Thursday, December 10, 2009

The White House's goals for healthcare reform

I'll try not to be snarky about this. I have my views on the issue, everyone else has their own views. I'm not trying to change any views, I just want to explore things from a rational, economic, and common sense point of view, instead of just making decisions based on emotions, which I think is a major shortfall of the left's greatest downfalls when it comes to these things.

Taken from:

Key things they want to change:

- Reduce long-term growth of health care costs for businesses and government
- Protect families from bankruptcy or debt because of health care costs
- Guarantee choice of doctors and health plans
- Invest in prevention and wellness
- Improve patient safety and quality of care
- Assure affordable, quality health coverage for all Americans
- Maintain coverage when you change or lose your job
- End barriers to coverage for people with pre-existing medical conditions

Let's take these one at a time.

"Reduce long-term growth of health care costs for businesses and government"

Government bureaucracy won't achieve this. When I say bureaucracy I'm not trying to simply use emotional words to evoke hatred or mental images of lazy government employees. I'm talking to convey the sheer amount of "movement" that has to be achieved to get anything done when it comes to getting stuff done in a government setting.

Government is inefficient. If you can't admit that then you're either so far up your own ass that you'll deny anything bad said about government, or you've never had to deal with the government doing something that should be incredibly simple but turns out to be a giant clusterfuck.

I helped my father-in-law with some government paperwork. Remember cash for clunkers? He's a car salesman, but was given the task of dealing with the immense amount of paperwork that was necessary to get the money back from the government. We spent over a month dealing with the asinine forms, scanning, filling them out, dealing with the CFC website (a horrendous experience in and of itself), and then trying to submit. Every couple of days they'd change the rules and reject an entire batch of cars. We'd do them over again.

Government is so vast that for anything to get done, it has to go through many channels. Adding more bureaucracy to the healthcare mix will not do anything to reduce long-term growth of costs. I'm not too familiar with this part of the proposals, but I've heard about increasing mandates on employers. I think it's a nice benefit when employers provide healthcare for their employees, but I also think it causes more problems than it's worth.

If people were allowed the same tax benefit as companies have when it comes to healthcare costs (such as getting rid of the 7.5% AGI floor the current tax code has now for medical-related costs), the incentive to shop around for a better deal would be greater. Not only would people be able to have more choice than just what their employer offers, it would help mitigate the effect of one of the major causes of the uninsured today, that is, having healthcare attached to a job. When your employer provides your healthcare, you'd better hope that the economy doesn't go through a down cycle. If you get fired, you will be without insurance. Sure, there's COBRA, but it's expensive and doesn't last long. Detaching coverage from employment would at least save people from being uninsured if they lose their jobs.

"Protect families from bankruptcy or debt because of health care costs"

I think this is a great idea, but you have to explore why people were in that position in the first place. If a family has a member get sick and they have to go into debt to pay the hospital, it's a clear case of not being prepared. I'm not saying they deserve the debt, but they should have been better prepared. One of the major rules of being financially responsible is keeping an emergency fund of at least nine months worth of expenses. Not only does this cover the family for nine months in case of loss of jobs, it also is there to help with enormous medical costs, should they arise.

This is actually a whole other subject that deserves its own article, but I'll have to mention it to get my point across. Too many American families are in debt. They're not in debt because of evil banks or crooked capitalists, they're in debt because they lack the long-term thought processes that are so prevalent in millionaires. Most wealthy people aren't wealthy because they make exorbitant amounts of money. They're wealthy because they think and plan for the long term. They don't finance cars because they know that if they save the money they'll save a lot in the long run. They don't spend every dime they earn on unnecessary items. They save, they invest, and they prepare for the bad times while they're in the good times.

Too many families nowadays are have negative net worths because of their spending habits. This isn't so much a healthcare issue as it is a lifestyle issue.

"Guarantee choice of doctors and health plans"

I doubt a public option would affect this in the short-term, but it would kill consumer choice in the long-term. The government doesn't pay doctors a lot when it comes to healthcare. Why do you think that doctors will order all tests necessary? Three reasons: 1) They need to actually make money doing their job 2) They want to make sure they have their asses covered so ambulance chasers like John Edwards won't come and sue them for tortious acts and 3) They have no incentive to reduce costs for their customer if their customer has no incentive to reduce costs for themselves. When you don't pay for something, you don't shop around for the best price.

There wouldn't be a mass exodus of physicians overnight, but overtime, as the government takes more and more control of the healthcare industry, the incentive to be a doctor will be diminished. At that point there WILL be rationing of care.

And let's be honest here, the "public option" is just a stepping stone on the way to a single-payer system. Don't kid yourselves.

"Invest in prevention and wellness"

I see no problem with this, but what I fail to see is why the government must step in and do this. People can do it for themselves if healthcare is more affordable.

"Improve patient safety and quality of care"

Government can't increase safety of care. They can "mandate" or "regulate" safety rules that will, in theory, increase safety, but they can't guarantee it. Think of the big peanut scare a year or so ago. The FDA had rules on how to inspect peanuts, and there was still a government failure to ensure safety.

You don't hear the words
government failure in the news very often, but gee golly I sure am accustomed to hearing market failure come from the talking heads...

As for quality, see above under "Guarantee choice of doctors and health plans".

"Assure affordable, quality health coverage for all Americans"

Governmental frolics into the free market, whether they be in the form of regulatory changes and/or "competition" in the form of a government-run option, will always raise prices. Just like new taxes on businesses. You're a fool if you think that the firms simply absorbed the cost of new regulations and taxes. They pass them into you, the consumer.

"Maintain coverage when you change or lose your job"

Again, if people were allowed the same tax benefit as companies have when it comes to healthcare costs the incentive to shop around for a better deal would be greater. Detaching coverage from employment would at least save people from being uninsured if they lose their jobs.

"End barriers to coverage for people with pre-existing medical conditions"

I'm all for this. It WILL raise prices for everyone, but I think it's a noble cause. It will raise prices because more money will be leaving the insurance company's big "pot", so more money will need to go into the pot to cover costs. Too many people are denied coverage in this country. The insurance companies aren't perfect, and this is one of their major transgressions.

On a side note, keep in mind that you always will hear about the failures of insurance companies, and never the millions of people who've been helped by their insurance companies. That's not emotional enough for the media to air.

In conclusion, try analyzing important things (especially when they make up such a large portion of the economy) from an economic standpoint instead of an emotional one. It's easy to say that we should have universal healthcare because "we're the richest nation in the world" or "every human has a right to healthcare" or "because Europe does it". Try doing some critical thinking on the matter, and crunch the numbers. God forbid you pick up a calculator.

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