Health Care
Well, wade right in.
It is November 2009. The Democrats have enough votes in Congress to pass something they will call “health care reform” and they are now pondering and pandering bills from both houses. The Republicans are howling at the moon, and the real discussion is between Democratic constituencies.
The current bill is 1900 pages long. It appears to be founded on a series of popular concepts which will achieve political success by avoiding choices and thereby maximizing the cost, which only works because Congress proposes not to pay the cost but to borrow it.
The first concept is that health care is synonymous with health insurance. Congress proposes to provide or require first dollar health insurance for all Americans, but that is not “insurance” at all, but a prepaid health plan. Since it is first-dollar coverage with no deductible there is no incentive for any individual other than to maximize the use.
The next concept is that everyone’s coverage and choices will remain the same. The government proposes to cover 30 million presently uninsured without expanding the delivery system or bringing about any systemic reform.
A third concept is that Congress is proposing hundreds of millions of dollars of unspecified savings in future years. End of life care which consumes perhaps 25% of Medicare will not be affected, nor will tort reform be imposed. The “Times” writes that industry and consumer lobbyists outnumber legislators in Washington by something like 5 to 1 and that Congress had actually taken out all cost savings from the bills.
Fourth, it is fundamental to Congress that all the benefits will be paid for by “the other”. Every benefit is without cost to the consumer, and while some income tax imposition on the wealthy will pay for a small percentage of the cost, and the rest will be simply added to the deficit.
We will greatly celebrate “health insurance for all”. It is probably not a bad thing, but I cannot help but wish that it could be coupled with some reform which is an actual improvement or at least that we agreed to pay for it.
It is November 2009. The Democrats have enough votes in Congress to pass something they will call “health care reform” and they are now pondering and pandering bills from both houses. The Republicans are howling at the moon, and the real discussion is between Democratic constituencies.
The current bill is 1900 pages long. It appears to be founded on a series of popular concepts which will achieve political success by avoiding choices and thereby maximizing the cost, which only works because Congress proposes not to pay the cost but to borrow it.
The first concept is that health care is synonymous with health insurance. Congress proposes to provide or require first dollar health insurance for all Americans, but that is not “insurance” at all, but a prepaid health plan. Since it is first-dollar coverage with no deductible there is no incentive for any individual other than to maximize the use.
The next concept is that everyone’s coverage and choices will remain the same. The government proposes to cover 30 million presently uninsured without expanding the delivery system or bringing about any systemic reform.
A third concept is that Congress is proposing hundreds of millions of dollars of unspecified savings in future years. End of life care which consumes perhaps 25% of Medicare will not be affected, nor will tort reform be imposed. The “Times” writes that industry and consumer lobbyists outnumber legislators in Washington by something like 5 to 1 and that Congress had actually taken out all cost savings from the bills.
Fourth, it is fundamental to Congress that all the benefits will be paid for by “the other”. Every benefit is without cost to the consumer, and while some income tax imposition on the wealthy will pay for a small percentage of the cost, and the rest will be simply added to the deficit.
We will greatly celebrate “health insurance for all”. It is probably not a bad thing, but I cannot help but wish that it could be coupled with some reform which is an actual improvement or at least that we agreed to pay for it.
posted by Contraria | 7:24 PM
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