Some good coverage today in the mainstream press about President Obama's proposed health care reforms and the effect they might have. First, the New York Times has a timeline of health care reform efforts going back to the 1930s. That was particularly enlightening to me, since in my lifetime reform consisted of President Clinton's botched efforts back in the early 90s and not much else. For one thing, the timeline charts how health care costs started spiraling upward only when more Americans moved to private health insurance. Interesting, and - sarcasm alert - totally coincidental, no doubt.
I also like the Wall Street Journal's breakdown, in the very clear form of a Q&A. Possibly my favorite part: "Families who have insurance pay an additional $1,000 a year in premiums to effectively subsidize all the people who receive care but don't pay for it, according to a separate study by the liberal group Families USA and actuarial consultancy Milliman Inc." This is why Americans pay more per capita for health care than any other industrialized country, and why we have so little to show for it. (This is also why I don't get the argument that the public shouldn't share one another's health care costs... Dude, we're already paying for it. We're just paying more.)
Actual health care - as opposed to sickness care - is cheaper in the long run. Last year I had the opportunity to hear former U.S. Rep. J.C. Watts speak at the college where I work, and he talked about this. Consider this: say the feds offer a $1,000 tax deduction for individuals for every year that his/her cholesterol is under 200, starting at age 40. Assuming that a man lives to be 80 and qualifies for the deduction every year, that's basically a $40,000 cost to the public. Now, imagine that the same man - without the very attractive incentive to stay healthy - has a heart attack at age 50 or so. That's as much as $50,000 by one estimate, and that's assuming the man doesn't go on to have another one. And the amount doesn't consider ancillary costs like lost wages or disability payments.
The WSJ piece also talks about what the proposed reforms would mean for business owners and employees. I don't like that (according to this summary) people with employee-provided health insurance (like me) would not be eligible for the public plan, but might be required to pay taxes on that benefit. I'm very much in favor of public health care acting in competition to the private industry, but it's not fair to exclude certain consumers from choosing among the competitors.
Two other things I want to mention: we hear a lot about how government-administrated health care would lead to "rationing" of services, presumably because of either increased demand or because those mean doctors would say "screw this" and provide fewer services (since they're not making as much money from them). Okay, first of all, I can't waltz into my doctor's office and get a X-ray on demand. If I want a medical procedure that my private insurer doesn't deem medically necessary, I pay for it out-of-pocket. We take that for granted, but how is that not rationing? Also, I'm dubious of the anti-reformers' claim that people in countries with public health care have to wait months for procedures, considering that when my grandfather got a kidney stone on a trip to England, he got right into a hospital for surgery (for which he, a tourist, didn't have to pay a dime).
Second... Last week I was in Atlanta for several days on business, and I noticed a small group of picketers in front of the office building across the street from where I was. They were members of a local drywall installers' union protesting the working conditions in the building. One of their complaints was lack of health care. It seems pretty simple. If you're an employer, you can either provide your employers with health care, or you can pay them enough so that they can afford to buy their own. Employers who do neither rely on you and me to subsidize those workers' care, and that's not fair.
In the past, it's been the medical establishment itself that's lobbied against the kinds of reforms Obama wants. But maybe things are different now. For one thing, with so many losing jobs (bye, bye, health insurance) and the fact that paying pension and health care costs is basically what broke the U.S. auto industry, more Americans are realizing that a form of public health care would benefit them, too. Clearly, we have a great deal to work out. But our system is broken. Hopefully all of the players - including us voters - can fix at least part of it.
(And here's hoping our media can cover this accurately and intelligently.)
No comments:
Post a Comment