{"id":53,"date":"2009-03-03T18:04:54","date_gmt":"2009-03-03T23:04:54","guid":{"rendered":"http:\/\/jparnell.com\/blog\/?p=53"},"modified":"2009-03-03T18:04:54","modified_gmt":"2009-03-03T23:04:54","slug":"solving-healthcare","status":"publish","type":"post","link":"https:\/\/battle4liberty.com\/?p=53","title":{"rendered":"Solving Healthcare"},"content":{"rendered":"

Healthcare is a complex problem. It\u2019s an emotional, literally life and death issue, and it\u2019s getting more expensive every day.\u00a0I’m going to walk through the major issues in this blog. I’ll also put a proposal on the table.<\/span><\/p>\n

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Before I proceed, I want to underscore two points. First, the U.S. provides the best healthcare in the world. You can argue about costs or access, but the overall quality in unsurpassed. Second, private healthcare works for most Americans. An estimated 45 million Americans lack health insurance, which means that 85% have it, either through private or government sources. Many of the 45 million are covered by Medicaid or choose not to purchase coverage, so the number \u201cleft out\u201d of the system is even lower. These facts should be obvious to most Americans, but they seem to be forgotten in the demand for \u201cchange.\u201d <\/span><\/p>\n

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There are some key challenges with healthcare, however. Those who can\u2019t afford care can get it anyway. Medicaid and other government programs provide health care for the poor and Medicare provides coverage for seniors. Further, the Emergency Medical Treatment and Active Labor Act (EMTALA) passed in 1986 guarantees emergency treatment to anyone regardless of citizenship, income, or legal status. The charges for those who do not pay for such care are inevitably absorbed by those who do. While arguably a humane policy, the EMTALA has made illegal immigration more attractive and has also created an incentive for some Americans to avoid purchasing health insurance. The most important part of a health care policy is that it covers you in the event of a major catastrophe. Why pay the premiums when that likelihood is fairly low and the government has provided a safety net?<\/span><\/span><\/p>\n

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What this means is that a complete free market solution will not be possible. The government will always provide coverage for a significant number of Americans. Many who can \u201cafford\u201d some coverage will simply opt out because of the high cost and the existence of the EMTALA safety net. <\/span><\/p>\n

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There\u2019s a sad irony here. The wealthy never have a problem getting the health care coverage they need. The poor, covered by government programs, have fewer choices but receive care at little or no cost. The middle class\u2014too rich for government assistance\u2014pays inflated prices for its health care to help cover those who don\u2019t pay at all. <\/span><\/p>\n

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There are two roads we should not take to solve this problem. Requiring employers to pay for coverage is NOT the solution. There is no moral reason why an employer should be required to accept financial responsibility for an employee\u2019s health just because he or she is hired to perform a task. Offering health care benefits is a good thing, but it should not be mandated. Consider how costly benefits have contributed to the demise of the U.S. auto industry.<\/span><\/p>\n

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Nationalized health care for everyone is NOT the solution either. IT WILL RESULT IN RATIONING FOR ALL OF US. Some on the left claim that this is a baseless charge designed to scare Americans. I suggest that they read the British press, where administrators of arguably one of the best socialized systems frequently use the term \u201crationing\u201d when they discuss the tough choices surrounding who gets access to expensive treatment and who does not. This is why many Brits purchase private health insurance. We simply lack the doctors and medical infrastructure to provide \u201cfree\u201d healthcare to everyone without empowering bureaucrats to decide who gets coverage.<\/span><\/p>\n

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Here\u2019s a second irony. Some in Canada and Western Europe chastise the U.S. as \u201cthe only developed nation without universal healthcare.\u201d Perhaps they should remember that the U.S. represents the primary market for the development of many new treatments and drugs because of its private system. The U.S. is also the \u201csafety net\u201d for the wealthy in other countries who can\u2019t get the treatment they desire or don\u2019t want to wait in line for it. <\/span><\/p>\n

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HERE\u2019S MY PROPOSAL: Replace all low-income health insurance programs with a no-frills universal plan. Other than basic preventive care (vaccinations, etc.), those covered could not choose their own doctors, would be responsible for sizeable co-pays, and could see specialists under the plan\u00a0only when absolutely necessary. Only essential medications would be covered–no Viagra. Expensive, recently developed drugs without generics would be covered only in extenuating circumstances. Patients would be responsible for a sizeable amount of hospital or ER treatment each calendar year, perhaps $2000-3000. Private insurance companies could bid for the right to administer the plan in certain geographical areas. The point here is to provide a minimum level of no-frills treatment at a rock bottom cost. The details would need to be ironed out by experts in the field.<\/span><\/p>\n

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THOSE WITH HEALTH INSURANCE WOULD NOT BE INCLUDED IN THE PLAN. THOSE WITHOUT COVERAGE WOULD BE REQUIRED TO CONTRIBUTE TO THE PLAN THROUGH A FLAT PAYROLL TAX. Everyone in the plan would pay a flat percentage, perhaps 7.5% of gross wages. The federal government\u2019s contribution would be capped in some definable way, perhaps 50% of the total cost.<\/span><\/p>\n

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Here are the advantages of my proposal:<\/span><\/p>\n

1.\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 <\/span><\/span><\/span>Everyone would have access to basic, no-frills coverage.<\/span><\/p>\n

2.\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 <\/span><\/span><\/span>Those in the barebones universal plan would be required to pay into the system. At present, many are not paying anything and have no incentive to use the system wisely. Most conservative proposals are designed to make it easier for individuals to obtain insurance in the private market, but they don\u2019t address those who refuse to do so.<\/span><\/p>\n

3.\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 <\/span><\/span><\/span>Financing the plan with a flat payroll tax makes it more expensive for those who earn more, encouraging them to get their own private insurance. The goal here is to get as many Americans into private insurance coverage as possible.<\/span><\/p>\n

4.\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 <\/span><\/span><\/span>Private insurance premiums would decrease because the barebones plan would cover most of the unpaid medical bills that currently choke the system.<\/span><\/p>\n

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OK, there are some drawbacks:<\/span><\/p>\n

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1.\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 <\/span><\/span><\/span>The no-frills plan would inevitably lead to some rationing. The advantage of my proposal, however, is that it would limit such rationing to those who are receiving government assistance through the no-frills plan. <\/span><\/p>\n

2.\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 <\/span><\/span><\/span>Some conservatives and libertarians would lament the fact that those without private insurance would be required to participate. I don\u2019t like this either, but the truth is that those who \u201cgo it alone\u201d inevitably ask society to step in when a medical emergency occurs. Given the EMTALA and America\u2019s penchant for generosity, the American taxpayer will always underwrite catastrophic coverage for the uninsured. We may as well face it.<\/span><\/p>\n

3.\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 <\/span><\/span><\/span>Liberals would contend that such a plan would strap the poor with a hefty payroll tax.\u00a0At a 7.5% rate, a\u00a0family of 4 with a gross income of $25,000 would pay $1,875 a year for family coverage, a bargain even for a no-frills plan. The truth, however, is that other taxpayers would have to cover the rest of the expenses. Why is it unreasonable to require the poor to make a significant contribution toward their own coverage? How many American\u2019s who \u201ccan\u2019t afford\u201d health insurance spend $1,875 annually for their cell phones and satellite TV? It\u2019s critical that those benefitting from the program pay as much as they can.<\/span><\/p>\n

4.\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 <\/span><\/span><\/span>Once such a plan is instituted, socialists would constantly campaign for greater contributions from the general fund. This is a real problem. Perhaps changing the government contribution should require a supermajority.<\/span><\/p>\n

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As you ponder this proposal, keep in mind the multiple competing objectives we need to accomplish:<\/span><\/p>\n

1.\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 <\/span><\/span><\/span>MAINTAIN private access to the best system in the world and creative incentives for everyone to pursue private coverage.<\/span><\/p>\n

2.\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 <\/span><\/span><\/span>COVER as many Americans as possible.<\/span><\/p>\n

3.\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 <\/span><\/span><\/span>REQUIRE that recipients of federal assistance pay for as much of it as feasible.<\/span><\/p>\n

4.\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 <\/span><\/span><\/span>MINIMIZE the role of the government in the process.<\/span><\/p>\n

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My proposal is not perfect, but I think it does a better job meeting these objectives than the current system does, and\u00a0it’s far superior to what we’ll get if we stay on the sidelines. Its real strength is the fact that it delivers a level of care to everyone without a government takeover of the system. Conservatives must take control of this issue with a comprehensive proposal that leverages the market and garners political support from moderates. If not,\u00a0we may be in for a complete government takeover that will be difficult if not impossible to undo\u00a0down the road.<\/span>\u00a0<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"

Healthcare is a complex problem. It\u2019s an emotional, literally life and death issue, and it\u2019s getting more expensive every day.\u00a0I’m going to walk through the major issues in this blog. I’ll also put a proposal on the table. \u00a0 Before I proceed, I want to underscore two points. First, the U.S. provides the best healthcare […]<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[1],"tags":[],"_links":{"self":[{"href":"https:\/\/battle4liberty.com\/index.php?rest_route=\/wp\/v2\/posts\/53"}],"collection":[{"href":"https:\/\/battle4liberty.com\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/battle4liberty.com\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/battle4liberty.com\/index.php?rest_route=\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/battle4liberty.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=53"}],"version-history":[{"count":0,"href":"https:\/\/battle4liberty.com\/index.php?rest_route=\/wp\/v2\/posts\/53\/revisions"}],"wp:attachment":[{"href":"https:\/\/battle4liberty.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=53"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/battle4liberty.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=53"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/battle4liberty.com\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=53"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}