I realize I’m probably walking into a gunfight but after speaking with someone about the state of American health care, I was blown away. By what? By the refusal to accept personal responsibility and the claim that certain things “just aren’t fair.” Who gets to decide if something is “fair?”
When Dan lost his job, he went three months without insurance and that just wasn’t fair. It wasn’t HIS fault the company folded.
Can you imagine saying this about any other benefit? As part of my compensation package, I have a company car. If I lost my job, how much sense would it make if I demanded that things weren’t “fair” because I no longer had a vehicle? Is it fair to demand that someone else (the US taxpayer) pay for my vehicle?
Some would argue that health care is far more important than a car, and I’ll grant that argument. But do I then demand that someone drive me to the doctor? Whatever happened to personal responsibility? “We’re dealing with LIVES!” I don’t believe it is. I think it’s more about controling LIVELIHOODS.
After digesting arguments from both sides about health care in the USA, I’ve stumbled on a few myths and facts:
Myth: There are 46 million uninsured American citizens.
Fact: The Census Bureau puts the number of uninsured at 45,657,000 people, but nearly 10 million (9.7) of the 45.7 million uninsured are classified as “not a citizen.” Claims of uninsured Americans higher than 35.9 million are wrong.
Myth: The 40 million to 50 million uninsured cannot afford health insurance.
Fact: Twenty percent of the uninsured have family incomes of greater than $75,000 per year, according to the Census Bureau. More than 17 million of the uninsured make at least $50,000 per year with a median household income of $50,233 – 8.4 million make $50,000 to $74,999 per year and 9.1 million make $75,000 or higher. Two economists working at the National Bureau of Economic Research concluded that 25 to 75 percent of those who do not purchase health insurance coverage “could afford to do so.”
Myth: The 40 million to 50 million uninsured do not get ANY health care.
Fact: The National Center for Policy Analysis estimates the average uninsured family of four gets about $6,000 in free health care per year. An Urban Institute study found that 25 percent of the uninsured already qualify for government health insurance programs. According to The National Institute for Health Care Management Foundation, 26 percent of the uninsured are eligible for some form of public coverage but do not make use of it.
Myth: People will remain uninsured without government assistance.
Fact: The Congressional Budget Office says that 45 percent of the uninsured will be insured again within four months. Former CBO Director Douglas Holtz-Eakin also said that the frequent claim of 40+ million Americans lacking insurance is an “incomplete and potentially misleading picture of the uninsured population.” Yet another CBO analysis found that 36 million people would remain uninsured even if the Senate’s $1.6 trillion health care plan is passed.
Even the liberal non-profit Kaiser Family Foundation put the number of uninsured Americans who do not qualify for government programs and make less than $50,000 a year between 8.2 million and 13.9 million. Splitting the difference means there are probably about 11.05 million without health insurance (not without health care – there’s a big difference). That’s 11.05 million out of 304 million or just 3.6 percent of the population.
What SHOULD we do to solve this “crisis?”
1. Classify any premiums spent on health insurance a tax credit and retain the deductibility of health care costs.
2. Lower the adjusted gross income requirement for the deductibility of medical expense from 7.5 percent to 3 percent or less.
3. Permit people to purchase health insurance from any state and make it portable from job to job.
4. Cut down the barriers that prevent/limit insurance companies from offering high-deductible insurance.
5. Repeal state mandates requiring a minimum level of health care coverage. Some states have established minimums so high that the cost of health insurance is unconscionable. The irony here is that government regulation sent the cost of health insurance soaring, but politicians claim that they alone know how to lower health insurance costs. It’s like the Black Knight from Monty Python and the Holy Grail telling you how to fight (’tis but a flesh wound).
6. Educate the public on health care costs. People know how much a gallon of gas costs but have no idea what an office visit to their doctor costs. They know the cost of a new Prius but couldn’t get close to telling you how much an MRI costs. An educated public will demand competition and market prices – they do in almost every other aspect of their lives! Everything being relatively equal, would YOU go to a movie theater that charged $30 for a ticket and $20 for a small popcorn? Competition drives down prices.
7. First reform Medicare. According to a Council of Economic Advisers Report,
“nearly 30 percent of Medicare’s costs could be saved without adverse health consequences.”
Medicare is a bureaucratic, bloated, huge, single-payer, government-run program so it should provide the perfect opportunity for a government run health care experiment, shouldn’t it? If more efficient government management can slash health care costs by addressing problems like high cost, low-value treatments, too little effective and high value care, variation in the quality of care provided to patients, medical errors that lead to worse outcomes and higher costs, and too much defensive medical treatments — why not start with Medicare? Let’s see what “better management” looks like applied to Medicare before we force it on the rest of the country.
Is there anything in your life you think would be better if it were run by government bureaucrats? For most of us, the answer is a laughable “No.” Yet oddly, there is sympathy for turning over our most private, personal decisions, not to mention one sixth of our economy, to the same unresponsive, anti-entrepreneurial culture that gave us the response to Hurricane Katrina.– Newt Gingrich
8. Place a cap on malpractice awards. Not only do the tremendous costs of lawsuits require doctors to pay massive premiums to get malpractice insurance (costs then passed on to consumers), but these costs encourage many doctors to engage in defensive medicine to avoid these lawsuits. They prescribe useless tests and exams that are expensive and have more to do with protecting themselves in court than with a patient’s health. A study in 2000, for example, estimated the cost of defensive medicine to be 70 billion dollars a year. A simple $2 million cap on malpractice awards would reduce insurer’s risk and lower malpractice premiums while still providing an incentive for doctors to practice good medicine.
We can have better, more available, less expensive health care in this country but it won’t be because the government got involved, it will be because the government got out of the way and allowed competition and choice to rule. Competition will make certain that more Americans are covered without destroying the impressive quality of our current system. We can’t put overbearing bureaucrats or green lampshade accountants in charge and expect that health care costs will go down and quality and availability will go up. We need to empower Americans with more choice and competition, not with a huge single payer system that will be just Medicare for all.