Comments on: FDL Book Salon Welcomes Eric Patashnik, Reforms at Risk: What Happens After Major Policy Changes Are Enacted

By: lambertstrether

lambertstrether — Sun, 26 Jul 2009 03:01:21 +0000

“Yup. Once a government program is created, it provides an easy platform for fresh change.”

Just… Wow.

By: lambertstrether

lambertstrether — Sun, 26 Jul 2009 03:00:05 +0000

Yeah, Jacob Hacker. I’m surprised to hear him mentioned here. Hacker is the “bait” to the “progressive” switch.

Hacker’s public option would cover 130 million Medicare or VA-style.

Public option as embodied in legislation only covers 10 million, according to CBO estimates.

By: lambertstrether

lambertstrether — Sun, 26 Jul 2009 02:57:11 +0000

You mean “robust” like not kicking in until 2013, and then only covering 9 million people until 2019?

Robust like MA, where the mandate forced everybody into the plan so the numbers looked great, and then compliance dropped when people figured out they were being forced to buy junk insurance?

Robust like a program that may not let people join public option, even if they don’t like their current employer-based insurance?

Robust like a program that leaves the real problem, which is health insurance for profit, in place?

Is public option even on topic, here? I thought the book was about major policy change…

Now, single payer: That would be a major policy change. Fortunately, it’s been tested and proven to work elsewhere, so there are precedents to follow and people to ask for help.

By: goldstandard

goldstandard — Sun, 26 Jul 2009 01:20:00 +0000

Congressman John Fleming ( Louisiana physician) has proposed an
amendment that would require congressmen and senators to take the
same healthcare plan they force on us (under proposed legislation
they are curiously exempt). Congressman Fleming is encouraging
people to go on his Website and sign his petition (very simple -just
first, last and email). I have immediately done just that at:
http://fleming.house.gov/ .

By: Phoenix Woman

Phoenix Woman — Sat, 25 Jul 2009 23:18:30 +0000

The problem is that the Chinese, who are the ones financing our debt, are starting to make like they won’t be buying any more of our T-bills. So there’s a limit to what we can do.

By: TheLurkingMod

TheLurkingMod — Sat, 25 Jul 2009 23:03:54 +0000

Jim Moss has a Seminal post, upstairs!
To Them, The Magic Of Low Prices Just Happens

By: bgrothus

bgrothus — Sat, 25 Jul 2009 23:01:04 +0000

Sorry, I got here late, but perhaps we start lowering the age that Medicare is available. People would be able to leave their jobs (retire) and new people could come into the job market. Suggested last night on Moyers.

By: Steven Teles

Steven Teles — Sat, 25 Jul 2009 22:57:27 +0000

I want to thank Eric and all the commenters for participating. And I want to reiterate that this is a genuinely great book. It’s a rare case of a book that has fascinating case studies (seriously the airline deregulation and carbon dioxide trading chapters rock, and are worth the price of the book all by themselves), a powerful theory, and real policy implications. The one final point I would make, perhaps to put a downer on the conversation, is that things that look like real reforms can sometimes come unwound. Winning a big battle is just the beginning of the process, not the end. I think this has serious consequences for organizers and activists. Once the bill passes, don’t just move on to something else. Locking a reform in, or expanding on it, is if anything a HARDER task than passing reform in the first place. To paraphrase something written over the building that Eric works in, the price of serious reform is eternal vigilance.

By: Hugh

Hugh — Sat, 25 Jul 2009 22:56:17 +0000

Evidence based medicine depends a lot on studies which as you point out are often industry funded. Those that don’t often take years to track and analyze results. In the interim new drugs and approaches can come on line making conclusions difficult. There are also a lot of off-label uses for medications that evidence based medicine might have a difficult time following. Almost all the anti-convulsants for example have important off-label uses.

At the same time, I think there needs to be more emphasis on agreeing on best practices standards. These certainly can be evidence based. But they can streamline approaches by reducing medico-legal liability.

By: BevW

BevW — Sat, 25 Jul 2009 22:54:23 +0000

As we come to the end of this very good Book Salon,

Eric, Thank you for stopping by the Lake and spending the afternoon with us discussing your new book and the current reforms.

Steven, Thank you very much for Hosting this Book Salon.

Everyone, if you haven’t bought Eric’s book yet, here is a link.

Thanks all.