse. We’re just not in favor of Washington doing it. We don’t want government-run health care.

Obama blew that one out of the water. The key difference between the party in regard to insurance exchanges, as he points out, is that the Democrats are in favor of a “baseline” establishing some standard below which insurance coverage and health care cannot fall.

Rep. Rob Andrews, D-N.J., used the example of a woman who has a C-section. Should the woman’s insurance company be allowed to send her home from the hospital whenever it chooses, as in the GOP ‘health associations’ proposal? Or should there be, as Andrews put it, “minimum federal standards”?



As a voter, I would favor minimum federal standards. Ryan got laughed at, even in the august setting of Blair House, when he touted trusting your state government to do the job. A minimum standardization across the country would give consumers some leverage against gargantuan insurance companies–which operate across the country, but do not have nationwide monitoring under the current system, which leaves regulation of the insurance industry to the states.

Steny Hoyer of Maryland made a related statement calling for an “open, free and transparent market.”

Some of the Repubs are using any suggestion of federal reform in insurance to mischaracterize same as hindering competition.

We already have too little competition among large insurance companies. As Obama pointed out, “It is true, you can always get cheaper insurance”–if you raise your deductible, raise your co-payment, reduce the coverage. What we cannot always get is more effective, better insurance–companies are not compelled to compete to provide more effective coverage.

White House health summit 11:17 a.m.
  —Sen. Tom Coburn of Oklahoma just wrapped up a few minutes ago. Focus: “cost containment.” (This was introduced as “our framing statement” by Mitch McConnell. McConnell devoted his remarks to opinion polls, to make an argument basically that all Dems shd just give up and go home.)

Coburn, saying that one out of three health care dollars does not go to making people well or to keeping people from getting sick, says that cost is the main obstacle to health care. He also claims, somewhat less solidly, that “the government” “directs” “over 60 percent of health care” in the U.S.

Coburn is all for incentives–“creating an incentive to reward” good health practices. Presumably good health is not in itself enough of an incentive; financial gain has to be included. Maybe some grain of truth in that. Laudably, Coburn also recommends that the school lunch program and the food stamp program should incentivize healthful eating. Some details will help, but the basic idea is good.

Then there’s that “tort system” emphasis. Coburn, a physician himself, if predictably not in favor of litigation. He seems to follow the line that medical malpractice premiums are entirely the result of malpractice lawsuits.

Once again: Some evidence would be helpful. Some close analysis. Here is a starting question: In the numerous states which have passed anti-tort legislation, HAVE MALPRACTICE PREMIUMS EVER GONE DOWN?

(Warning:: I already know the answer to this one.)

It might be illuminating to try to compute, with exact dollar figures, how much our insurance companies are spending on lobbying and related political activities, each year, to bring about “tort reform” on the state-by-state level. Then we cd compare those figures to the dollar amounts (actually) forked out by the companies, as the result of successful lawsuits or out-of-court settlements.

Then we cd compare both to the health care costs of rising malpractice premiums.

More later . . .

White House health summit 10:32 a.m.
  –Following President Obama’s opening statement, Mitch McConnell and John Boehner turn to Sen. Lamar Alexander, R-Tenn., to “frame” (McConnell’s word) the Republican opening statement. We’re not off to a good start. Alexander, advertised as introducing the Republicans’ proposals, starts speaking c. 10:23 a.m. He spends at least 90 percent of his time arguing against the Dems, in favor of “putting the current [health care] bill on the shelf”; going to “a clean piece of paper”; “starting over.”

GOP proposals? In “one or two sentences,” as Alexander says, they are–what? Didn’t get or hear #6, myself. Eliminating “junk lawsuits”–i.e. medical malpractice litigation–is predictably #3. Alexander asserts that medical malpractice premiums are being driven up by the lawsuits.

HAS ANYBODY EVER CHECKED THIS?

What, exactly, is the ratio of malpractice litigation costs, for the insurance companies, to malpractice insurance premiums? Do the companies jack up premiums afterward, on any doctor who actually files a claim–the way they do to the rest of us?

Alexander also favors allowing customers to buy insurance across state lines; some unspecified helps to small business, referring to Enzi, previously mentioned by Obama; giving states unspecified incentives; individual health savings accounts; and that unstated #6.

Rep. Betty Sutton: “It comes very late”

  –Another good point, in the ongoing Toyota hearing, this from Rep. Betty Sutton, D-Ohio. When Toyota USA head James Lentz testifies again that the company is now going to include a North American rep on its committee on fixing problems, back in the home company, Rep. Sutton comments mildly that the news is good, but “I have to tell you, it comes very late.”



Once again–it is interesting that Toyota, which as Sutton points out has received much from the U.S., has never felt impelled to have this kind of give-and-take, or this channel for “appeal,” as Lentz refers to it, before.

And once again, the reason would seem to be not that defective throttle openings are somehow less a problem on the North American continent than they would be elsewhere, but that the authorities are not equally able here to address such concerns, or to induce a company to deal with them.

At least the hearing is a step in the right direction. Tomorrow the head of Toyota is up.

Why aren