Posted on 08/18/2009 11:35:06 AM PDT by bcafrotc
Let us assume all parties agree that we need to reform our health care system despite the fact that 80% of Americans are at least somewhat satisfied with their health care and their health care insurance [according to a recent Washington Post - ABC News poll]. However, reform must not be a slash-and-burn revolution but rather a rational, judicious evolution of an industry which is far too profit oriented and ineffectively regulated. For the vast majority of Americans a true health care “crisis” does not exist.
It’s instructive to examine the statistics concerning the millions of uninsured. According to the 2006 Census, 47 million people were reported without health insurance, of which 9.5 million were not citizens. Parenthetically, I suggest that figure is far too low, because even old statistics estimate 12- 20 million illegal - non-citizens - reside here.
Furthermore, 18 million of the 47 million were between the ages of 18 to 34, most of whom were presumably in good health and not in urgent need of health care coverage – or who chose not to purchase it. Also, 14 million of the 47 million are already eligible for government insurance through Medicaid but have not signed up for whatever the reason.
Now, here is the critical figure to focus on: only 30% of the non-elderly who became uninsured in a given year remained uninsured for more than 12 months – almost 50% regained their health coverage within 4 months. In other words, the 47 million figure is not reflective of reality.
To make health reform a success we must do it right. Though the House, with unconscionable arrogance, tried to rush HR 3200 through to a vote, the current delay has resulted in all parties taking time to examine that bill more thoroughly; the end result will undoubtedly be far better legislation.
Whatever bill eventually appears before the President must not be one containing the single payer provision. The supporters of such a system are people who believe in a free lunch – paid for by someone else - and who are totally oblivious to the abysmal performance of other government sponsored entities (GSEs) such as Fannie Mae, Freddie Mac (both taken over by the taxpayers), Ginnie Mae and the FHA. Medicare, Medicaid and the VA are all examples of poorly run government programs with huge bureaucracies, recurring fraud and abuse and exploding costs, and need I mention Amtrak?
If current trends continue, by 2030 one out of two federal revenue dollars will be spent on Social Security and Medicare – not counting Medicaid. So, if we dare learn from history lest we be doomed to repeat it, a single payer government health care system is out of the question.
The left’s secondary position, just a government “option” for health care insurance would be a Trojan Horse, inevitably leading to a single payer system. Because government pays no taxes, prints money and can cost-shift deficits to future generations it will always be able to offer lower cost policies. In short order, private insurers would leave the health care industry and we the people would be left with a stolid, unresponsive bureaucracy, with the efficiency of the U.S. Post Office and compassion of the IRS. The federal government will then have monopoly over the 17% of the nation’s GDP spent on health care. Even today, with the many faults we attribute to the insurance industry, we have in principal at least, the choice of going to another insurer. Under a single payer system we will not have that option.
The most basic human drive, self-preservation, closely associated with self-interest and embodied in the economic theory of capitalism, if properly harnessed, will achieve positive economic results utterly unobtainable from collective, utopian socialism. However, some argue that over the last decade health insurance industry capitalists have been allowed to do what they do best – maximize profits through consolidation and reduction of competition. This amounts to restraint of trade, or at least tendency to monopoly, which would predictably result in soaring insurance rates, profits and CEO compensations. If that is the case, there are legal remedies readily available for the Federal trade Commission and/or the Department of Justice to implement. The FTC and/or DOJ can proceed to enforce provisions of antitrust legislation such as the Sherman and Clayton Antitrust Acts. It was the Justice department filing of an antitrust lawsuit against AT&T that lead to the breakup of Ma Bell, resulting in a welcome increase of competition in telecommunications, innovation, lower consumer prices and better services.
What has to be done?
Legislation must be passed that will be national in scope and will override state laws. We cannot tolerate the current circus of individual state laws, rules and mandates.
Next, we must pass tort reform – that will take the profit out of the exploitation of sickness and misery - compulsory arbitration may be the answer. This will drastically lower the often unnecessary expenses stemming from the practice of defensive medicine.
Most states require mandatory minimum liability insurance for automobile drivers. Federal legislation should be passed requiring individuals to carry at least a minimum health insurance policy. Private individuals should be granted tax credits, or at the very least tax deductions for the purchase of such insurance. Those who, through means testing, prove they cannot afford such insurance should be offered a voucher for the purchase of same; they would choose the insurance company and coverage they could then best afford. Proof of insurance, tax credits and deductions and vouchers would be easily handled by the existing IRS infrastructure.
Two thirds of Americans are now overweight and one third obese. This, along with other lifestyle choices, accounts for the relatively poor health of the average American compared to most western countries. Much can be achieved in the long term to improve the nation’s health through a cost-effective program geared to prevention of disease. For example, starting in the first grade, part of school curriculum should be focused to encourage healthful living – from eating the proper foods to the physical and psychological benefits of exercise – all leading to longer, healthier and happier life. In the long term this would translate into a healthier population and commensurately reduced medical costs.
People should be given tangible incentives such as reduced rates, if they undertake healthful lifestyle changes resulting in, for example, weight loss, lower blood pressure and lower cholesterol readings.
With regard to “pre-existing conditions” – yes, they should be covered by an insurance company but with some risk-adjusted additional cost to the individual. Else, if healthy, why buy insurance at all? If pre-existing conditions are to be covered without penalty, buy insurance when you get sick. Look at all the money you save! Alas, that is not the business model of any extant insurance program. After all, if one wraps an uninsured motor vehicle around a tree, would one expect an insurance company to pay for one’s “pre-existing condition”? I think not.
Note: Many aspects of insuring with pre-existing conditions are covered by HIPAA, passed in 1996.
Carrying the automobile analogy further, “guaranteed issue” would charge the individual with an exemplary driving record the same insurance rates offered to a poor driver with recent traffic infractions and accidents on his record. That makes no sense at all.
“Community rating,” where all persons in a large geographic area or grouping are issued the same policy at essentially the same cost is another problem that has to be dealt with realistically. For example, the obese chocoholic may consider community rating “fair” but not the health minded, abstemious marathoner; fairness is in the eye of the beholder.
According to the WSJ, New York, New Jersey and Massachusetts have both community rating and guaranteed issue. Health insurance premiums run two to three times higher than the rest of the country.
Insurance must be portable and obtainable across state lines – that would assure enhanced competition on coverage and costs on a nation-wide basis.
Medical forms and record keeping must be standardized and computerized and accessible via encrypted Internet link; privacy has to take second place to speed, safety and efficiency in the diagnosis and monitoring a patient’s condition and the proper prescription of drugs.
Most importantly, a person’s health care coverage must not be dropped because they become ill – however, within federal guidelines to be determined - their rates may risk-adjust upward at policy renewal. Perhaps an individual could protect himself from this eventuality by purchasing insurance rate protection, at a reasonable extra cost.
The institution of an “insurance exchange,” much like what government workers and members of Congress have access to, would encourage competition and allow individuals to tailor their health care coverage to their own needs. In fact any coverage available to government employees should be available to the public.
I totally disagree with the efforts made to place the onus of health insurance on the back of small business – or even big business. In fact I believe health insurance should be decoupled from employment at any level. The employee should be granted commensurately increased pay instead – with full tax credit (or tax deductibility) of insurance he purchases tailored to his needs – but with economies associated with group rates obtainable through the proposed insurance exchanges.
Those who are for all practical purposes so sick as to be “uninsurable” have to be placed into an “assigned risk pool” – and covered by an insurance company pool, perhaps with a government subsidy. The philosophical model for this may be the Public Pension Guarantee Corporation (PBGC).
No person, stricken with a serious illness, should lose his home and/or the preponderance of his net worth to pay for requisite medical care. There is a place for government at time such as this. I suggest that once the individual has spent down a fixed percentage of his net worth, that the government step in to cover the remaining medical expenses.
Clearly, health-insurance reform – as opposed to health-care reform - is indeed in the offing. I believe that the sine qua non for reform is that the best interest of the American people must be government’s first and foremost consideration in determining the shape of this reform - not that of trial lawyers, unions, the open border lobby, Big Pharma, the insurance companies, the party in power, or any other special interests I might have left out. J
Bzzt. Next.
‘Legislation must be passed that will be national in scope and will override state laws. We cannot tolerate the current circus of individual state laws, rules and mandates.’
Wrong! Each State has the right to govern as it pleases.
What would be next? Federal take over of State sales tax?
If you need to understand why is is so wrong just Google up Social Security disability benefits
You will see why the lawyer president and the lawyers in congress want to expand government into health care so badly. Just like you need a lawyer to represent you to get Social Security disability benefits you will need a lawyer to represent you to get anything other than basic health care treatment.
They might believe it is going to be free but that isn't what is being offered. 0bama and other Dems have been pushing the idea that we must get those 47 million uninsured insured. His/their answer has been that they will get a $4,500 tax credit to PAY for their government offered health insurance. So let's dispense with their deceptive rhetoric that gov offered insurance will be free.
They are going to charge for it.
Now let's look at how many uninsured people will become insured under 0bamaCare.
I don't have any figures available so I will leave it to everyone's common sense to answer one question. How many of the people in those three groups pay enough taxes to receive a $4,500 tax credit? Most of them pay no taxes at all under the current tax schedule.
The vast majority of people who are uninsured now will still be uninsured under 0bamaCare. Wasn't getting them insured the main point being sold to us by 0bama?
The biggest problem is the one that they will do ANYTHING to AVOID fixing - the insidious, expanding, and overbearing interference of government into health care. They will do nothing to improve the situation, and everything they can to make it worse.
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