The WSJ describes how smaller firms are having to drop health care coverage as the economy worsens, as an alternative to laying off workers. In another article, economist Greg Mankiw explains how shifting responsibility for health care to the government just moves things around in the aggregate. So what happens to health care consumption in a recession? Apparently it declines. The cake gets smaller and slicing doesn’t change the fact that there’s less cake.
As the Obama administration wrestles with broader questions of health-care overhaul, tough economic times are forcing more businesses to grapple with stressful questions about discontinuing coverage. Health-insurance premiums for single workers rose 74% for small businesses from 2001 to 2008, the latest year data are available, according to nonprofit research group Kaiser Family Foundation.
About 10% of small businesses are considering eliminating coverage over the next year, up from 3% in 2005, according to a recent survey by National Small Business Association.
That follows earlier declines in coverage, with just 38% of small businesses providing health insurance last year compared to 61% in 1993, according to the trade group. In 2007, 41% offered coverage. A Hewitt Associates survey found that 19% of all companies plan to stop providing health-care benefits in the next three to five years.
Havard professor Greg Mankiw, quoting Paul Krugman and a recent CBO study, among other data, says that from the point of view of total economic competitiveness, shows there is no lasting advantage to moving the responsibility from one payer to another. The CBO study said:
The equilibrium level of overall compensation in the economy is determined by the supply of and the demand for labor. Fringe benefits (such as health insurance) are just part of that compensation. Consequently, the costs of fringe benefits are borne by workers largely in the form of lower cash wages than they would receive if no such benefits were provided by their employer.
Which is a way of saying that the money for health care has to come from somewhere. Health care can be paid for from fringe benefits, self-insurance or state benefits in exchange for higher taxes. And these can be shifted around on the same payslip, but there is essentially no free lunch. Yet the debate doesn’t end there; within that inescapable constraint, there remains a dispute over efficiencies and distribution. Proponents of universal, single payer system argue that such a system would be cheaper and better. In other words “health care reform” would allow people to get more value for money.
President Obama made the argument in a recent CSPAN interview that he needs trillions more dollars to keep the United States from running out of money. Essentially he argues that people need to spend a large lump sum to re-architecture to health care system in order to get a cheaper system. Glenn Reynolds called it the “I’ve bankrupted the nation, so now your only hope is to pass my healthcare plan” argument. But does Obama have a point?
OBAMA: Well, we are out of money now. We are operating in deep deficits, not caused by any decisions we’ve made on health care so far. This is a consequence of the crisis that we’ve seen and in fact our failure to make some good decisions on health care over the last several decades …
Along that trajectory, we will see health care cost as an overall share of our federal spending grow and grow and grow and grow until essentially it consumes everything. That’s the wrong option. I think the right option is to say, where are the game changers, the investments that we can make now that are going to
reduce costs, even if they don’t reduce them this year or next year, but 10 years from now or 20 years from now, we are going to see substantially lower costs.
Maybe theoretically, but theory isn’t everything. The abstract argument centers around the question of whether health care will become cheaper or better with “health care reform”. Obama’s plan would create a “National Health Insurance Exchange that would include both private insurance plans and a Medicare-like government run option. Coverage would be guaranteed regardless of health status, and premiums would not vary based on health status either. It would require parents to cover their children, but does not require adults to buy insurance.” The academic debate has points on the side of both those for or against. A single system would probably make basic health care more available, but in a rationed way. More people could use it, but it would be less innovative and probably less capable at the higher levels of care. It would be different from the current system, for good or ill. On that level the choices are hard but amenable to a rational consensus.
Yet sitting like an elephant in the living room is a noneconomic consideration. Though it is has little to do with the architectures of health care systems themselves, one of the unstated objections to “reform” is probably a deep seated reluctance to entrust government or a single entity with any further control over yet another aspect of life. Experience with public institutions and bureaucratic red tape have stamped the image of failure all over the state-provided brand. To advance the provision of medical services under this label is likely to be a tough sell. This is probably why any debate over “health care reform” is likely to go beyond any mere comparison of features based on statistics and economics. It was no accident that CSPAN’s Steve Scully immediately followed up Obama’s exposition on the savings on health care with the question of whether Obama could reform Detroit. “You mentioned the auto industry. What will GM look like a year from now?” The implication was clearly that if you were willing to believe that Obama could rebuild the auto industry, then you would be willing to grant him the benefit of the doubt in health care area. The question of whether the car industry could be rejuvenated was distinct from the proposition of whether Obama could rejuvenate the car industry.
And therein lay the rub. Just as it was theoretically possible that government assistance could help Detroit pull itself out a hole, it is theoretically possible for “health care reform” to be attractive at some level which a rational person might accept. But theoretically and actually are two different things; and the difference between the two often isn’t systems or concepts but implementation and execution. Maybe it isn’t that people disbelieve in the proposition that health care can be reformed. They simply may not believe that government can do it.
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Wretchard:
“. . .a deep seated reluctance to entrust government or a single entity with any further control over yet another aspect of life.”
And
“They simply may not believe that government can do it.”
I think these comments frame the debate on the con side perfectly. And on the pro side, the debate is joined with the thought that there really such a thing as a free lunch.
How to reconcile those two sides of the debate? Well the pros regularly jump at “free goodies” from the government, so there’s no question there. For the cons, the argument must be made abundantly clear that health care is health care, no matter how it is paid for, and making the government the intermediary can only be more efficient if the government can impose some form of rationing that will hold down costs. The question then becomes, what are those limits? Either we limit the amount of care available or we limit the quality of care. Take your pick, then come and tell me government will do it better, but admit at the same time fewer people will be served or the quality will suffer. F
Look back at Germany’s 1930s “healthcare” policies for a reminder of the joys of socialized medicine. Eugenics, forced sterilization, state mandated euthnasia, selective breeding, etc. were all for the good of the nation.
Frankly I don’t want some government official weighing my survival needs versus their budget mandates. No healthcare might be better than government healthcare. At least them we don’t have to get the implanted RFIDs. Or give all our personal medical records to the “authorities” to use in their decision making processes. We all know how “private” our documents become when the spotlight of public attention shines our way.
Whad’ya mean Wretchard there’s no free lunch?
For the Democrats, Universal Heath care would mean endless opportunities for graft and a much greater ability to control the populace. And it’s free- for the Democrats. Those evil Republican taxpayers can be stuck with the bill.
them=then
Government health care will mean one thing: rationing. In a big way. Overweight and need a triple bypass? Well, you should have thought of that when you were stuffing cheeseburgers down your gullet. Get in the back of the line. Smoked and now you have lung cancer? Well, lung cancer isn’t curable anyway, so why bother to try. You brought it on yourself.
We see the outlines of these arguments already, in the demonization of lazy, fat Americans. The groundwork has been laid.
To provide high quality health care to as many people in this nation as possible, we need one thing: a prosperous nation. We need wealth. This is something the Left will never get. They are killing the goose that laid the golden egg.
One of the unstated objections to “reform” is probably a deep seated reluctance to entrust government or a single entity with any further control over yet another aspect of life.
I can’t imagine that doctors, nurses, and others in the health professions are eager for “reform” either. It wouldn’t surprise me if a significant number of these folks change careers or retire early– which would make health care rationing even more stringent.
The Obamacare plan is basically a conversion to the European model. Who will suffer are the taxpayers, the patients, and the doctors. Who will prosper is the bureaucracy.
Obamacare docterine says that the US health care is $2.5 trillion/year with a planned reduction of household cost to $25 thousand from the average of $2.75 thousand. My question and request is to see the breakdown, preferably on a pie chart of that expenditure.
That is a very large number $2.5 T. and without the official government figures I would think that it includes everything: medical research, social security, buildings, medicare workers’ pensions, FDA costs, and who knows what. That startling healthcare cost figure seems to be more of a shoot-the-moon ruse, than a basis of workable anaylsis.
A politician looking at that number sees a great opportunity to sell a plan. A doctor looking at that number see a very sick society.
Darn it, my previous comment got caught by the http moderation trap. Here’s another attempt:
On the subject of Paul Krugman, the following is a nice example of a shrieking moonbat:
http://www.nytimes.com/2009/05/25/opinion/25krugman.html
Krugman starts out correctly by pointing out that California’s economy is in thermal runaway. Unfortunately, he then morphs his argument into a crazed polemic against conservatives.
The Nobel Prize for Economics is administered by the Sveriges Riksbank. It’s not really a “Nobel Prize” like those awarded to Albert Einstein and Max Planck. The actual title is: “The Sveriges Riksbank Prize in Economic Sciences in Memory of Alfred Nobel”. The Sveriges Riksbank played a dirty trick on the United States (and the developed world) when they gave their prize to Krugman.
Some organization needs to come up with an alternative prize that actually awards genuine merit in economics rather than merely pursuing a socialist political agenda. There needs to be an alternative to the Sveriges Riksbank Moonbat Award.
Off topic: Nice article by Ralph Peters:
http://www.nypost.com/seven/05262009/postopinion/opedcolumnists/instant_justice_171002.htm?page=0
Peters is correct. The only Islamic fascists allowed to survive the battle field should be those possessing information of military intelligence value. They should be promptly tried by a military tribunal, interrogated and then immediately disposed of. These monsters should not be the long term wards of the US taxpayer.
Nationalized healthcare = rationing. And those in charge of rationing will squeeze every dollar out of the providers. When you are selling at marginal cost, you have zip left for innovation. So kiss goodbye to the next generation of technology. Kiss goodbye to the brains and skill base to come up with a better drug, a more reliable cheaper more comfortable replacement part. New vaccines or antibiotics? Sorry, Congress couldn’t fit that into the appropriations last year, Senator Slug doesn’t believe it’s needed right now.
Nationalization is also a one-way function. It will make the electorate so beholden to the bureaucracy that they will never ever re-privatize. Bismarck was no fool.
When I graduated from medical school 54 years ago, the only words I ever heard to describe the relationship between me and those I served were ‘doctor’ and ‘patient’. These words have not been replaced entirely, but more and more other words are displacing them: ‘provider’, ‘client’, and worst of all, in my opinion, ‘consumer’.
It seems to me that the relationship between a provider and a consumer is defined by a contract; the relationship between a doctor and a patient is defined by a covenant. There is a difference between a contract and a covenant, even if a subtle one.
The more third parties enter into the relationship between the doctor and the patient, the more the nature of the relationship will shift from covenant to contract. That difference, over a period of time, will affect the kind of persons attracted to the medical profession, from those who prefer a covenant kind of relationship toward those who prefer the contract kind of relationship.
I think that will be a loss for medical care–but maybe I am just tied to the past and resistant to change. Others, perhaps some doctors as well as patients, may prefer the new kind of relationship. But in the interests of informed consent, the more third parties enter in, the more the shift from covenant to contract.
Jim
Like all liberal ideas, the unintended consequences of federalizing Health Care (18% GDP) are enormous and fatal. There is no need to “reform” the best health care system in the world – for about 15 million “uninsured” people. It is a far left orgasmic smokescreen to control life at both ends – abortion; assisted suicide, etc., as well as the middle – what procedures you can/cannot have. What is to come will make the auto/bank takeover seem like a walk in the park.
The timeline will go as follows: First, Obama offers the Government “Option” to employers. He then undercuts all competition by making it very cheap. Second, for the employer holdouts still buying “private sector” insurance he will remove the tax deduction clause; Third, as cost sprials out of control (what costs has government ever controlled) – Obama will be “forced” to limit nurse/doctor/hosptial pay and ration care (old people and neonatals will DIE). This will all happen over the next 3 years!!
The unintended consequences will effect large cities. Hospital systems have consolidated over the last decade, especially in urban areas. As reimbursements are cut, hosptials will be forced to lay off workers by the boatload as well as unload loss-leaders (smaller inner-city hospitals). This will cause the “One” great consternation because this will hurt his “people”. Bailouts will be given, but in the end the Government will buy all the smaller inner city hopstial systems. If you think he can’t do this – think about Chrysler, AIG.
#6–re ‘retiring early’: I can guarantee you this is already happening. Morale amongst doctors is awful, hardly any of them (that I’ve talked to anyway) are encouraging their children to go into medicine, young doctors are weighed down with heavy debt and not doing as well financially as they’d hoped.
Ditto for nurses, who work in short-staff environments minus the aides, orderlies and practical nurses who used to be around to share the work. They have to stay after shift to complete the paperwork which is largely surplus but theoretically will protect the hospital from lawsuit (according to their ‘risk consultant’).
In the private office, staff have to be increased to cope with the insurance and HMOs, arguing over every jot and tiddle of every form, while fees get cut repeatedly–notice how our president proposes to save money buy cutting payments to doctors.
Who wants this? We are crapping in our own nest.
#9–yeah! “Provider” … “consumer”–bah!! There are doctors, nurses, and patients.
Thermodynamics is a real bitch, isn’t it?
I spent 25 years on active duty in the USAF. Absolutely free health care, right? Dedicated facilities right near where I worked, right? But better than 75% of the time I just went out and paid for it myself, whether it was an FAA flight physical, contact lenses and glasses, medication for the common cold or the flu, an ace bandage for a sprained ankle, or what have you. I guess I was lucky to never need very much, but I made my luck, too. Since retiring I ask for even less from government health care.
I have heard friends, career military officers, say that the driver in when they get out was providing health care for their family. And by that they meant that they would have to leave the service in order to get the health care they needed, not the opposite.
And folks, this is in the US Military, the ultimate fraternity, the only Unlimited Liability Contract with the employer. Single Payer will bring all the zest and verve of the US Post Office and the friendly responsive customer service of the Motor Vehicle Bureau to everyday health care. It already has in many ways due to the huge impact of Medicaid and Medicare.
RWE (12): “It already has in many ways due to the huge impact of Medicaid and Medicare.” You got that right. Almost 50% of the healthcare spend is now Federal. What it wants, it gets. And often what it wants is to go witch-hunting for “fraud.” There is no arguing with the OIG. The compliance burdens are huge and will only grow. Because there will always need to be a crisis, a scandal, a scapegoat, to explain away and distract from the mediocrity. Mis-code something? Off to jail, kulak.
There is no system that bean-counters cannot analyze and come to the conclusion that One Big [...] is the optimum, because it will be more efficient.
The savings never materialize. First, the Big [...] is designed around the conditions current when it came to be, and the real irony is that “change” is inevitable — and when change comes, the Big [...] can’t cope with it. Second, the Big [...] is irresistably attractive to people who want power, and the power-seekers inevitably migrate decision-making to higher and higher levels, farther and farther away from the ability to detect change when it occurs.
It doesn’t matter whether the One Big [...] is “the Government” or “a Corporation” or what have you. The Achilles heel isn’t how the One Big [...] is styled, it’s that it’s One Big [...] in the first place.
Regards,
Ric
Well, yeah …. duh.
I sell insurance, so I know – and tell my clients: when you buy insurance to pay for something that you KNOW will happen (like a common cold or mammogram or PSA test) you pay twice – once for the procedure, and again for the insurance company’s bureaucracy. It is always cheaper to self-insure to the extent you can afford, and pay premiums to protect against catastrophe.
If the political class has fought hard in the past for nationalized health care, then just think about how hard the political class will fight in the future….for the right to exempt itself from nationalized health care.
RWE:
“Single Payer will bring all the zest and verve of the US Post Office and the friendly responsive customer service of the Motor Vehicle Bureau to everyday health care.”
Well said. Very well said. Wish I had said that! F
Health Care reform means a lot of women and non-Whites in various oversight/government jobs at good pay.
Therefore, Women and non-Whites will vote for it in a big way. White Men will not.
It’s just like Supreme Court Justice Nominee Sotomayer. She’s on tape saying that as a Latina and Woman, she has better qualification, hard-wired and through experience, than a White Man.
Shrug. That’s what Identity Politics is all about. And that’s what Health Care debates are about … making a lot of jobs for Women and Non-Whites. Just like the DMV.
When, exactly, did you ever see a Straight White Guy in the local Library, DMV, or other government office?
That is the whole point and with a recession and nothing for Straight White Guys, they will push back.
Actually, right here in America it’s possible to see the end-games of both pure-private and pure-government health care, almost like a lab experiment.
For the pure-government example, run down to your local VA Hospital and get an eyeful.
For the pure-private example, go to the one shining example of healthcare that neither the government NOR insurance companies will touch with a ten-foot pole: cosmetic surgery.
When my wife had her eye correction done (technically a “cosmetic” operation), we had service on-par with any high-end hotel. Friendly staff, prompt appointments, attentive follow-ups, clear descriptions of what to expect, and great results.
Why?? Hmmm… something about providers having to compete for MY dollars, not a bureaucrat, be it from the government or from my insurance company.
This is not rocket science. They’re so all-fired excited to experiment and fix the system, why doesn’t anyone ever do an experiment with lassiez-faire medicine. Perfect? No. Orders of magnitude better than what we have now (and what’s coming)? Indeed.
What will the people with enough money pay their own medical bills do? They will become members of the Private Cleveland Clinic Membership program. The Clinic will either be here or in some other country where the govt stays out of private business. The previous comments state what the rest of us will have for health care. Just look at the history of the Va hospitals over the last 40 years and what kind of care the govt gave our vets.
1. The US healthcare system is very expensive, but it is bumpy, idiosyncratic: Sometimes you have to change your doctor when you change your job. Coverage varies a lot by year and location, it produces insecurity.
2. The high cost will be hard to change as the US has embedded a great many social contracts, such as the high salaries of specialists and the high profits of drug companies, into the system.
3. The entire world benefits from the unique US contributions to research and development, especially of new drugs. This is not replaceable.
4. Many democracies provide good coverage at good prices without a bureaucratic mess or oppressive regulation: Norway, Israel, France.
5. The US is more complex than these other countries. In particular the US must avoid having 50 systems for 50 states, plus the Feds.
6. Employers have gotten used to using medical coverage as an incentive. Socialization of medicine will change work incentives for many, especially mothers.
7. Health care is a fraud: we are all going to die anyway.
Oman #13: Yes, no doubt, and at the same time the amount of fraud is massive. You would not believe the things my brother, a pharmacist, tells me. We got rid of so much of Federally funded welfare in the 90’s and many of those same slugs just moved over to Medicaid. And then there are all those legal firm ads on TV for asbestos exposure and drug side effects, more scams.
F #17: Glad you liked it. I must confess that it is not entirely original, but I added my own adjectives. Some years ago I heard someone say that on the radio, but, believe it or not he was advocating, National Health Care, saying that at present we had to realize that the post office and motor vehicle bureau were likely examples of the service we would get, but that we had to fix that. Sure we can fix that, Real Soon Now.
Whiskey#18: Unfortunately, I have to admit that I tend to think the same thing. On more than one occasion I have had to go in search of a place to get an FAA Medical Exam. I invariably ended up talking to various people all over the place, and most of them were either female or black or both and at least one had some difficulty with the English language. And not one could answer my question or seemingly even comprehend it. I came to realize each time that I had talked to a whole bunch of people who were paid with healthcare dollars but in fact were not involved in it in any useful way. In one case I even gave up calling around and went to the actual office (at Reagan National Airport) where I had the last exam to make the appointment (Note: going to a place right next to an airline boarding gate and taking off your clothes ranks high on my list of Weird Experiences).
Richard #20: In Canada the head of the Canadian version of the AMA opened his own privately funded pay-as-you-go, clinic. By the way, that is illegal in Canada. He said “We will see.” I don’t think he went to jail.
In Hawaii they offered free medical insurance for children of parents who didn’t currently have insurance for lack of money to pay for it. They cancelled the program after multitudes more dropped their private insurance they were paying for to opt for the free stuff.
Is that how this system will be set up? Some will have private insurance through employers but for those without that option a free government insurance? Won’t this turn out the same way? Who is going to pay $200 a month or more when they can get it for free? Or do I misunderstand the process? Can someone clear this up for me?
National health care is doomed to become a big flop because of the myriad reasons stated by the insightful BC correspondents. I’ve been living in Mexico for four years now and have enjoyed world class health care at extremely reasonable rates. I pay about $5,800 per year for health insurance with a $1500 deductible for a family of four. Most trips to the doctor cost $20…emergency room $80. My wife and mother have spent a few days in hospital and the care was exceptional and the bill was under $1000. We also have subscribed to the Mexican national health care system(IMSS) as a back-up. $300 per year per family member with full vestment in the system after three years for all procedures and services. When we travel out of Mexico, I simply buy travel health insurance on line from World Nomads for less than $20. My worry is that when the Big 0 gets his way on this trillion dollar health care program many more gringos will head south and health care prices here will skyrocket. The Canadians living down here are ecstatic as they get what the need when they need it not when some government bureaucrat rations it.
As suggested earlier, I’d go for any “reform” that included every member of Congress. No, come to think of it, that wouldn’t work–it’d just end up like the old Soviet Union. Some would be more equal than others. The old Kremlin Clinic was the finest in the land.
To paraphrase today’s WSJ column on South Park’s Gnomes
1. Spend trillions
2. ?
3. Universal and cheaper healthcare!
I just had an interesting experience with Canadian health care. Anecdotal, but a reflection of what socialized health care looks like.
January 14 had an appointment with my GP. I’m over 50, issues with bottom end. He checked what he could, said we should get this looked at. Booked an appointment with a surgeon to do colonoscopy.
Monday May 25 had the test. Good news. Doctor was excellent, nurses capable and efficient. All went very well.
I’m lucky. What I felt was nothing serious. What if I had something serious? That 4 months probably would mean that an early detected cancer with great prognosis into a late detected with all the difficulties and reduced survival rates.
I’m what you could compare to an insured American.
If I was working and living in say, Phoenix or even a mid sized US town, how long would I have waited before the test?
Another thing. In the 90′s the governments listened to Marxist claptrap on how supply creates the problem, and all provinces cut back seriously on the training of doctors and nurses. Last time I had the privilege of needing care, the nurses were working 60-70 hours a week because of the severe shortages. I talked to the nurse yesterday, and she said they don’t or rarely work overtime now, as a result of serious concentration on training nurses. Doctor shortage has been alleviated by closing hospitals and surgery facilities.
The rapidly increasing costs of health care is a problem.
How to fix the system? The danger, not imagined or possibly the danger, but what will happen, is government will ‘solve’ the problem of the uninsured by ruining the system for the insured. They will solve the cost problem by making it more expensive for someone else.
A couple of observations. I had for a short period, dental insurance. We have always paid for necessary dental care out of pocket for our children and ourselves. Interestingly, when insured, suddenly everyone needed expensive and extensive work that we didn’t need 6 months ago.
The socialized system and the market insurance of the US has a bias or incentive that is perverse. My GP gets around $35 for a consultation. Usually to refer to a specialist, or to prescribe treatment for something. The fees are too small for a GP to maintain a practice, pay for college debts, etc. No sane person goes into general practice. That $35 is the end result of on his estimate $250 going into the system, the balance eaten up by collection, overhead, processing, etc. I would be farther ahead to pay the guy $200. But single payer or insurance systems are extraordinarily expensive for small transactions. So get out of them.
This has other detrimental effects. Minor injuries, tests or treatments can be done by a well equipped doctor. But they have to be able to afford to be well equipped, pay a nurse, etc. The system encourages not doing anything, passing them on. Emergency wards, probably the most expensive per foot medical facilities, are full of minor ailments that need care but not a fully equipped facility. But no one can afford to set up such facility, because no one will pay for it.
And it makes no sense for an insurance company to pay for maintenance. Catastrophic illness, chronic illness, whatever, things beyond the means of almost anyone to pay for, needs insurance. But common maintenance items? If we paid for them, a supplier market would exist that would cost what people could afford to pay.
Derek
My GP won’t take any insurance and chooses her patients carefully and bills at a reasonable rate, paid on the day of service. She’s not a very good diagnostician, but she can handle the basics and refers me to specialists as needed (I have cancer). She listens well, keeps excellent notes so we have all the data in one place, and she’s an effective advocate when things get dicey.
Her husband is also a GP and takes insurance and has a high end practice in SF on a concierge system. Last I heard the up front payment just to get on his patient list was $21,000, with an additional $15,000 for your spouse. That doesn’t pay for any treatment. It’s a cover charge. I’m not sure whether his is annual. I know of other physicians in SF who charge $3500 per year. If you don’t need a doctor that year, then you don’t have to pay your insurance deductible, but you’ve already paid the full concierge fee and it’s gone. If you do need a doctor, he’s good, and from what I’ve heard, the level of care is very good. I prefer his wife and her much more economical plan.
We have good insurance but certain blood tests are cheaper purchased through lef dot org than if we have them done and billed to insurance. Go figure.
The current one is obviously not a perfect system, but if, like Derek/28 I’d had to wait for months to see a specialist, I would be dead now. As is, I saw the specialist the next day, the more special specialist the day after that, and was recovering from surgery on a morphine drip early the next Monday morning. A rather hellish but very interesting batch of radiation later, a handful of years of bed rest, and I’m once again a productive member of society. The tumor was two millimeters from the point of no return, so I’m lucky.
I propose two things: The first is, since we can’t stop the feds from sticking their noses in where they do not belong, perhaps we can get them to do something useful;
Buy everybody in the country a traditional insurance policy with 100% coverage and a $75,000 annual deductible. Insurance carriers would bid on the policies by bidding premiums per 100 or premiums per 1000 population. Total cost should be less than what The One is proposing with his latest budget figures. Noticeably less.
With this program in place, there will be a loss limitation on all policies/programs obtained elsewhere. That will make private insurance affordable and premiums steady. Maybe even lifetime rates can come available.
The second thing I would like to see done is for employers to cease and desist from paying health insurance premiums. Instead, employers should give vouchers redeemable for health coverage. When insurers have to ask for your business instead of having it given to them, their prices will become more reasonable. Half of what General Motors is currently paying per employee would probably be among the most expensive offered.
Remember that all insurance is a form of gambling. In health insurance, you bet you get sick. They bet you don’t. You hope they win. By placing the wagers in different places and in different forms, the game becomes affordable.
And since in America, the problem is monetary (how to pay for all this wunnerful stuff), problem solved.
Any comments anyone????
The Republicans have offered a perfectly sensible health care reform plan since 1990. It is market based and would take care of the problem of the uninsured while helping to rein in costs (Basically, it is the McCain Plan). The people who prevented reform are the political left and the Mainstream Media, because they want control of your health care. That is the only reason they have prevented reform — they want control for themselves, not you.
Ever notice how, when a tax increase don’t pass, the bureaucrat’s will cut out “High School Football” or some other item that is poplar with the voters? Or maybe they will cut fire and police — just a little extortion to get the levy passed? Well, soon you can substitute “your family’s health care” for “High School Football.”
You cannot fight something with nothing. The fact that workable health care reform has been held up since 1990, in favor of a Washington power grab by Democrats and their media wing, might be the way to go — and it has the advantage of being true.
HDGreene/31 and Dave/30: I think you guys are on the same page. And I agree: do a two-tier system. (1) Universal insurance for catastrophic illness and injury, with a very high deductible. Those who can’t afford the premium get a voucher. Government does NOT own the insurance plan(s). It would still try to mess with them but they should be forced to compete. (2) Everything else is pay-as-you-go, with market forces setting price. Again, those who can’t afford it would get vouchers. Again, the Government should keep its nose out of how the vouchers are spent. If people waste them on Botox instead of dental care, too bad for them. Actions have consequences.
I think this would be the least-bad solution. You want people incentivized to spend their money, wisely, on stuff that will keep them healthy. Not on using other people’s money to hire an ambulance to go to the ER for a boo-boo.