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Monday, February 22, 2010

The Only Thing Worse Than The Republicans' Position On Healthcare Is The Democrats' Position On Healthcare.

Attorneys, real estate brokers, salespeople, sometimes even teachers and parents, routinely read books or take courses in the art of negotiation. I took a three day course myself. This is what I learned.

Assume there is a house worth $100,000. Your client wants to buy it for only $50,000. The seller is represented by an attorney or agent, and the seller wants to sell the property for $150,000. It is a given in this scenario that the fair market value of the house is $100,000.

In most cases, when people are asked to play the roles in this hypothetical, the matter is resolved -- the house is sold, transaction concluded -- at around $100,000. In a few cases, the house is sold for less, in a few cases it's sold for more. In a few cases, there is no deal because one side or the other took an extreme position. If one side takes an extreme position, that may cause all discussions to terminate.

What can we learn from this? First, get your facts straight before beginning negotiations. If you believe your position is weak -- let's say you believe the house is only worth $75,000 -- you will likely start with the wrong demand, and will end up selling for less than it's worth.

Two, figure out what the facts are, what is a reasonable position, and don't back off of it. If you are sure $100,000 is a fair number but the other side won't go above $75,000, you're better off walking away and finding another buyer. Why give up $25,000 if you're right in the first place?

Three, when the other side takes unreasonable positions, you might as well end the discussions because there will never be a successful transaction. If you gave them the moon, they would ask for a few stars on top of it.

What does this have to do with Obama and the Democrats and healthcare? If they really wanted to "reform" healthcare, then the first thing they needed to do was to get their facts straight. What needs to be reformed? In healthcare, the problem is that it's too expensive. How can that be changed? Not by talking about everything else in the world.

For example, as these discussions have gone on, and as the public has seen that the Democrats' proposals are sham, will accomplish nothing of value, the Democrats have hung their hat on the pre-existing condition issue. They trot out pathetic stories about sick people who cannot get insurance to tear at our heart strings. But let's remember our facts: the problem with healthcare is that it's too expensive, and the "reform" must reduce the costs.

Pre-existing conditions is a separate subject and only affects a few people. It is entirely separate from the central problem with healthcare, which is that it's too expensive. The Democrats could solve the problem of preexisting conditions by making Medicaid available to any family with pre-existing conditions who cannot get insurance. They would have to buy into it, but problem solved. But that is not the problem with healthcare. The problem with healthcare, the problem that is crushing the great majority of people in this country (as opposed to the very few who have pre-existing conditions) is that healthcare it too expensive. So why do the Democrats always refuse to discuss that? How can they expect to solve a problem when they won't even mention it?

Instead of talking about how they will bring down the costs for the majority, the Democrats cheer themselves by including as the centerpiece of their reform proposal the requirement that insurance companies must give insurance to people with preexisting conditions. The insurance company can charge whatever they want in the Democrats' proposal. They can charge $10,000/month if they want, but they've got to allow people to buy the insurance. Such complete nonsense.

Let's get back to learning the facts. Our central fact is that healthcare is unaffordable for most people. The best way to bring down prices would be to allow a large group of affected people to buy into Medicare on a non-profit basis. Start with anyone over 50, unemployed, or not part of a group policy. That would bring a healthier group into Medicare along with premiums they would pay, which would financially benefit Medicare. Since it would be non-profit, most people could expect at least a 1/3 reduction in what they pay now. This directly addresses the central problem with healthcare: it's too expensive.

Once the insurance companies saw this, and saw that in another year people from 40-50 would be allowed to buy in, the insurance companies would start to compete to keep their customers. Which means bring the prices down. Doctors, drug sellers all would start to compete because they would be paid less under the bulk-rate-discount set by the government in the Medicare program.

What was the central issue? Price. This is a proposal directed at that issue.

What the Democrats have done is failed to propose anything to accomplish the central problem: it's too expensive. Everything in the Democrats' bill is irrelevant. It appears the only reason they want to pass healthcare reform is so they can campaign on the representation that they passed healthcare reform. But nothing they have proposed will solve the central problem: it's too expensive.

Now we hear Obama has come out with his own plan. Terrible timing. And suspicious. As soon as the public pressure was mounting to get the Senate to pass a bill including a public option (whatever that means), Obama takes center stage and says no, his bill is better, and it has no public option. Thanks for nothing, Barack. It seems like the health insurance, drug dealers, doctors, hospital groups must have been very generous in their secret meetings with the Democrats early last year. Because the only thing the Democrats do is propose bills that will make their friends rich, and do nothing to help the public.

The Republicans' healthcare plan: do nothing. Die quickly.

So there you have it. The Democrats failed in the most critical step in any negotiation: know the facts. They have completely ignored the only fact that matters, which is that healthcare is too expensive. Because of that, either their negotiations will fail, or they will come out of it having sold the house (or sold the public) cheap, when we should have gotten full-price.

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