Posted by
FeargalX on Tuesday, August 18, 2009 9:49:58 PM
The fact that the U.S. spends more than twice what diverse developed countries like Japan, the U.K., Switzerland and Canada spend on healthcare is something we need to take ownership of. At the same time, there is no basis to chant the circular argument that reform will mean that our healthcare costs will go up. All things being equal, older people have more health issues -- and demographics tell us a "baby boom" happened between about 1946 and 1962. There were less people born, by a big amount, from 1963 to 1979 than during the baby boom years. Baby boomers are retiring, and getting conditions that older people get -- and we have fewer people to pay for care. Medical care issues will be a challenge based on those numbers (a similar issue to that of Social Security). I see no reason that reform would make healthcare more expensive -- for example -- if the UK's system took over our healthcare with its NHS -- the "care" might not be as "good" but we would have, per person, about $3000 more dollars in our pocket. Would that be a good tradeoff? Some would say yes, others no.
Here is really how to achieve universal coverage -- it should have no real cost associated with it (merely a transfer of costs at most). Our demographics will mean challenges though. Here it is:
1.) Everyone is now eligible for Medicaid. Medicaid is not very good, neither are public schools in Washington D.C., most middle class people send their children to private school in D.C. -- most middle class people would want better coverage than Medicaid.
2.) Expand the VA. Allow more people to be covered while preserving the mission. That is, expand the years of coverage for children of Vets and spouses. Like with Medicaid, most people who are eligible for the VA coverage who are retired Vets opt out of VA coverage. Of course, it is better than no coverage or treating yourself.
3.) Congressional plan -- which is very generous -- all Americans should be able to buy into this government insurance plan for 50 cents on the dollar. It would cost more than what most people would want to pay -- but it would be a "fair" system.
People would gripe about the Medicaid and VA coverage (they already do). But, we would have no middle class bankruptcies due to healthcare. Crappy insurance companies would go out of business -- if a company could offer nothing more than medicaid nobody would want it.
Rationing and waiting? Anyone ever deal with an HMO -- anyone ever get pre-approved coverage only to have the HMO retroactively deny coverage? Guess what -- you don't fight over that $500 -- it is too difficult and timely to be worth it. You work a deal with the doctor and insurance company. It once took me about 6 months for pre-approval for a medical procedure when I had an HMO. It is silly to claim that insurance companies naturally "better" than government -- it is like claiming KBR and Blackwater are "better" than our military. Unfortunately, many in the GOP really believe this (paying a contractor $200 per hour that a civil servant will do for [with all benefits etc included] for $50 an hour is a bad deal for the taxpayers. It is only a good deal for zealots who believe in no government (and irrationally hate government employees) and those who work for and own these contracting firms.