Friday, March 5, 2010

The Right Way to Overhaul American Health Care....

Let’s be honest and start off by acknowledging that we DO have some problems with America’s health care system – PRIMARILY, it costs too much.

By 2020 it is alleged that America's health care costs will devour fully ONE THIRD of America’s GDP!

The Democrats have offered a plan that expands coverage (and increases COSTS) while doing virtually NOTHING to bring down costs!

And to be quite honest, the GOP has offered very little in true cost containment measures.

That’s simply unacceptable.

What needs to be spoken out loud about is what the Democratic Plan only hints at...that impolitic word which is never spoken – RATIONING.

Like it or not, “free ANYTHING” has always got to be rationed by a stingy group of bottom-line book keepers. Otherwise demand will increase to the point at which that upkeeping the costs of that “free thing” will swamp and bankrupt the entity offering it. THAT immutable fact is called "the tragedy of the commons."

Once we start out by acknowledging that; the PRIMARY, if not ONLY problem with America’s health care system is its cost and that its cost-overruns are directly related to us giving away far too much “free care” to those who do not/cannot pay, the problem...AND the solution become all too clear.

You see, we already have “free, universal health care,” as our hospitals are mandated to care for whomever comes through their doors. In that way every indigent and illegal immigrant is given free, universal care WITHOUT being subjected to ANY costs or rationing at all!

That’s economically unsustainable and counterproductive, as well as morally wrong. A government has no business taking care of those who CAN’T/won’t pay by overburdening those who CAN and DO.

Moreover, we already have a PUBLIC OPTION in the U.S. in the form of Medicare and Medicaid...and they are both already insolvent at this point. BOTH those public options owe hundreds of BILLIONS that cannot possibly be paid!

So what to do?

Simply put, we MUST address the core problem – cost containment.

And that means RATIONING.

But how do we accomplish that and get from over there?

Well, the simplest route would be to create the “expanded public option” the Democrats had initially advanced, while eliminating the existing two (Medicare and Medicaid), something the Democrat plan did not address.

Everyone would be given a basic bare-bones coverage through this new public option, with ONE CAVEAT – you will be restricted to a maximum of three, maybe four physician visits per year and a maximum individual health care budget of say (somewhere around) $10,000/year, with neither visits, NOR budget dollars carried over into any subsequent years.

But what happens if we need more than four visits and $10,000 in care in a single year?

Well, you’d have two options, either buy the necessary “gap insurance” from the private insurers, now able to compete across state lines with this new set-up, OR dig into your own pocket and pay for it yourself.

What about the seniors already on Medicare who’ve paid into Medicare their entire lives and been promised care?

Those already on Medicare could be “grandfathered in” and kept on the books as is.

Those who opted to switch to Medicaid in order to get even MORE “free care” - they, like ALL Medicaid recipients and all other new public option recipients would face some rather severe cutbacks and NOT be immunized from the rationing that comes along with this new “expanded public option.”

How will we pay for this massive new “entitlement”?

Finally, a GOOD question! First, it’s NOT a “new entitlement,” since we entitle all those within our borders, even those here illegally, to unlimited/unrationed FREE Health Care at our emergency rooms.

Second, we roll over BOTH the Medicare and Medicaid budgets into this new program, we strictly monitor those programs for fraud and abuse and make examples of some of the initial fraudsters caught with a series of draconian penalties to discourage further abuse. We also add into this program the estimated $150 to $200 BILLION per year that health care for illegal immigrants are already costing us and we should be able to fund that program without any problem at all and more importantly, with NO tax increases of ANY kind.

In other words, the cost containment wouldn’t come via increasing revenues, but by cutting back access and containing existing costs – that is to say, CUTTING government spending.

Moreover, we’d have eradicated the MOST crucial flaw in our current health care system too much free care given to those who do not/cannot pay for it.

This plan would greatly boost our economy;

(1) By freeing employers from the excessive burden of providing healthcare for their workers. How much money would GM save by getting out from under their health care costs? How much would Municipalities like New York City, Chicago and L.A. save in getting out from providing their generous health care plans for their Municipal workforces? ALL that money will be there to help American Corporations expand and create new jobs and for Cities and States to save money and run more efficiently. Much of that private sector money would go into paying raises for workers, who’ve seen the bulk of that money plowed into increasing health care costs instead. In the public sector, hopefully that money would be used to pare down budget deficits, etc.

(2) It would, by addressing our system’s primary structural defect (excessive generosity, in the form of giving unlimited free health care to the indigent and illegals among us), SAVE HUGE amounts of money and those savings would start immediately, not eight years from now!

AND (3) It would provide ALL Americans with a very basic healthcare coverage, while enabling them to opt for MORE coverage by simply buying the needed “gap insurance” from the myriad private insurers and paying those premiums.

But we MUST first be honest about what the current “health care crisis” is all about.

It’s about COST.

And cost containment means RATIONING, and that rationing, in a free society, is going to impact those who will not/cannot afford the needed “gap insurance” to circumvent that rationing in a time of critical need.

Physicians would, of course, have to be barred, by penalty of law, from providing pro bono services to those on this expanded public option who’ve expended their allotment of visits and/or annual budget. That care would be needed on the open market – for those who are paying those premiums for all that “gap insurance.”

What if it’s May 6th and an illegal immigrant is being treated for lung cancer and has already reached his allotment of visits and depleted his annual budget?

Treatment would end at that time and would have to resume, if possible, the following January, or whenever the new fiscal year would begin.

Cost containment will not come without some difficult choices and some draconian decisions like that.

We have to face facts. Right now, we are being confronted with the limits of our overly optimistic generosity, born of a once free and unfettered free market economy and we must adapt and adjust to those limitations.

We simply can’t afford to give away unlimited free health care to all those who “need it.”

Quite simply put, “If you can’t pay for it, then you probably don’t really ‘NEED’ it.” Besides that, we simply can no longer afford to give away the best, most high tech health care on the planet free to all who ask...truth is, we never could.


Linda said...

This is a great post. I am on Medicare, and I have to tell you, no one is knocking on my door to sell me health insurance. I have a great secondary, and it goes up every year.

One of the problems with seniors, especially those who are sick, is they can't get jobs. I know many seniors who are not sick, and having to supplement their income by working as greeters, etc. My hubs, who is also on MC, is still working. I don't know what we will do if he does get sick.

There have got to be some smart people out there who have the answers to the questions. I just don't think BO or his cronies are listening. They'd rather just spend the money, and not worry about the consequences.

JMK said...

One of the problems with the currently proposed "reforms," is that they target MediCARE for cuts instead of the far more often abused MediCAID.

Fraud and abuse in BOTH should be stopped, but Medicare recipients PAID INTO that system, while MEDICAID recipients DID NOT.

A fair reform would "grandfather in" those already on Medicare and Social Security....just as we grandfather in those on Social Security when the retirement age is raised...before imposing any new strictures.

But beyond that, we have to address the PRIMARY problem with America's health care system - COST.

And the ONLY way to reduce cost is to reduce access and the ONLY way to reduce access fairly is to make sure there is "gap insurance" available to those who can and will pay for it.

We've given away far too much for far too long....and sadly, there are no "easy answers."

We're going to have to cut back on spending....especially "entitlement spending" for things like Medicare, Medicaid and Social Security....originally these kicked in at 65 when the average life expectancy was 67 for women and 64 for men.

As we should adjust programs for inflation, we should've adjusted the age requirements along with changing/increasing life expectancy.

That is a problem that should be remedied as fast as possible.

Another problem is that highlighted by a poster who defended Medicare recipients "scamming the system" by divesting their assets and moving onto Medicaid for even MORE FREE STUFF!

There never should've been a "transfer period." That "scam" should NEVER have been allowed, so we must simply end it now.

Joe said...

I'm in the same boat as Linda, only I have lost my job and have not found another, being physically limited to the sit-down variety.

Were it not for Medicare I would be dead now, given the cost of care, yet I do not support government involvement in our health care.

I believe that it was government's excessive involvement that brought us to this place and only its painful extracation from involvement will get us out of it.

In more than one area, America needs a "do-over."

JMK said...

"Were it not for Medicare I would be dead now, given the cost of care, yet I do not support government involvement in our health care." (Joe)

Here's the problem Joe, we already HAVE a single payer, public's called Medicaid and Medicare.

Yes, BOTH are broke and BOTH are rife with fraud, abuse and mismanagement.

We already have "Universal Care" paid for by the taxpayer, in the form of the BILLIONS of Dollars in FREE care doled out in Hospital Emergency Rooms each year to the uninsured (yes, even illegal immigrants).

The PRIMARY problem with American health care is COST.

The ONLY way to cut costs is to limit access and to ration care.

The most efficient way to do that is via a "public option," which would give a bare-bones basic health care plan to ALL at taxpayer expense, limited to 3 or maybe 4 doctor visits in any given year and up to $10,000 in care in any given year....those numbers could be tweaked within a very narrow range.

After that, anyone looking to circumvent that rationing and those restrictions would have to buy private sector "gap insurance" - the younger one is, the cheaper that gap insurance would be to get.

Yes, current Medicare recipients would be treated better than their Medicaid counterparts as they "paid into that system."

But once the "expanded public option" kicked in, all those not yet on Medicare would be placed on that....and would have to pay the premiums to avoid the rationing.

It would save businesses and Municipalities BILLIONS in costs, make the American worker far more productive, relative to others and make America's Corporations far more competitive in the global economy.

The one thing we can't do is continue on the reckless and irresponsible path we're currently on.

The problem with both Obama-care and Pelosi-care is that they DO NOT rein in costs.

Rationing and restrictions via a strictly regulated expanded public option would be the most efficient way to go.

Now, the late, GREAT Milton Friedman (Nobel Laureate in Economics) supported a "PayGo system (the individual would pay as he went for treatment) that would turn physicians into de facto plumbers or electricians, having to sell their services in the open market without either government of Corporate (insurance) support/cover.

He believed in eradicating Medical licenses and allowing any and all to compete in the health care marketplace, in which the buyer would have to educate him/herself and beware.

I like Dr. Friedman's idea, but it's far too radical for a country as spoiled as we currently are.

WomanHonorThyself said...

Like it or not, “free ANYTHING” has always got to be rationed by a stingy group of bottom-line book keepers. true JMK...who is not weary of all this socialism masking as compassion!!!?

Skunkfeathers said...

Dang, JMK, you just exposed one of the great Leftist lies: many of those millions of uninsured folks herebouts that the Left howls NEED Barry's hellthscare plan, ARE the illegals, who GET free universal healthcare already, by swamping our hospital ERs, and walking away, leaving taxpayers the bill.

Barry's plan has nothing to do with healthcare for all and cost control; it has EVERYTHING to do with COMMAND AND CONTROL, and expanding DEPENDENCY ON GOVERNMENT. It is as simple as that.

It is a recipe for collapse and failure, and it is sandpoundingly stupid to support this plan. I'll tell you when Congress is truly ready to enact thoughtfully-analyzed reform: when THEY DON'T WRITE THEMSELVES OUT OF THE REFORM. Until then, it's all political smoke and mirrors.

JMK said...

True enough Angel, the most vile aspect of Leftism/socialism is that it always masks itself in some kind of "compassion," often an actual subversion of religion, as in "Liberation Theology."

It is hard, NOT to view that as a palpable evil in this world.

JMK said...

"Barry's plan has nothing to do with healthcare for all and cost control; it has EVERYTHING to do with COMMAND AND CONTROL, and expanding DEPENDENCY ON GOVERNMENT. It is as simple as that." (SF)


It IS all about control and it's also about subverting and discrediting the means to true reform.

WE ALREADY provide "FREE universal health care" to those who cannot, do not and refuse to enroll in their employer's health insurance plans (appx 19% of the uninsured fall into that category...the res into the cannot and do not categories).

It's also true that right now, we're already paying for our own health insurance. The rising costs of health care plans is one of the major factors that have kept wages stagnant over the past decade.

Removing the burden of providing health care from our employers, both Corporate entities and Municipalities, would make BOTH the American Corporation AND the American worker more competitive in the global market.

That would translate into much more foreign investment in this country due primarily to the relative cost-effectiveness of the American worker.

It would also save Municipalities BILLIONS of DOLLARS that could be used for other things, including tax cuts that would spur more investment, more job creation and more progress.

The KEY is that this be done "the right way."

Using any new "Public Option" PRIMARILY as a cost containment measure. That can ONLY be achieved via rationing and restricting care.

And that can only be done so long as private "gap insurance" is available to those willing and able to pay the premiums.

We CANNOT continue to give away the staggering amount of unfettered FREE care we do WILL bankrupt us.

It's NOT "the Public Option" that's the problem, it's the improper use ot MISUSE of that option that's the root of our current problem.

That's why the Liberal Dems did their best to slime that option, to make it all but unpalatable to the American people.

We NEED to cut costs, and that means we HAVE TO CUT or restrict access/ration health care, especially to those who pay little or nothing for it!
"I'll tell you when Congress is truly ready to enact thoughtfully-analyzed reform: when THEY DON'T WRITE THEMSELVES OUT OF THE REFORM." (SF)


No such plan should be passed that exempts Congress. In FACT, Congress' other perks, its overly generous pension plan, for instance, should be replaced with SOCIAL SECURITY.

THAT should be placed before the American people on a referendum, one that would pass as overwhelmingly as the recent Icelandic measure that rebuffed England's and the Netherlands' demand for repayment OVER Iceland getting its own house in order....that measure passed in Iceland by a 93% to 7% margin.

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