I was driving down I-35 one afternoon when I saw a billboard that made the key to health care reform crystal clear to me.
As much as we need to deal with health insurance portability, pre-existing conditions, and the millions of uninsured, the biggest problem — the one we absolutely must address — is rising health care costs. Every health care system in the industrialized world is struggling with this. No plan — be it a "public option," a co-op, or single-payer — can survive long-term without finding a way to contain costs.
And this billboard made the key to cost containment clear.
What did it say? Buy one pair of glasses
Get one free
What is the one area of health care where you see specials and coupons? Eye care.
Why?
We see price competition on eye care because most of us don't have insurance to cover that; we pay for it out of pocket. Some people can get their expenses reimbursed from a pre-tax health savings account, but just about everyone has to put out their own money at some point in this process.
What's the result?
When people are concerned about costs, so are the practitioners. From 1986-2003, inflation for all consumer goods was 66%. For health care, it was 150%. For eye care and glasses, it was 56%. (pdf)
How would we apply this to general health care? Let health insurance be like every other kind of insurance -- coverage for unforeseen catastrophes. Pay for regular, predictable health care with health savings accounts that belong to the patient. When patients lay out cash for every medical procedure, they become acutely aware of and concerned about costs, and when the patients become concerned, the clinics and hospitals will too.
Wouldn't that be disruptive to our health care system? Not nearly so disruptive as having costs continue to sky rocket. And we don't have to do it all overnight; we can ease into this.
But what we cannot have is any system that makes health care continue to appear free to the user. That is a recipe for bankruptcy.
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related:
Real Health Care Reform
Healthcare Reform: Meeting in the Middle
Medicare: Shades of Things to Come?
Two unrelated articles that flickered across my screen today have got me wondering if we're being had.
Let's review the recent history of the health care reform debate: After watching Washington spend billions screwing up the bank bailout and the stimulus, large numbers of the public told their Congressmen they didn't want any kind of publicly managed health care. The House thumbed their nose at this, but the Senate (whose members are not gerrymandered into office) responded by dropping any kind of public option from consideration.
This is in spite of the fact that the public option has been clearly documented as the preferred road to get us to that holy grail of American liberalism, single-payer health care.
But what if they gave us something so bad that we begged for a public option -- or even a single-payer system?
Now let's look at those two articles.
The Wall Street Journal points out that, as expected, the Bauchus bill has income based subidies on health care insurance in the "exhanges." So someone who makes $50,000 per year will pay more for a given health insurance policy than someone who makes $30,000. It sounds logical, but it can bite you in the butt:
"Think about a family of four earning $42,000 in 2016... CBO says a mid-level "silver" plan will cost about $14,700 in premiums, of which the family will pay $2,600—since the government would pay the other $12,100. If the family breadwinner ... then gets a raise or works overtime and wages rise to $54,000, the subsidy drops to $9,900. That amounts to an implicit 34% tax on each additional dollar of income."
That's quite a reward for your hard work!
The second piece, in the Denver Post, repeats something I've heard a few times in recent weeks: The proposed penalties for not having insurance are actually cheaper than buying insurance. So those who want to save some money will be better off paying the fines until they're sick and then buying insurance -- which they can't be denied under the new law.
So the feds get the fine money until you get sick. Then the insurance company, which hasn't been getting your premiums, gets the burden of paying your bill. Which makes premiums go up for everyone playing nice and buying insurance before hand, and some insurance companies will probably go bankrupt. Who wins? The government.
And as the cost of health insurance sky rockets, people will demand action, and government will decide that the problem in this situation is the insurance company -- that it would be much more efficient to take the middle man out of this system.
This summer, America all but blew a collective gasket at Congress and told them to back down on the public option. Liberals don't like it when the masses don't follow their all-wise lead. Would they try to get their revenge -- and their way -- by making us ask for what we loudly rejected?
Yeah. What do you think?
76 days since request for more troops, Obama accused of stalling
And we thought a president couldn't vote "present."
Get in shape or pay a price
Get ready: Under national health care, your every personal decision becomes government concern.
California appears poised to ban big-screen TVs
This might actually cause a revolt.
Magic Numbers in Politics - Thomas Sowell
The law of unintended consequeces applies to economics, too.
Today is Blog Action Day 2009. To date, I've participated in Blog Action Day, but this year I can't.
The hysteria over global warming "climate change" is ridiculous.
Our planet might be getting warmer. Human behavior might be influencing that warming. Destroying our economy with Kyoto might reduce far future warming 1%.
But since the warming trend appears to have stopped, since Mars is also warming, and since reduction in fossil fuel use by the West will only make them cheaper and easier to get for India and China, perhaps there are other issues we should focus on.
There are people in this world today without clean water, lacking access to simple medical treatments, and living in constant fear of their neighbors' barbarism.
We can actually do something about these problems! So should we spend billions on fighting global warming that may not be real, may not be a real problem, and may not be fixable, or should we spend the billions on clean water, stopping malaria, and helping children live to adulthood?
I vote for the latter.
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Related:
Christianity & the environment: 7 principles
7 principles and 1 hot topic
It's increasingly PC to spit on the memory of Columbus and his intrepid band of explorers. After all, you can't "discover" a place that already has people in it! And then introducing them to disease, slavery, and colonialism simply ruins all chances of having a Hallmark holiday in your honor.
But I think ol' Chris is unfairly getting the shaft. Here are three reasons Columbus should get historical amnesty and I should get the day off.
1) He may not have been the first guy on the continent, but he was the first guy to tell everyone else about it.
It doesn't matter if Squanto or Erik the Red were here first. They didn't tell anybody.
2) The moaning about the wretched treatment of the indigenous peoples tends to make the pre-Columbus Americas sound like the Garden of Eden when in fact they were just as horrible to each other as everybody else is.
Yes, Europe introduced them to guns, but before that they were happily beating each other's brains in with clubs and tomahawks. We unintentionally exposed them to various diseases (and no doubt got a few in return); sorry. My daughters do that to me all the time! Slavery? Europeans didn't exactly introduce the concept.
3) Neither Squanto nor Erik the Red had the foresight to found the US. Ok, neither did Columbus. But the latter's actions did directly lead to our existence.
While the loss of the US wouldn't have ended the world, it would have certainly postponed some very important advances such as electricity, airplanes, spaceflight, and the polio vaccine, not to mention the defeat of Nazi Germany. I say, yay for anything that led to the creation of the US.
I'm not campaigning for Columbus' sainthood, but it's time we give the guy a break. No one in history is as pure as the driven snow, but Columbus changed the world, and it's worth honoring his memory.
Here are some stories you might have missed this weekend if you have a life.
Wait for benefits is 3 years if health care passes "Under the Democratic bills, federal tax credits to help make health insurance affordable for millions of low- and middle-income households won’t start flowing until 2013 — after the next presidential election. But Medicare cuts and a sizable chunk of the tax increases to pay for the overhaul kick in immediately."
Ah, now I understand why something had to be passed before the August recess; they wanted the money.
Nobel Peace Prize Should Go to Nuclear Weapons
Peace through MAD.
Tea partiers turn on GOP leadership
Good! These are the guys who gave us six years of reckless spending under W. Fool me once...
When I heard that Pres. Obama had been given the Nobel Peace Prize, so many thoughts ran through my head:
7. We've just crossed over into... the Twilight Zone.
6. Al Gore's prize is no longer the committee's biggest embarrassment.
5. His reward for throwing Poland and Israel under the bus.
4. Maybe I'll win next year.
3. This actually makes sense for a man who's written two memoirs before his 50th birthday.
2. The final piece of evidence that the Peace Prize is either a purely political statement or a complete joke.
1. He deserved to win! For his tireless work on ... on ... on ...
We can certainly make too much of Pres. Obama's failure to sway the Olympic committee in Chicago's favor, but it's not something we can completely ignore.
Before and after the election we were told that Mr. Obama would be able to bring about world peace — turning our enemies into friends and healing wounds of every sort — by his eloquent words and the power of his presence.
Now we know he can’t even get the Olympics to Chicago. Not much hope for Iran, NKorea, or Russia.
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