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10/15/2009
The trouble with health care is paying for it
What have I been saying? I stole the title from a Michael Barone piece yesterday. The article expresses my thoughts – and frustrations – exactly.
… legislators would like to provide generous, even gold-plated health insurance coverage to almost all Americans, but … no one wants to pay for it.
So who is Congress going to get to pay for it? Barone goes through the list.- First, prevention was the answer. “Early screening can reduce the cost of treating a particular patient. But the costs of early screening add up when you test lots of people who will never such need treatment.”
- Then it was a "millionaire's tax." “But freshman Jared Polis, a successful entrepreneur, and 20 other House Democrats came out against that…”
- Then it was all the Baucus bill’s fees and taxes. $829 billion worth. “One is a tax on so-called Cadillac health insurance plans. But unions that have negotiated such plans are opposed and House Democratic leaders are uninterested.”
- And a Baucus penalty tax. “paid by those who don't buy health insurance. But the penalties in his bill are so low that many will choose to pay them and go uninsured, thus foiling the goal of lowering the uninsured percentage.”
- “Then there are the Medicare cuts…”
- And taxes on insurers and medical devices. “The insurers and medical device people are squawking now; look for more squawking from pharmaceutical companies, hospitals and physicians groups when they get targeted [for more taxes than they agreed to]”
Barone sums up the “who’s going to pay problem” by quoting Michael Cannon of the Cato Institute: “Universal coverage is so expensive that Congress can’t get there without taxing Democrats.” (The Cannon piece is an excellent article – Why the Democrats’ Health Care Overhaul May Die) I might also throw in Margaret Thatcher: “…Socialist governments traditionally do make a financial mess. They always run out of other people’s money.” (2/5/76)
I know I’ve written about this a million times, but it’s absolutely the case that none of the five very complex plans currently on the table contain significant incentives for an ounce of cost controls. And without that, these plans will fail and most of us will be much poorer at the end of the year, because we’ll be paying for our own plans and lots of other people’s plans as well.
Again, Barone hits it.
… insurance coverage that further insulates patients from costs, results in unanticipated increases in health care spending.
Period. Period. Period.
Listening to C-Span this morning, callers were talking to a sympathetic Wendall Potter, the insurance company executive turned whistleblower. Each had a different tale of woe to tell. One caller said, as if it were the most acceptable thing in the world…
I dropped my health insurance because I couldn’t afford the co-pays.
So who is supposed to pay for this woman’s health care if she doesn’t even think she needs to afford the co-pays? Yes, the caller could indeed have been a low-income person. And yes, subsidies will be necessary for some. I agree completely. But far too many people in America believe health care should be free. Actually, far too many people in America actually believe health care is almost free. It’s always someone else. Taxpayers pay for rich public employee plans. Employers pay for some rich, some not so rich plans. Car-buyers pay for rich union packages. It’s no wonder many of us think we don’t have to pay for health care in America.
So I ask what I’ve asked in the past – just what percentage of a family’s income (yes, probably different at different income levels) should a family be expected to pay for their own health care? And again I ask, who is supposed to pay for health care for everyone in America that doesn’t think they have to pay for it?
Jo Egelhoff, FoxPolitics.net
COMMENTS
Once again Jo (and Barone) overlooks the obvious: the 31% waste in the private healthcare system:
* High CEO salaries and bonuses and stock options
* High shareholder profits
* Broker commissions
* Marketing costs
* Actuarial costs (cherry picking)
* Denial of care costs (nurse gatekeepers)
* Rescission costs (canceling policies retroactively)
* Political costs (lobbying and campaign contributions)
All of which are in the private system, none of which are in Medicare.
The best American solution -- Medicare-for-all -- changes only how health care is paid, not how it is provided. I see the same doctor today as I did when I was employed. Medicare just eliminates the 31% waste of the insurance bureaucracy.
For the same dollars we are spending today (16.5% of GDP) we could provide first-class Cheney-care to 100% of our population.
Sorry, Jo, I just had to say it. One of these days a friend or family member is going to need care they can't afford, and then maybe we'll get you on board.
Jack Lohman (Thu Oct 15 10:29:03 2009)
Va and tricare seems to work well. Retired USN
mike white (Thu Oct 15 20:57:33 2009)
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