busy
haikujaguar tipped me to an interesting article which proposes alternatives to the kind of universal health care currently debated in Washington.The Whole Foods Alternative to ObamaCare
"The problem with socialism is that eventually you run out of other people's money." —Margaret Thatcher
With a projected $1.8 trillion deficit for 2009, several trillions more in deficits projected over the next decade, and with both Medicare and Social Security entitlement spending about to ratchet up several notches over the next 15 years as Baby Boomers become eligible for both, we are rapidly running out of other people's money. These deficits are simply not sustainable. They are either going to result in unprecedented new taxes and inflation, or they will bankrupt us.
While we clearly need health-care reform, the last thing our country needs is a massive new health-care entitlement that will create hundreds of billions of dollars of new unfunded deficits and move us much closer to a government takeover of our health-care system. Instead, we should be trying to achieve reforms by moving in the opposite direction—toward less government control and more individual empowerment. Here are eight reforms that would greatly lower the cost of health care for everyone:
That opening quote is hilarious, and I should point out that it's equally true of the government budget in general, which is raised from taxes.
Remove the legal obstacles that slow the creation of high-deductible health insurance plans and health savings accounts (HSAs).
This might be advisable, though it should be examined closely first. The main problems with HD plans is that people often buy them because they can't afford (or can't qualify for) anything else, when those plans are not suitable for them; and that people often cannot afford a savings account to cover what the policy won't cover. Before taking steps to expand HD plans, steps should be taken to address those problems. However, HD plans are very useful to people who rarely need medical attention, so should be available for that purpose.
Equalize the tax laws so that employer-provided health insurance and individually owned health insurance have the same tax benefits.
I strongly agree with this.
Repeal all state laws which prevent insurance companies from competing across state lines.
This is probably a good idea, since the current system cuts down competition in ways that favor insurance companies over consumers. However, I'd want to investigate why those laws were created in the first place; if they're intended to stop specific problems, that needs to be addressed.
Repeal government mandates regarding what insurance companies must cover.
I disagree with this. In my experience, companies often make choices for their own benefit at the expense of their customers. I believe that removing these mandates would allow insurance companies more freedom to cheat people of medical care they need.
Enact tort reform to end the ruinous lawsuits that force doctors to pay insurance costs of hundreds of thousands of dollars per year.
I'm ambivalent about this. Ruinous lawsuits are certainly a problem, and certainly contributing to high costs of health care. America's legal system is turning into about as much of a disaster as its health care system. However, it is equally true that medical mistakes injure and kill thousands of people per year; those people deserve recompense for their loss. I'm not sure whether more laws would improve this situation. Other methods might be more effective. Finally, a key reason for medical lawsuits is that some people have no other way to afford care. Removing that pressure would be more effective than new laws.
Make costs transparent so that consumers understand what health-care treatments cost.
I agree very strongly with this. It's difficult or impossible to make good decisions without accurate, complete information. I would add that we also need access to studies that show how effective (or not) various treatments are.
Enact Medicare reform.
This is probably a good idea, although I suspect we might differ on the details.
Finally, revise tax forms to make it easier for individuals to make a voluntary, tax-deductible donation to help the millions of people who have no insurance and aren't covered by Medicare, Medicaid or the State Children's Health Insurance Program.
I strongly agree with this also.
There's a basic activist principle that you should team up based on common ground. Work with whomever agrees with you on a given point to promote that. Then switch partners if needed for the next round. I wish our politicians would do that, because some of these points would gain much wider support than the mass package they're currently trying to shove through. Also, it's easier to work on the hard stuff if you have several easier successes behind you.
In this regard, if there are petitions or other support options for the above points that I agree with, I'd be happy to see those. I don't actually like or trust the government, I just think that things are so terrible that even the government might manage to suck less. If some other solution could be made to work better, I would prefer that.
Many promoters of health-care reform believe that people have an intrinsic ethical right to health care—to equal access to doctors, medicines and hospitals. While all of us empathize with those who are sick, how can we say that all people have more of an intrinsic right to health care than they have to food or shelter?
In fact, I believe that people have a right to food and shelter too. Why? We are guaranteed an inalienable right to life. If that does not include the basic means needed to sustain life (food, water, shelter, clothing, health care) then it is meaningless, because depriving people of those things tends to reduce or remove their life. In ancient times, people had access to territories from which to gather what they needed to survive, which cost nothing but the time and effort to gather them. Modern society no longer allows people to do that, for the most part, so it is obliged to provide an alternative minimum support. Otherwise, people suffer and die, which undermines the health of the society, impairs its function, and causes other societies to criticize it.
Most of the diseases that kill us and account for about 70% of all health-care spending—heart disease, cancer, stroke, diabetes and obesity—are mostly preventable through proper diet, exercise, not smoking, minimal alcohol consumption and other healthy lifestyle choices.
It would certainly be a great idea to work on prevention instead of cure, and to make people healthier. The problem is that we're unhealthy because we've designed a society and infrastructure that makes it easy to do the wrong things and hard to do the right things. People are extremely resistant to many changes that would help. Outlawing tobacco would help; the tobacco companies are rich enough to prevent that, so far. Rezoning unhealthy types of fast food to the edges of town rather than the center would help; the business sector is against that. Banning high-fructose corn syrup as a food additive would be a huge help in reducing both weight and diabetes; the food and farming industries are against that. Reducing cancer risks would be really hard, because we've surrounded ourselves with carcinogens in our foods, homes, and products of all kinds. We could start banning all sorts of known carcinogens, but almost all businesses use them and scream hysterically when even one is threatened -- as witness the recent resistance to banning bisphenols from baby bottles. Ensuring that all urban areas have sidewalks and bike paths would improve fitness; that costs money and people don't want to spend it. Urban design for walkability would have similar benefits; businesses have spent decades fleeing in the opposite direction. It is the responsibility of individuals to live as healthy a lifestyle as they can, but it is the responsibility of society to create circumstances that support this. It is unfair, stupid, and wicked of society to set up unhealthy conditions and then blame individuals when most of them become unhealthy. That's like blaming the animals in a factory farm for getting sick.
We need more than health care reform, really. We need social reform -- and most people simply do not want to do that, and fight against it.
On a related note, I've observed that many people arguing against "socialized medicine" do not ackowledge (or perhaps realize) that we already have multiple versions of it in play. Congress has a lovely health care plan paid for by taxpayers. Elders have Medicare. Military personnel have medical services through the military both during active service and afterwards through the VA. For those people who oppose a health care system that provides for everyone: Are you also against the socialized medicine systems we already have? If so, what would you do to replace them? If not, why is socialized medicine okay for some people but not for everyone?
August 13 2009, 17:05:56 UTC 11 years ago
However, I wanted to vent that I'm so frustrated to be reading healthy people with good insurance* screaming this health care reform bill is forcing socialization down their throats, all the while talking these past few weeks about taking little precious to his first day of (public) school.
* It's only good insurance until you get sick! I know. I worked for 3rd largest health insurance company in U.S.; my coverage under them was great, until I almost died and needed a lot of care. Then it was all red tape and jumping hoops - while I was sick and brain damaged. I've, as of yet, not heard any sick person brag about their great coverage.
Ysabet, you may want to skip this comment due to medical details
August 14 2009, 15:18:51 UTC 11 years ago
My dad had great insurance coverage both while he was working and after he retired. It covered him after he developed diabetes and Parkinson's disease, and it covered his final illness, which included a month in the hospital, a month at a transitional facility, and three weeks in at-home hospice care. As far as I know, his share of the costs for that was $20: the copay for the initial ER visit.
My own insurance, through my employer, covers me, with my chronic depression and mild hypertension. When I went to the ER a couple of years ago because I had a sudden visual issue, it covered all but $50 (my co-pay).
My husband's insurance, through his employer and his union, covers him, with his epilepsy. When we went to an ER out of state because he'd had a sudden and severe allergic reaction to something, it covered all but $100 (his co-pay).
My brother, on the other hand, had insurance through his employer. When he ended up in the ER on Christmas Eve one year because of severe abdominal pain and had his gallbladder removed (he said the surgeon said it was "full of sludge"), he owed the hospital about $70,000, plus the amounts owed to radiologists, anesthesiologists, and surgeons. His insurance company denied coverage on the grounds that he hadn't gotten a second opinion on an elective surgery. He's now unable to get insurance because the jobs available in his field are all long-term temporary positions (12 months, non-renewable) with no benefits, and he makes -- literally -- $10/month too much to qualify for AHCCCS (the Arizona version of Medicaid -- note that it's called the Arizona Health Care Cost Containment System, not something like the Arizona Health Care System).
So, while I have outstanding insurance, I see the problem and I'm in favor of fixing it. My ultimate preference would be something like the UK or Dutch systems; however, I'm willing to try an incremental approach where the government creates a large insurance pool for people who can't otherwise get insurance, provides assistance for people who qualify for private or employer insurance, and enforces some regulations that protect the individual rather than the corporations.
I'm not sure how I feel about current tort law. I'm in favor of protecting doctors and other medical personnel from frivolous lawsuits, or lawsuits based on emotion rather than fact (hypothetical example: baby born with minor and correctable birth defects, parents sue obstetrician). I'm also strongly in favor of allowing people who have been harmed by medical negligence or malpractice to be made whole, insofar as monetary compensation can manage, and of punishing the negligent or malfeasant (non-hypothetical example: patient tells ER triage nurse she's allergic to penicillin and tells ER doctor who sees her she's allergic to penicillin, but is not a sufficiently informed consumer to know that she's probably also allergic to ampicillin and ends up back in the ER with an anaphylactic reaction).
Also, just a few general notes, not directed at you since you didn't bring them up, but this is as good a place as any: I don't mind paying taxes. I dislike some of the uses to which my taxes are put. I would be willing to pay more taxes for government services that I thought were helpful and appropriate. I think the government is allowed to levy an income tax (by Constitutional amendment) and that providing a social safety net is a valid federal action ("promote the general welfare" in the preamble).
It's a nice change...
August 14 2009, 17:38:45 UTC 11 years ago
My daughter turned 18 this May, she lost her coverage a few months later - she's been battling spleen cancer for the past couple of years and now has no health care (her father *could* have extended it, but he's another story). All I could do was advise/help her to apply for AHCCCS; she cannot work like this and the medications alone are eating her meager settlement ($2500) from the car accident that almost killed her and that triggered this cancer (smashed spleen removed, individual cells keep trying to re-make a spleen anywhere they can). She's had ENOUGH trouble, but now she has more.
I would have happily paid extra taxes to keep my daughter, and many others I know struggling, on some kind of health coverage plan. I would happily pay extra taxes to keep strangers on some kind of health coverage. And I'm poor. But I'd do it.