Monday, June 15, 2009
Who Controls Your Health?
President Obama has said that he wants a comprehensive health care bill through Congress by October. "Comprehensive health care bill" covers a lot ground and when most people hear it they think of universal health care in the form of a Federal health insurance program to cover those currently without insurance. To many this is one of the single biggest issues in our country--the millions of Americans without health insurance--and it is there goal to ensure every American is insured. But "comprehensive health care" can, and will, go far beyond insurance, count on any such bill to include regualtions on the food and restaurant industries, health care providers, labs and any sector of the country that in somehow impacts personal health. It will offer another opportunity for Obama's growth of the Executive Branch and Federal Government into our daily lives--this time under the guise of health.
The focus by the media, and those in government who craft the bill, will be on the health insurance component. Count on Obama's media machine, and his allies in the Mainstream Media, to touts the benefits of a universal insurance plan and that every American will have health care. Count on them to ignore the details, as they did for the stimulus package and his budget. Having seen first hand and upclose the financial intricacies of health care delivery in our state I am very certain the current system is seriously flawed. But with this knowledge I am even more skeptical of any program that comes out of Washington to "fix" our health care system, and any program that provides universal health care run by Washington. No amount of positive spin from the policy makers or the media will allay this skepticism.
Obama is saying that any national health insurance will be paid for by the "wealthiest Americans," his favorite source of cash. The group of Americans that already pay in the neighborhood of 80% of taxes will be asked to shoulder a bill that is now priced at $1.2 trillion. To further pay for the package will be employers, large and small, either through health care providing mandates or penalties--I'm sorry, contributions--to a health care pool. On top of this is a proposal to stip away the tax deduction for health care insurance premiums, so those employers who are now paying all or part of their employees medical insurance premiums will no longer be able to deduct those premiums from their income tax, or if they are allowed to do so the recipients--the workers--will have to pay taxes on the benefits. On the one hand Obama is throwing trillions of dollars in "stimulus" funding into the economy to create jobs, on the other he is proposing increasing taxes on everyone who works, and/or their employer, which will result in job losses due to higher operating costs.
When it comes to taxing working Americans to pay for the health care insurance of others, I ask: Do we not already pay a tax to provide health care to those without insurance? Look at your paycheck, do you see deductions for MediCal? For MediCare? What is the purpose of these deductions? To fund health care for uninsured Californians and Americans.
Further our hospital and health care system is also self-funding health care for illegal aliens who are treated the same as those who are benignly clasified as "self-pay." The law, and morality, mandates that hospitals treat anyone who walks, or is transported, in the door, whether they have the ability to pay or not. To stay in business hospitals raise their charges to try to cover the amount of free care they are providing from those who are paying through their insurance coverage. This increases the costs to the insurance companies, who in turn charge higher premiums. In the end, through a very flawed system that is costing the health care system the most, everyone who needs treatment gets it. Realizing this is very broad stroked and there are Americans with serious medical situations without coverage that are struggling, overall the vast majority of those within our borders have their most basic health care needs met--whether insured or not.
So that brings us to what will change? If there is a national insurance program what will change in our health care delivery? Besides even more government beauracracy than there is today. Besides even more resources having to be spent by hospitals and doctors to hire employees just to bill the government and follow up when they do not pay--as happens today. Besides have someone at a government desk with no medical training making a decision as to whether a medical procedure is necessary or not. Besides increasing the taxes on every American with a job--not just the "wealthiest among us." Besides that what will change? A base level of health care insurance for all Americans currently without insurance? That we already have but is being funded by the hospitals?
A major reason our health care system is screwed up today is government intervention. In California the state is so involved in health care that it mandates how many nurses have to be on shift for every patient that is in the facility--whether it be two in the morning or two in the afternoon--thanks to union influences on health care legislation. Government is involved in micromaging what equipment can be used in hospitals, where it can be placed and how health care programs can be run. Regulations mandated by elected politicians with only the advice of the lobbiests with the most money, not the most experience. Patient health is not nearly a primary consideration. Need proof: Martin Luther King Hospital.
Ask yourself how will the overwhelming majority of Americans be better off by more control of our health care system taken out of the local hospital, out of your doctor's office and out of your own control and put into the hands of politicians who are already making decisions based on campaign contributions and not what is best for the rest of us. Ask how a new level of spending in excess of $1 trillion, on top of the $2+ trillion already dedicated in five months, will be paid for if not by you and your taxes. Ask how our economy can absorb yet more debt, force yet more taxes on employers, and expect to add jobs? Ask how a system that currently has a fraud rate of about 10% will not maintain that same rate of fraud when the spending increases to $1 trillion (that would equate to $100 billion in fraud)?
My solution to the health care crisis is somewhat simplistic. First, any hospital that is licensed in the state is eligible to receive MediCal/MediCaid/MediCare funding. Second, all payments are the same to all hospitals for the same procedures and treatments, no more contracting with specific hospitals. If all hospitals have to take all patients when they come in, then all hospitals should be reimbursed the same for the same treatments. This includes private insurance--no more separate contracts for every group and hospital. Third, no more system where the more patients a facility or state has under MediCal/MediCaid the more funding they get from MediCare; fund based on need not on what is already being billed. Fourth, use Oregon as a model with promoting treatment and payment of preventative medicine first, encourage well-checks and screenings on a regular basis. Fifth, for those uninsured with employment when they file their taxes they are billed for a health care account; for those without a job their other public benefits are adjusted for the medical coverage provided.
There will always be a small minority of our populace that will not work, that will not pay for insurance, that will not take care of themselves. Our most fundamental question must be: to what extent must we burden the responsible to care for the unresponsible? I know this opens a big can of worms, especially among the most liberal among us, but that is the most basic question. How much must you pay to care for the drug addict, the habitual alcoholic, the woman who sees no problem in multiple children with multiple fathers, what is your personal responsibility through your hard work and success to support those among us that are least responsible? Obama and his allies think it is all your responsibility and the health care bill going through Congress will show that philosophy.