First, I am concerned because of the reason why this reform is supposedly needed. The reason why many people believe we need this reform is the fact that we have 45-50 million uninsured people in America. I do not believe this is a good reason because:
- 12-18 million of the uninsured are illegal immigrants.
- 14 million of uninsured are eligible for government insurance programs but fail to sign up, including 70% of children.
- 17.6 million of the uninsured earned over $50,000/year, with 10 million earning over $75,000, presumably able to afford insurance, unless they are self-employed, or employer doesn’t offer insurance, and have a pre-existing medical condition.
- The 45-50 million number of uninsured includes people temporarily w/o insurance in midst of job transition.
According to the non-partisan Congressional Budget Office, the number of working poor w/o insurance for the entire year of 2008 was 8.6 million.
Second, I am concerned by the cost. The 10 year cost of the government proposals range from $1.1-$2.5 Trillion. If we use the 8.6 million number of uninsured from above, we will spend between $12,000 and $29,000 per year for each of the 8.6 million working uninsured. If we were a nation with a government afloat in cash, this might be worth it. However, with 3 months left in our fiscal year, we just hit an annual deficit of over $1,000,000,000,000 (that’s one-trillion dollars) for the first time ever.
The third thing that concerns me is what has happened when other nations have implemented single-payer health care systems, which is what this will turn into because for many employers the government fine will be cheaper than private insurance. Top industrial countries that have single payer healthcare include Australia, United Kingdom and Canada, and they all have lower survival rates for such diseases as cancer and heart disease and longer waiting lists for “elective” surgeries like hip and knee replacement.
Fourth, I believe this could have a crippling effect on the economy. First, much of the health insurance industry will become unemployed. Second, the proposed taxes on the wealthy to pay for this shrink the economy. Third the taxes proposed won’t be enough and will have to be raised, or expanded to lower income brackets, which will further hurt economy. It will become a vicious cycle that we will not be able to get out of and will lead to GDP growth rate of 1% or less and permanent unemployment rate of 15-20%.
And finally, when government is paying the bills they will get to dictate behavior. Employers are already doing this by providing incentives for quitting smoking and losing weight, or not hiring smokers & obese people at all. However, if I don’t like what my employer is doing, I can get a new job. When the government is doing it I won’t be able to get a new government. The UK has already started denying care to smokers.
I agree we need to find ways to reduce healthcare costs, but a government take-over of the healthcare system is not the answer. Here is my solution.
First, we need tort reform to reduce healthcare costs by reducing amount of liability insurance doctors need to carry. When a doctor screws up badly, I believe damages are due to victim. But, these damages should be limited to cost of care related to doctor error, loss of future earning and a small amount for pain, suffering and inconvenience. Tort reform could also reduce medical cost through fewer unnecessary tests ordered because doctors need to cover their own butts incase of a lawsuit.
Second, I think we need to encourage consumers to be better shoppers by requiring hospitals, doctors and clinics to publish price lists so the consumer can do competitive shopping.
Third, require all citizens to carry health insurance. If an individual does not have insurance privately or through an employer they will be required to enroll in a government subsidized HMO ran by private insurance companies. The government subsidized HMO will be similar to all other HMO’s in terms of deductibles, coverage and co-pays. This will be paid for pay an employee payroll tax on those enrolled in program. The tax would be between 10-20% of their income. This would be similar to what average employees pay in employer provided plans. Also, upon your death the total amount paid on your behalf will be deducted from total payments you made into the system and if that amount is negative the difference will be subtracted from your estate.
Also, I would allow any individual who qualifies for Medicaid because of disability to maintain their Medicaid coverage regardless of income level with condition that once employed with earnings over poverty level they must either use employer provided insurance as primary insurer and Medicaid as secondary, or similar program of 10-20% payroll tax and net cost deducted from estate. This could reduce both Medicaid and Social Security tax payouts and increase FICA controbutions.
Things to ponder:
Before we have the government pay for, or provide, healthcare to the majority of American citizens lets fix the systems it already runs: Medicare, Medicaid and the VA.
If we need to do this because healthcare is a right, then how can we ration healthcare. Which President Obama admitted in his town hall meeting is how the government will save money administering healthcare. Isn’t that contradictory?
You may have a right healthcare, but with rights comes responsibilities and your responsibility is to pay for your health care.
Resources used above include:
Key Issues in Analyzing Major Health Insurance Proposals, by the Congressional Budget Office
And My Brain
Cross-posted and comments welcome at America’s Small City Mayor.