Posted by
Bill Crawford on Friday, May 15, 2009 1:19:26 PM
This issue is about as complicated as they come, so bear with me, folks. I'll try to keep it as simple as possible. Not because you may not understand it- it's that this subject can easily turn into a three hour C-Span discussion.
Obama Care is coming, and soon. The bipartisan party is holding Democrat only meetings on this every other day, behind closed doors. Talk to Henry Waxman about that one.
Already we are learning that the extra $650 billion from the "stimulus" package for health care is going to have to be augmented by a Senate proposal to tax non-diet soft drinks, juices and snack foods. This is stuff that only the rich consume, because Barrack was clear last year that the middle class would not see their taxes go up, "not one thin dime".
Obama is planning to insure the uninsured by expanding the federal entitlement pools, mostly through Medicare Part B, and then penalizing companies that don't provide the same level of insurance-to coerce them to dump their employees into the same pool. This is old news, and the details are in Tom Daschle's wonderful book, in case anybody is interested.
Then the real joke begins: Obama claims he is going to cut costs in the process. This will not happen, for a whole host of reasons.
Here are some realities that will prevent this from happening:
One: We have made a decision as a society that life is medically precious, and we will use the insured to subsidize a homeless man who gets dumped in the ER and needs $150,000 in services. This would not happen in ANY of the great single payer health care countries around the planet.
Two: If you don't solve the problem of the illegal immigrants among us, or even the millions who are woking here on valid visa's and have no intention of becoming citizens- if you dump them in the pool of newly insured and make us all pay for well care services for them and thier families, there will be hell to pay in both parties.
Three: We must come to terms with the McCain campaign notion that we should eliminate employer based health care and make insurance personal and portable. This will take the third party inflation factor farther out of the mix and will be the last line in controlling costs in any way. It will also force providers to compete more often and with millions of individuals instead of hundreds of companies.
Four: We need to face the fact that Doctors and Nurses are a finite resource and take three to twelve years to train out of High School. If we expand the patient pool immiediately, and the provider pool doesn't follow, how long do you think it will be before government rationing is called for?
Five: We have to face the fact that smokers do not pose the long term costs for the system they are reputed to. Smokers tend to develop problems and die relatively soon afterward. In the meantime, they fork over tons of tax money to fund all sorts of things. Obese people, on the other hand, get symptoms and cost money from childhood and go for decades. The numbers on Diabetes alone would boggle your mind. Here's a hint on that one: passing one of the most regressive taxes you can think of on soda and potato chips is NOT going to get them better.
Six: there will be no cost savngs at all until we engage in tort reform. Extra testing for lawsuit aversion ('Defensive Medicine') is a direct result of litigation-driven malpractice insurance costs. Ob/Gyn insurance routinely runs six figures a year, for gosh sakes. Who do you think pays for that? Do the Doctors starve their kids, or raise their fees?
I don't pretend to have the answers for this. It's a complicated issue. All I am saying is that the present system here is better than many are making it out to be, and if you overhaul it the way Obama is soon going to propose, all hell will break loose.
Fortunately, it will be politically unpalatable, and Maureen Dowd will be singing her laments later this year about it. If she gets a heart attack in the process, I'd like to see if she would rather be treated in Ottowa.
You can guess where my betting money is on that one.