On health care, whose side are Coons and Carper on?

Filed in National by on August 4, 2017

RE Vanella excoriates Coons and Carper for their market-based, for-profit health insurance stances.

I read with great disappointment the op-ed written by Sen. Chris Coons regarding his proposals to repair the U.S. health care system now that the latest round of radical Republican schemes have been foiled. Senator Coons makes it a point to state that both his own opposition to the recent Republican bills “was not rooted in partisanship,” and that partisan discourse “won’t get us anywhere.”

He even throws in the obligatory shout-outs to GOP Senators Marco Rubio and John McCain in case anyone was slow on the pickup. Some form of the word “bipartisan” is used four times.

I’d argue that partisanship simply means actually standing up for a side.

Coons declares that the problem with rising health costs is the “lack of a competitive marketplace.” To address this price issue, the bill he is sponsoring “incentivizes insurance companies” to remain in markets which only have one dominant insurer. Further, the proposed legislation would “encourage other insurers to come into the marketplace and provide more competition.”

I think Senator Coons is taking a side. I challenge readers to decide whether he’s taken theirs.

Every other modern democracy has solved this problem. Any reader of the local newspaper knows this so I won’t waste too much space. Government subsidized single-payer health care plans work. This is a fact.

Read the whole thing.

About the Author ()

Jason330 is a deep cover double agent working for the GOP. Don't tell anybody.

Comments (24)

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  1. SussexAnon says:

    The problem of a “lack of a competitive marketplace.” may exist but right up there with that is ridiculous unaccountable medical costs.

    There is no “competitive marketplace” model for hospitals or other medical delivery systems that have zero cost transparency and can charge whatever the hell they want.

    My Primary Care Doctor charges my insurance company $175 to meet with me for 12 minutes.

    Not to mention the fraud at hospitals. I have a family member that works in health insurance and when a family member got sick he went through the medical bills line by line and told the hospital what was actually going to be paid because they did things that were not required for normal course of care or requested or just plain didn’t happen. How many people are getting robbed in that scheme?

  2. RE Vanella says:

    Will be published is Sunday’s print edition also. Available at newsstands everywhere.

  3. Jason330 says:

    As a country we’ve always been good at pretending that the rest of the world doesn’t exist. You’d hope for better from US senators.

  4. Paul Hayes says:

    If Senators Coons and Carper want to say that they champion Democratic values, then they must be very uncomfortable with the number of Americans who remain uninsured, if that is the battlefield we are discussing. It should be unacceptable to any Democrat that an millions of American can fall through the cracks of the medical finance system. Cutting Medicare, the Republican response, makes the problem worse, adding millions more to the roles of the uninsured. For us, the question is “how uncomfortable are they”? Surely not as uncomfortable as the uninsured.
    An aside, in my opinion, focusing on making the market more marketable is a red herring approach to the problem. Health insurance game player corporations are few because of mergers, but more because despite all the breaks the industry enjoys because of the ACA, it still isn’t enough to make corporate boards willing to take the risk. Going after this group of “out of the box thinkers” (sarcasm intended) is a fool’s errand. That is the response I would offer to Mr. Coons and his staff. Even the plan designed by the AEI isn’t profitable enough. And as for appropriateness, when it comes to healthcare, we might as well write a new law that all churches must be profitable. I don’t know why anyone would do that either, as think medicine should be profitable. Medicine doesn’t add value to anything, but it is well suited to preserve value, which is what medicine does reasonably well.
    Let’s let the good senators know that running extremely fast in place on healthcare is not what we really want from them.

  5. Paula says:

    @REV — great op-ed! And this health economist agrees with you:
    The author works with the World Bank and has helped a number of countries design their national health systems. He points out that we (Americans) pay twice as much as most industrialized countries for inferior health outcomes and ends the article by saying that our health care system represents our biggest vulnerability in terms of homeland security. (Disclaimer — I helped edit the article.)

  6. meatball says:

    I work in medicine. As far as profit goes, I don’t see it as any different than any other industry.

    Why should I not be properly compensated for my knowledge, experience and expertise like any other professional who “sets prices where ever the hell they feel like?”

  7. Dana says:

    Thing is, by supporting “market-based, for-profit health insurance,” Messrs Coons and Carper are supporting the Affordable Care Act! You know, the one passed in 2010, entirely with votes from Democrats.

    Protecting that “market-based, for-profit health insurance” system is what the majority of Democratic primary voters chose to do, when they nominated Hillary Clinton over Bernie Sanders, who was calling for expanding Medicare to cover everybody. Are not those two fine gentlemen adhering to the will of the majority of Democratic voters?

    The biggest problem for Republicans has been that they were unable to produce a “market-based, for-profit health insurance” plan that was different enough from Obaminablecare to keep their promise of “repeal(ing) and replac(ing)” it to both keep their voters happy and not kick a bunch of them off Obumblecare Medicaid.

  8. alby says:

    It was a problem for Republicans because Obamacare was the best way of solving the problem conservatives could devise. Coming up with another one would mean going with the second-best plan.

    Your logic fails, because it assumes this was the only issue on which people made their decisions. We both know that’s not true.

    Besides, the election was months ago. Many Democratic politicians have moved on to discussing various single-payer scenarios, so the post is noting that, as usual, Coons and Carper are behind the curve.

  9. SussexAnon says:

    There is a big difference between proper compensation and $175 for 12 minutes.

    Please don’t act as if the medical profession isn’t padding its numbers.

  10. meatball says:

    That may be what they bill, but it’s not the same as what they are compensated.

    Also, that rate covers the nurses, medical records peeps, the janitors, the electric bill, the lease or mortgage, maintaining and updating electronic records, compliance, etc. What’s a guy that may have 16 years of higher education expenses supposed to do?

    What does an auto dealer charge these days… $80/hr plus parts, environmental fees and such.

  11. SussexAnon says:

    That is what he charges and that is what my insurance actually pays (less my co-pay). I have the paperwork that shows that is what he is paid. And when I didn’t have insurance that is what I had to pay. The office is small. One doctor, one nurse/records person.

    There is a big difference between $80/hr and $175 for 12 minutes. Not even my lawyer could pad up a bill that high. And he has all that higher education and overhead too.

  12. 00elainesmith says:

    @REV, time for another visit to Coons’ and Carper’s Wilmington offices?

  13. Paula says:

    Hi, meatball — fair compensation should be a given with any health reform. What I object to is a company that does not provide health care (i.e., an insurance company) making a profit by betting either for or against the likelihood that I will need medical services. And on the other hand, I am not thrilled with insurance companies strong-arming medical providers on rates in return for including them in their networks. (Some give and take is OK, but today, with only one insurer in a county or region, the insurer has too much leverage over providers, who have to play along or be shut out.) The only entity that profits in our current arrangement is the insurance company, and yes, the government is giving them a bailout. Meanwhile, insurance company CEOs are taking home million-dollar salaries. http://www.fiercehealthcare.com/payer/health-insurance-ceo-pay-tops-out-at-22m-2016
    Plenty of people earn a good living in the non-profit sector. I think that all of the health sector should be non-profit and that health care workers should be well compensated. I don’t think the two are mutually exclusive. I think that the government should be the insurer, and I think that there are beneficial societal incentives in making the government the insurer. It’s not going to happen, so as an alternative, I’d like to see some compensation and shareholder dividend caps on insurance executives and stockholders. Can’t they get by on, say, $1 million a year?

  14. meatball says:

    You must not have a very good lawyer if he is charging less than that, lol. A typical lawyer goes to school for 7 or 8 years. Doctors most often endure a residency beyond that. My example of the mechanic rate was to show how little value we as a society place on our human health and wellness vs our material health.

    Please don’t assume that your visit ends when the physician leaves the room.

    And Paula, couldn’t agree more on insurance companies but don’t assume not for profit hospitals aren’t trying to make a profit to “expand services.”

  15. Dana says:

    Paula wrote:

    Some give and take is OK, but today, with only one insurer in a county or region, the insurer has too much leverage over providers, who have to play along or be shut out.

    Remember: even when there is only one Obaminablecare insurer in a given market, most people don’t get their insurance under that, but through their employers. In a way, it’s like Medicaid, and many doctors refuse to accept Medicaid patients because, in most states, Medicaid compensation is low and slow. (The temporary ‘bump’ in Medicaid compensation expired in 2014.) Physicians do not have to accept patients using the ACA insurance if the insurer tries to negotiate payments which are too low.

  16. I’ll believe that Carper and Coons are on the RIGHT side of the health care debate when they support enabling Medicare to use its purchasing power to lower costs of prescriptions and medical supplies, and when they vote for the reimportation of drugs. Carper is perhaps the main reason why Astra Zeneca pharmaceuticals cost 75% less in France than they do here.

    If you visit their offices, ask them what their position is on that.

  17. Faithful skeptic says:

    This holier-than-thou stuff is getting out of hand.

    Take a break from self-absorption and read this:


  18. alby says:

    @FS: Yes, when “centrists” don’t have a decent rejoinder to the fact that their heroes would sell them for a big enough donation from Wall Street, best to round up all those anti-leftist tropes into one big House of Straw.

    This is real simple: Either you take corporate money, which means you view the left as a bunch of unrealistic people who must be denigrated and placated, or you don’t, in which case you are free to advocate for the public regardless of what Wall Street thinks.

    Every centrist argument still boils down to “but if you don’t vote for us, the right-wing loonies win!” What we’re saying is, “No, if you run a centrist/corporate-backed Democrat, the right-wing loonies already have won.”

    Electing “centrist” Democrats is our version of kicking the can down the road.

    The Tea Party lost a lot of battles, but they won the GOP war.

  19. Jason330 says:

    What Alby said. Also, you know how the GOP came to power? By shitting in their sell outs.

  20. Paula says:

    Correction on insurance company CEO salaries — AETNA CEO got $41 million in 2016. http://www.courant.com/business/connecticut-insurance/hc-aetna-ceo-pay-20170411-story.html
    My next call to Carper and Coons is that they insist that accepting ACA exchange stabilization funds requires insurance companies to cap CEO compensation and stock payouts. For once I think Trump might be right — this is looking like a bailout, especially for the largest companies. Maybe stabilization funds need to be disbersed on a case-by-case basis.

  21. Paula says:

    I don’t know how I missed it, but Jason posted on the topic of insurance exec salaries just last week:
    Reiterating that the page to comment on the requested 33.6% rate increase for individual market plans (on the ACA healthcare exchange) is here: http://insurance.delaware.gov/public-comment/

  22. RE Vanella says:

    Resorting to puns on “Obamacare” is a tell, I think. There’s some fear there. Palpable. Nobody uses shit that weak unless they’re out of their fucking element. Now’s the time to stand up. On all of it.

    Audere est facere. …RV

  23. Paul Hayes says:

    It makes no sense to set up a competative system of medical care. So many standards of care to be met, we all only want a positive outcome for the patient. There is no room for “second place” in medicine. The public would not stand for it. There is no way to create a for-profit business model. It doesn’t work. Start over, yes. Emphatically yes, because the underlying principles of what we have now are the most expensive, unsustainable and unprofitable. When we send our loved ones for medical care, we want to think about profit? NO! We only focus on a positive, the BEST outcome for our loved one. Nothing less will do. So it is for medicine. The psychological rules (economics) that govern medicine are atypical. Profit never even enters our minds. Cost yes, profit no. Start again and see what we can create, if we can suspend ego and politics.

  24. stan merriman says:

    If you take a hard look at the healthcare cost inflation numbers and their history since the 80’s, Senator Coons, with all due respect, you cannot conclude lack of competition is the culprit. The majority of the cost and inflation lays squarely with both hospitals and their removal from state regulation in the 80’s and Big Pharma. With the latter, there is plenty of competition in many of the largest volume meds categories. But no price regulation and no competitive bidding excepting with the VA.
    Hospitals, for profits and non-profits alike began ferocious competition in the 80’s until the late 90’s/2000’s when consolidations began to occur. And with that competition came not lower costs (most hospitals then had minimal to no cost accounting to know costs) but massive acquisitions and overpurchase and underuse of technology unneeded, facilities with concierge services, bidding wars for hot shot physician groups with p.r. built reputations and there you have it….this nightmare we are all experiencing. Cost escalation, fraud and abuse of charity care reporting to keep tax exemption and all the rest. Please, Senator, have your staff do better research. This is an industry, not a profession. It desperately needs regulation and cost controls, which by the way, go unmentioned in Bernie’s plan. Yes, I am solidly for single payer, but it must include a plan for displacement of tens of thousands of insurance employees in those companies and inside the hospitals and medical practices, also missing from Bernie’s plan, however well intended.