Health Care
Home Up on Costs


bulletFor that person who is old -or sick- Health Care probably is the number one issue. No question!   If we can not take care of our old and sick then society -as we know it- has failed
bulletWhy did not I put this issue as first on my list despite of its critical importance?  Because for the society to survive as such, and be able to properly take care of its members, it needs to -first of all- be healthy and viable itself.
bullet For the sake of clarification, allow me to use a metaphor.  Let's say we are in a galleon, and the pirates are shooting cannon balls at us.  Some of our sailors are down.  What do you do first as Admiral of the ship?  Pick up the fallen sailors and take them to the infirmary?  Well, you will have to do that pretty soon of course, or they will be dead on arrival.  However, first you need to assess your situation.
  1. Is the ship sound? (technology and education). Otherwise all crew may have to jump overboard.   Abandoning those fallen and injured comrades. 

  2. Do you need to make urgent repairs? (labor).  Delaying might bring the ship under and crew might perish. All injured and all healthy.

  3. Are the defense positions covered? (defense).  Make sure all cannons are shooting back to your enemy, and your sailors ready for a possible boarding attack by the corsairs.

  4. Having assessed all of that.  Now, and only now, it is time to pick up your injured soldiers and take them to the infirmary! (health care)

bulletThis -in my opinion- is the proper sequence of priorities.   Hypothetically speaking, a nation is nothing less than a big ship surrounded by some pirates,  fortunately for us most of the ships circling us these days are also friendly allies.  But as the World Trade Center event has proven to us, that is not always the case!
bulletUNIVERSAL HEALTH CARE:  My position on health care is pretty clear, and has not changed in several decades Every person should have access to universal medical care. Every person should have the right to be properly cared for when sick, or adequately treated when in need of some kind of medical procedure.  This regardless of their monetary means.
bulletSome of those who read this might say:   I read enough, this guy is another spend-spend Democrat !.  Well, you are wrong!  As a matter of fact I was a Republican during the Reagan years, and I was thinking exactly the same way about this issue. If we valued our society for what it is, we can not afford to offer less to our weak, sick, or old fellow citizens.
SENSITIVE COVERAGE, NOT A FREE-FOR-ALL:  As an Economist I understand that this goal could be very costly to our society.  There is a second part to my position that is not shared by many others.  And that is: "Only standard medicines and procedures should be included on this universal coverage.  No extraordinary efforts should be made to extend for a few days, or weeks, the life of someone who is already in a critical irreversible state.   Resources should be saved for those who can better benefit from those services".

There will be another group of individuals who would say: I read enough, this guy is another NoTax-NoTax Republican Not really, what I am is a person -not biased by religion- who believes in honoring people with their right to die with dignity when their final days arrive.  And it will arrive for all of us!  No need to hide!

bulletI wish we could have it both ways.  But there is a limit to everything.  More so when the resources are limited in nature.  When you use one of those resources somebody else would have to abstain from having it.  There is no magic.  Everything has an implicit cost.
bulletIn 2001 the average "per-employee cost for health care" to employers exceeded $5,000, and it is expected to go up 14% in 2002.  It has been going up year after year.  This despite of higher co-payments and higher deductibles.  The trend is likely to continue going up, because hospitals have been scrambling to meet their operating costs, now that Medicare will be spending many billions less ($100 billions less over 5 years) to meet the mandate of the BBA (Balanced Budget Amendment of 1997).  
bulletThe United States spent $1.3 trillion in health care in 2001, that is 13.4% of the GDP (gross domestic product).  That is higher per-capita than in any other Western country.  And some of those European countries offer Universal coverage to all their citizens.   Notice that Germany spends in health care only 10% of their GDP, Canada 9%, and Japan 7%.   Not only that, it is expected that the health care bill will go up by 14% during 2002, making it 14.1% of the GDP, or even 18% of GDP if the recession materializes (decreasing the GDP). Can you believe this!  Almost one fifth or our GDP is spent in Health Care, and yet more than 40 million Americans are not covered by medical plans (and -listen to this- 80% of those uninsured have either a job, or a family member who works), and 70 million Americans do not have any drug coverage? 
bulletLet's work together to control medical costs and improve technology, so more advanced procedures and more powerful medicines would be available for all of us.
bulletUnless patients pay with their own money- nobody should have the right to undergo those expensive medical treatments/procedures if not affordable to be offered to the rest of our fellow citizens who might also need them.
bulletThis may sound a little bit draconian, however it would be a big step forward over what we have right now.  And it will make good savings in our current national medical bill.  Do no feel shortchanged.
bulletGiven the advanced state of the medical/pharmaceutical technologies, with these standard medicines and procedures (that have reasonable costs) we could palliate the misery of most maladies, and have all people reasonably covered without taking the nation into bankruptcy.

President Bush plan, proposes to give a tax credit of $1,000 for singles, and $3,000 per family for those uninsured to pay their medical premiums.  This is -at best- a partial solution.

bullet(a) Those persons who are high-risk will not be able to get the coverage they need from insurers, for that kind of money. 
bullet(b) Those who do not fill out IRS tax forms (either because they have no-income, or ignorance, or are illegal or guest workers) would still be left out on the blue.
bullet(c) Individuals could smartly choose the best coverage for them -in theory.   In practice, their individual leverage would not stand much of a chance against unscrupulous insurers.  Citizens will be milked!
bullet(d) Large families will be again discriminated against, pushing further down the size of the American family, and putting pressure on keeping the floodgates opened for young immigrants to move in, so they replenish our young society.  That is needed to keep Social Security in the black, or it will go red on 2025.   I do not like that dependence on immigration.  It is not good!
bullet(e) Employers will have a higher share of high-risk employees, who have less turn-over than the rest of employees only because they need the medical coverage for them or their families.  As mentioned above, employers currently pay more than $5,000 per employee in health benefits.  It will only go up.
bullet(f) The Government will continue losing $120 billion in tax revenues, because employee's health care benefit's cost it is not considered taxable anymore.  With the right leverage, you could buy a lot of premiums with that loss of revenue alone.
I despise big Government!

I am one of those who believe that private enterprise works much better than Government bureaucracies. An yet, I think that Health Care and  Drug Coverage are the type of things that only the Government can do effectively.  Of course, changes are needed, coverage has to be sensible and with limits, compassion -and not religion- should dictate public policy.   But the Government is the only body which has enough leverage and weight to get reasonable affordable coverage for ALL people in America.

By the way, Dr. Kevorkian (71) should be out of jail, and should have never been put there to begin with.

As per the first postulate of my tax doctrine, again it should be a right of a taxpayers to get back some of the SS tax, that has been paid.  SS Tax is paid to cover the expenses the Government will incur to provide Medicaid and Medicare for the elderly.

Similarly to the solutions predicated for education, the best course of action here would be to provide high-quality universal health care.  But, as I covered above, there might be medical procedures and treatments that:

  1. Can not be offered -affordably- to all whom might need them, or
  2. They might be perceived as frivolous by some taxpaying folks who think those services not only are costly, they are waste of public funds.  (For instance, an expensive procedure to be applied on a patient who -even with the treatment- is not given more than a few weeks/months  to live).

I am of the opinion, that in these cases, we either establish some kind of lottery system, or give a "voucher" (allowance) for that person who feels in need of that service, so as to request that service from a "private" provider. This meets the "better service" requirement of the second postulate of the doctrine.

The question is again: for how much the voucher would be ?

The last postulate of my doctrine suggest  that only a portion of the "private" cost will be subsidized by the voucher.  I am of the opinion that the allowance should be equal to the cost of providing the "closest" procedure -that one not included and being requested- as offered in the public health system.

For instance, let's say the patient needs a "new and innovative" experimental heart-pump implant that costs $200,000.  And let's assume Medicare only provides coverage for a heart transplant costing $50,000 to which the patient could opt.  Then the voucher should be for $50,000.

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