Well, looks like the good ole' John McInsane Health Care Plan that I so justly derided back in October 2008 is back, as the brand-spankin' new GOP Health Plan. As is usual for GOP proposals, it is a huge honkin' tax increase for the middle class disguised as a "tax cut" -- it eliminates the tax deduction for employer-provided health insurance, and replaces it with a laughably inadequate tax credit that provides less than *HALF* of the cost of the average family health insurance policy. It also adds some cool pork for Republican donors, such as privatizing Medicaid (more profit for insurance companies! Yum!), auto-enrollment in insurance at the emergency room (yay, more customers for the insurance companies!), limit malpractice lawsuits against bad doctors... and all while doing nothing, nada, zip, zilcho, for the problem of out-of-control health care costs in America.
The United States is spending 17% of its GDP on health care. France is spending 12% of its GDP on health care, or 30% less than the United States. Yet France surpasses the U.S. on *all* measures of health care -- outcomes measures (life span, cancer survival rates, etc.), waiting periods for treatment, number of doctors per thousand population, number of hospital beds per thousand population, access to advanced medical treatments (only 66% of Americans have *any* access to advanced medical treatments -- the other 33% of Americans have no insurance or are too underinsured to have access to advanced medical treatments), access to advanced medical technology... and they do that all for less money than the U.S., because they have a guaranteed universal single-payer health insurance system rather than the costly and inefficient bunch of money grubbing leeches that is the U.S. privatized health insurance system. Now, the big problem here is that this is unsustainable. We can't spend 20% of our GDP on health care and expect to maintain a viable economy, and at current rate of growth of health care spending, we'll be at 20% by the end of this decade.
Yet the Republicans have nothing -- nada, zilch, zero -- to offer regarding fixing this problem. Indeed, by pushing yet more people into the costly and inefficient individual health insurance market instead of the far more efficient group health insurance market, they'll make health care costs go up even *more* -- and almost all of the increased costs will be profits pocketed by health insurers. Meanwhile, the most cost-effective solution for funding, single payer ("Medicare For All"), *still* isn't on the table... gotta make sure the blood-sucking leeches in the private insurance industry get to make more profit from the illnesses of Americans, sigh. And President Obama seems just peachy-keen comfortable with that. Best Republican president of the past thirty years? We'll have to see, hmm?
-- Badtux the Health Care Penguin
Nice Post BT - My own opinion is that a frontal assault with single-payer is doomed to failure. We can get there in stages and I hoope this is the overall strategy. IF we finish up with an oprion between signing up for single-payer - which costs less and gives everyting that BCBS does, then the exodus will settle the issue. What we can't do is guarantee that the insurance industry will always get a cut of all the comprehensive health care.
ReplyDeleteRight. It's doomed to failure because the majority of the American people want it, but our Congress -- the best politicians that money can buy err rent -- doesn't want it. But hey, we vote for the assholes anyhow, whazzup with that?!
ReplyDelete- Badtux the "Better crooks please!" Penguin
The U.S. spends more on health care because our tax system incentivizes people to rely soley on their employers for managed healthcare. In our managed healthcare system there is always a middle man between you and the health service such that you don't experience the market feedback mechanism of price. In France, they also don't have this feedback, which is why, out of all European countries, they spend the most. They too are trying to deal with rising healthcare costs. In France they control things with a mixture of wage controls, education subsidies, and some rationing. You do have to pay extra to get the best service in France.
ReplyDeleteSo at this moment in time, France is lucky to have a lot of winds blowing in their favor. But the situation will not be sustainable for them any more than it will be for us. So why trade one unsustainable situation for another? And why reneg on the principles of the Constitution in the process? I don't care if the Constitution was written by outdated guys who lived in an agrarian society. The principles of the Constitution, if you'll care to study it, transcend the type of economy you're in.
The question should be, how can we solve the U.S. healthcare issue while holding true to principles of the Constitution. Tens of thousands of lives have been sacrificed to protect our Constitution, we should at least amend it if we think it is outdated, not flout it at every turn. And no, the "promote the general welfare" clause is not an excuse to blow away the other 99% of the Constitution.
You should be asking, can I solve healthcare while remaining true to American ideals, not how can we copy France the best. As the Constitution was beacon of hope to the world, so should we again be that beacon in solving modern issues.
The Republican plan at least removes the most important disconnect in the price signal mechanism. It makes people *feel* the cost of healthcare again. When you *feel* it, you are willing to save money by *voluntarily* staying in shabbier French style hospitals as long as the care is good enough. You are willing to exercise more to stave off medical expenses (I spend hundreds a month for the exercise regimen of my family.)
The Republican plan *does* borrow ideas from the French model such as tort reform. And the Republican plan does try to improve coverage. I hate the idea of a tax refund because I loath using the tax code to manipulate people. But oh well, it hate it much less than the Medicare-for-all plan that TampaDoug has admitted is just a Trojan horse for a single payer system. Nothing like duping your fellow Americans into what you want right? How democratic.
So, the Single player plan will fail every bit as much as Social Security and Medicare are going to fail in the long term. No system that cost shifts a significant debt into other people is *ever* sustainable.
You are wrong presume that only insurance providers will benefit. When people are free (as they currently *aren't*) to buy from any insurance provider, the market will ensure the existence of low cost providers. And yes, the government (at the state level I hope) will have some role in tackling the pre-existing conditions issue.
Finally, I give you my little anecdote. I use a high deductible plan with a health savings account. I love it! I am rewarded for living a healthy lifestyle. This year we're having a baby and we will hit the high deductible. But last year we had fewer expenses and saved about $5k. There is no reason I shouldn't have over 100k in this account when I retire. The only difference between me and everyone else is that I am rewarded for saving money. And no, I don't skimp on preventive healthcare. If that big catasrophe hits, my insurer will cover it. (Yes, I do believe in enforcing contracts)
So I hope Republicans succeed in giving more people what I have been lucky enough to have because my employer provides it (my old employer didn't...how un-american that your choices be limited because of who you work for).
Nathan, your faith in your oligarchs is touching, but ignores critical facts. The problem is that funding health care via an insurance model works only if a) everybody is required to pay into the insurance fund (whether it is public or private , and b) the insurance fund is required to accept everybody. Otherwise, a) people who are currently healthy will not pay into the insurance fund, and b) the insurers will not cover sick people. Add in the fact that the system is incredibly inefficient -- over 30% of payments for individual insurance go to overhead such as billing individuals and sorting out "insurability" (i.e., making sure no sick people can get insurance) -- and you have a health care disaster if your ideology becomes fact.
ReplyDeleteThis is not speculation on my part, this is fact. If you are diabetic in America, there are zero (0) private individual insurers who will accept you into their insurance fund, and there's a lot of younger people who deliberately fail to purchase insurance because they are healthy and feel it's not worth the money (I was not one of these people, BTW -- I paid for health insurance on the private market when I was younger). The end result is a lot of dead bodies. And as I've pointed out previously, if your ideology results in a lot of dead bodies, it Officially Sucks, regardless of whether you call it "freedom" or "communism" or whatever name you want to call it.
- Badtux the Healthcare Penguin