1,018 pages of … what?

Conor Friedersdorf:

The worst thing about “comprehensive reform” efforts are that they shut the average citizen out of the legislative process by making bills so complicated that it is nearly impossible for the average citizen to properly evaluate whether on balance it is a wise or unwise measure. Who can predict all the effects of a 3,000 page bill spanning all manner of issues? Often times not even the legislature itself. Certainly not the press, which often focuses on bits of the legislation that won’t actually have the most impact, sometimes because legislators themselves are deliberately obscuring what’s actually at stake.

Who’s to say the average citizen wants to read the legislation?  Or the interested citizen for that matter?

The internet, again, changes everything; the coming health care battle

Up to now, the debates/ideas/plans for health care reform have been mostly cordial.  There’s been some give and take, even chatter about compromise and bi-partisan support.

But, and this is a big but, if the debate is fortunate enough to move closer to an actual vote, the battle for support (read: Congressional votes) between the traditional “big guys” (pharma, AMA, insurance companies) and the now internet/community empowered little guys (individuals, activists, smaller special interest groups) will be excitingly interesting on the premise that the internet changes everything.  We’ve all learned that financial resources mean very little on the internet.  The virility of a production is most important.

From Boing Boing contributor Adam:

Online petitions are a dime a dozen these days — it takes something special for the citizens to break through and get the attention of politicians. The folks at the Progressive Change Campaign Committee (founded by Reddit co-inventor Aaron Swartz and former MoveOn.org folks) may have found it. Today, they unveiled http://www.WeWantThePublicOption.com featuring a new TV ad that you can sign — which will then be aired in Washington DC on MSNBC, CNN, and the Daily Show. It contrasts the 76% of Americans who support President Obama’s proposed public health insurance option with the insurance interests who oppose it and have given Democratic senators $80 million. It asks those senators to pick a side. You can sign your name as a member of the 76%, and names will be continually rotated into the actual ad aired on TV. Pretty innovative. Check it out.

Will such efforts be enough to overcome Harry-and-Louise-like campaigns (or the requisite advances thereof)?  Could be an intriguing health care reform side story.

Ahhh, competition?

The Health Care Fed idea was one of the best in the now waste of $10 Daschle book (Amazon tags it a BARGAIN PRICE, go figure; any lawyers want to start a class action filing to get our money back?).

Anyway, aren’t the “Me-too” drugs and devices critical to competition?

What we need is a “health-care Fed”: A panel of independent experts, consumers and ethicists who would make these tough decisions based on scientific evidence about what works, and what doesn’t.

Technologies that are real advances would go on the “A list” and be covered in full. “Me-too” drugs or devices with modest benefit for patients would only get partial coverage. And forget about treatments with unsubstantiated efficacy.

Making them more expensive (to the paying party) than the first movers defeats the purpose of competition.

SimHealthCare (plus some reform links)

Health care reform heated up over the weekend, here’s a rundown of both the Senate and House proposals; Democrats generally seem to be in agreement; Republicans not so much; President Obama’s call for action was met with angry tweets (one, two) from Senator Chuck Grassley’s mercurial Twitter stream.

All of that serious stuff aside, the question is will the new plan work?  And if not, what would?  Using a point from Noah as inspiration, Robin comes up with a really cool idea (especially for those of us who enjoyed the Sim series growing up, or still do…):

Or how about some kind of bifurcated simulation: SimHealthCareSystemAndIndividual. One side’s macro, the other’s micro. You play both, and see how decisions on one side affect the other. I like the sound of that, actually. The trick with any social simulation is that, inevitably, the way you design it says a lot about how you view the world. So the micro/macro sim would play up that tension; the models might even be designed to sort of “fight” each other. SimBourgeoisAndProletariat.

That would be fun.  Also educational: we could find out what iteration of our “health care system” works best *and* improve stakeholders’ orientation of micro decisions on the macro environment.

The promise is on paper, fingers crossed?

Execution! “The last 98%.”

Groups representing hospitals, health-insurance companies, doctors, drug makers, medical-device makers and labor … will promise to help reduce the growth of national health-care spending by 1.5 percentage points in each of the next 10 years. (Wall Street Journal)

Cynicism aside, it’s a good first step.  Certainly a far cry from Harry and Louise (though even their views have changed).  But remember, a reduction in health care cost growth still means health care cost growth.  The left is optimistic, the right is trying to get organized.