georgeob1 wrote:I find the "analysis" here a bit amusing. Once we opt for universal, government finances or supported health care, several things will inexorably happen;
1. Consumers of health care, now disconnected from any responsibility to relate their demands to the cost of meeting it, will seek more and more of it.
2, Providers of health care services and material will advertise, seeking more and more customers for their services.
3. Government, in order to contain its rapidly escalating costs, will quickly set limits on the health care services, pharmaceuticals, and procedures that are authorized for everyone. If that doesn't succeed fully it will go farther, setting limits on the allowable supply of services - i.e. numbers of doctors; hospital beds; outpatient clinics; etc. -- thus limiting and ultimately defining the total amount of health care available.
4. Innovation and deployment of new medicines and services will decrease, as the pace of progress is set more and more by what is allowed or tolerable to the government bureaucracy administering the program. Rules and numerical codes & limits will multiply, and the administration of them by government and patients & providers trying to work around them will consume more and more of the total cost of health care.
5. The system will descend to more or less uniform mediocrity with advances in medical science, technique and pharmaceuticals set by the "always alert, aggressive,adaptive and entreprenurial" bureaucratic drones who will control the system. Health care will become a perpetual political issue with endless government initiatives to "reform" the ills that government itself has created.
What was the cynical Russian joke concerning the wonders of the Soviet Socialistic paradise -- "We pretend to work, and they pretend to pay us."
Too true.
When one reviews the so-called Universal Heathcare proposals of Obama and Clinton the differences are really insignificant in the context of the complexity of the issue.
Clinton's will mandate that all citizens have insurance
Obama's will mandate that all children are insured.
If there is an inherent problem with mandated insurance it will manifest within Obama's plan as well as Clinton's.
Both intend to fund their plans with money taken from families with total incomes of over $250,000.
Obama's only wants to increase the amount of money these people now pay as an income tax.
Clinton's will add to the amount taken from these people by treating their employers contributions to their health insurance as income, and taxing it.
Both offer the obligatory nods towards partial funding through increased efficiencies in the healthcare services of the country. For instance, one of them (I can't recall which) contends that
billions of dollars can be saved by converting patient files from paper to electronics. Of course the Federal Government will have to spend money (How much? Who cares?) to
assist rural and inner city healthcare providers in obtaining the required IT infrastructure.
Does anyone actually expect the Federal Government to succeed as the efficiency expert for America's healthcare system?
Because neither are single payer plans, individuals will be able to continue with their existing plans. Not only will you be allowed to, you will be forced to since the government plan will have income level eligibility.
Both plans will require employers to either provide health insurance to their employees or to help fund the respective versions of a Government insurance program. I have not been able to determine if the plans will require the employers to pay the full cost of insurance or if employee/employer sharing of the cost will be allowed to continue. If employers must pay 100% of the cost, employees can expect to see reduced healthcare benefits or reduced compensation.
I've not found details on the proposed government plan in terms of what coverage will be provided, and the authors of the plans may have not got that far. Intuitively, we might expect that the private plans we now have will be more comprehensive than the government plan, but that may not be the case. What if they are more comprehensive than what is generally available to the average working stiff? And if they are not, at what point does the political current make an issue of the inequality between insurance privately purchased and insurance the government provides for thos unable to afford private plans?
Both plans place great emphasis on preventive care, rightly pointing out that preventive care is cheaper than the care required to treat illness. This, intuitively, makes a lot of sense, but I recall the early days of HMOs when the sales representative explained to all employees who had a choice to make that the HMO plan was cheaper because it encouraged members to see their doctors early and often. Preventive medicine was cheaper than the therapeutic variety. Of course, in practice, the notion failed miserably. Even with lower echelon doctors, receiving lower rates of compensation, the HMOs could not afford to let their patients see the doctors as often as they liked --- for one low cost. Eventually they were telling patients who called for appointments with actual illnesses "Oh we're not seeing anyone with just stuffed noses and scratchy throats. Here's the OTC meds your doctor recommends. Get plenty of rest and call back in a week if you don't improve." In many cased HMO doctors were prescribing medicine based only on tel-conversations they had with their patients, or (far worse) based solely on a description of the symptoms provided by the patient to the nurse. Then came co-pays, which while not burdensome, they put the brakes on seeing your doctor as often as you wanted or if you only had the sniffles or some minor ache or pain. Will the Obama and Clinton government insurance plans employ co-pays or as george suggests and the history of HMOs supports, will
george wrote:Consumers of health care, now disconnected from any responsibility to relate their demands to the cost of meeting it, will seek more and more of it.
And what about the poor bastards who are paying for the government plan but forced to remain with plans that discourage preventative care?
A family with a combined income of $250,000 does not contain Hedge Fund managers or the CEOs of Insurance companies. It could contain a husband who makes $85,000 a year as a professor, and a wife who makes $125,000 as AVP of an insurance company, and receives an additional $50,000 a year in bonus and stock options. An income that can provide a comfortable lifestyle for certain, but not without work and sacrifice, and certainly not at the level of the people who wild-eyed Marxists might curse as bloated oppressors of the poor; ripe for the looting.
(Note: I'm not certain that the $250,000 income even excludes the value of employment benefits. If it doesn't, then our hypothetical couple can become a pair of HS teachers).
In any case, you can bet your last dollar that neither increasing the taxes of families with incomes over $250,000 a year or Federal efforts to reduce waste will produce enough money to fund these plans. Then either these folks will be hit up for more or the tax increases will drop below the $250,000 level.
I do believe that no American citizen should go without adequate heathcare, and I also believe that to assure this the federal government will have to spend money, but there are better and more equitable ways to accomplish this goal.
