Presidential candidates Barack Obama and John McCain are promising to fix the nation's health care system, at a cost of more than $1 trillion over the next decade.
When a program's price tag hits 13 digits, it's reasonable to expect that it solves a clearly defined problem. Obama and McCain define that problem in completely different terms.
Obama's plan is designed to reduce the number of people without insurance. There are nearly 46 million uninsured Americans, according to Census data. The number in Virginia tops 1 million, according to the Commonwealth Institute for Fiscal Analysis, a group affiliated with a coalition of 22 religious organizations.
Obama's plan would add an estimated 34 million people to the insurance rolls at a cost of $1.6 trillion, based on a study by the nonpartisan Tax Policy Center. He would create a government-operated insurance program and require larger employers to provide coverage for their workers. Parents would be required to cover their children, although adults would not be mandated to cover themselves.
McCain's plan is designed to increase consumer choice and drive down insurance prices. In seeking to spur competition, he would encourage people who already have insurance through their employers to leave those pools and purchase individual policies on the open market.
McCain achieves that goal by imposing new taxes on employer-provided health benefits and offering tax breaks to workers who buy insurance on their own.
It is a risky idea that would undoubtedly be bad for business. And it wouldn't do much for the uninsured, either.
To avoid the tax in McCain's plan, healthy workers would drop out of group plans and seek cheap individual policies. Businesses' group plans would be stuck with a small pool of older, sicker workers, and their costs would spike. Many businesses would be forced to cancel coverage.
The tax center study estimates McCain's plan would cost $1.3 trillion but would reduce the number of uninsured by just 5 million because the tax credits would be insufficient to buy even the barest coverage. Most of the money would be funneled instead into the profits of insurance companies.
In criticizing Obama's health plan as too expensive and disruptive, McCain glosses over the upheaval his own proposal would cause, and its expense.
Most Americans understand their health care system is broken. If they are going to spend $1 trillion to fix it, they have a right to demand that their money be used to help people in need and not to penalize the very businesses that have tried to do the right thing for their workers.
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that's my point
"Most people have never seen their policy, only the booklet their company provides describing it." - Tabor
In part that's my point. People think because they have a policy they are covered, and they may very well not be under certain conditions. I have a policy, but who can understand all that's in it? Certainly not me! It was not writen for the average person to every understand. If all you have is a booklet, it's my understanding you can get a copy of the policy by contacting the company. I pay for my own policy, not through an employer, union or anything else, and I don't bowl. With a serious or major illness insurance companies pay on the average cost of a procedure, and the insured can be left with a hefty bill. Most people do not understand that.
don, we have to be realistic here
even if the employer's tax benefit were removed, you would still have the same problems of insurability we have now. If you are not healthy, or have had problems you are left out. The insurance companies are not going to compete for anyone but the young and healthy. And, as far as policies go, it is the insured's responsibility to know what he has, but very few people have the understanding required to plow through one of those. So that means we should hire a lawyer to help negotiate the contract. And most of those contracts do not tell you what they are going to cover, just the myriad of exclusions in such arcane language that it guarantees legal help in a dispute for coverage. There are a lot of problems with our system, but dumping everyone into a pools of their own will not solve the issues. Companies can at least negotiate on a moderately level playing field with insurance professionals, but individuals don't stand a chance dealing with someone who spends his life in the specialized world of coverage.
Biggest Mistake is who buys the policy
"The biggest mistake people make is not looking into the policy they currently have." - Gertz
Most people have never seen their policy, only the booklet their company provides describing it. But the problems you posed, unrealistically low limits and exclusions, are terms about which you have no choice, because your employer chose your policy to meet his needs, not yours. If you were able to choose, on a level playing field in regards to tax consequences, between several group policies, offered by your employer, your church, your professional organization, your union, or your bowling league, you would chose based on the value of the policy to you, balancing price and features just as you do with every other purchase, and the insurance company would have to please you to get the business.
As it is now, the tax advantage given to employer plans leaves you effectively with no choice as all.
about your health care
So you have a health care plan and you think you are covered, and all is well. Not so fast! Do you really know what is and is not covered, do you know that each medical claim from you is reviewed, your deductable can go up if they see you "at risk", and you can be canceled. The biggest mistake people make is not looking into the policy they currently have. A serious procedure may costs $100,000 in NY but $150,000 in CA, your insurance company will only pay the $100,000 and you eat the rest of it.
Justanotheruser and cancer treatment
should not rely on health insurance of any form. If you and I are both in Anthem, your cancer is a drain on my insurance company. Enough of that treatment to you and yours and my rates go up. As a healthy person I want you banned from my insurance company, you are too expensive. Go join a company that has nothing but sick people. We'll consider you when you are cured, but never for that disease in case of a remission. Can't find another company? Well, that's is just too bad, maybe a charity will pick up the tab for some treatment. Just don't make me pay for it. Sound familiar, because that is just the way it is in the private sector today.
The exception is that the original company can't kick you out, but they can make you leave either when you leave your job (and if you're seriously sick, you probably have to), or raising the rates of a class of people to ridiculous levels. Then you are on your own.
justanotheruser
"Answer your own question: If I have cancer, why should you be expected to pay for my treatment?"
I firmly believe we are all in this together, and I firmly believe we should ALL have health care.
I have my own insurance, but if you cannot afford yours, then we as American citizens should all pitch in. Be it taxes or whatever. We have become the most selfish thinking group of people I've ever seen, and everyone is just out for "Me". I think that's wrong!
Actually, Gertz, the discussion is about health care,
and how much or how little the government needs to be involved. Don's position is Libertarian,which would make health care completely market based, without any governmental oversight. I think the problem with that is evident in the abuses now taking place. Insurance is denied or prohibitively expensive for a segment of the population that is not healthy, or potentially not healthy due to family history or chemical parameters. The prevailing practice among many, if not all, medical insurers, is to deny or curtail coverage, even they are contractually obligated, and see if the patient pursues the case. I think that is criminal, if not at least ethically repugnant. But it is profitable. True, we don't have government bureaucrats determining your health care, but we are dependent upon corporate accounting departments to direct your medical needs. I don't see where those practices would change in a pure, market driven system. And if some don't see why they shouldn't pay for other's medical care, then they could at least consider what is best for America…healthy workers anyone?
the article is about health care
Now that you've beat libertarian utopia to death, maybe we can get back on topic.
We
already pay, through taxes, for the health-care of our military & their dependents & our federal legislators, President & Vice President. Speeders & reckless drivers use the roads. They're not always caught & cause many wrecks & damage, even to state & federal property. Our taxes allow these abusers to use the road. Persons in group insurance plans, already pay health-care, for the overweight, smokers, etc. The prosperity of the late 19Th century, was, in large part, driven by abusive child labor, & the mistreatment of minorities,(low pay, unsafe working conditions, etc.). The minorities included Blacks, Irish, Italian & other European & Asian immigrants. Their was very little regulation of industry. Upton Sinclair, (among others), exposed many of the workplace abuses, in "The Jungle."
Libertarian Utopia?
Len, I am not avoiding your question, its that 750 character thing.
So far as I know, no 100% Libertarian government has been tried. Think about how that would have to come about, a group would have to gain power without being seduced by power, and immediately divest itself of most of that power they had won. Humans like having power over others.
But a pure Libertarian regime is not necessary to demonstrate the value of libertarian philosophy. Look at the history of this country, and trace its progress during the time it has become more and less libertarian and allow for about 20 years lag time, and you will see that libertarianism is associated with our prosperity and that as we have drifted from the relative economic libertarianism of the late 1800's to the socialism of FDR, we have fallen into decline. We became an industrial superpower when we rid ourselves of slavery but our decline began in the 50's as the capital dissipation of the progressive income tax took hold.
gertz
Answer your own question: If I have cancer, why should you be expected to pay for my treatment?
Don, I knew you would privatize everything
that is you philosophy. I see virtues in the free market, because I am an active participant in one, in an unlicensed profession. If I remember from way back in school, one of the issues with private fire departments was the competition was so cutthroat, that they would sabotage equipment, create fires, etc. Not a pretty picture. Yes, we solve it in the courts eventually after property and lives are burned to a crisp.
But you still haven't addressed the issue I am curious about. Is the Libertarian philosophy at work anywhere in the world, and how is it doing?
Or is your economic system a theory that sounds wonderful, but, as any utopian plan, probably unworkable in real life?
I think the reality is that corporations as large as many countries are not in the same league as millions of individuals and companies working for their own self interest as a way to prosperity for all. As huge corporations absorb and merge and buyout or drive out any competition, we are merely dealing with another form of governance.
is this the way you think?
You have cancer I don't, why shoud I care if you get tratment or not, it's not my problem, and why should I help pay for it?
Subscription Fire Departments
Len- You mentioned subscription fire departments unfavorably, but they actually worked quite well. They were mostly semi-volunteer and franchised by the State. They did not let houses of non-members burn down, but they billed for their services if you weren't a member and obtained a primary lien on the property, as allowed by the franchise, to ensure payment.
In my hometown, EMS services are still provided that way by Acadian Ambulance, a private company franchised by Louisiana. Its costs are substantially lower than municipal systems and service is excellent.
Most health insurers in Louisiana will allow a discount equal to the annual premium to members as they would have to pick up the tab for non-members. Subscription Fire Depts worked the same way, with fire insurers discounting to encourage membership.
the "me" mentality
As long as poeple think "ME" and the heck with everyone else this country will never be united. We are all in this together, we spend billions helping any and every country, but don't want to take care of our own. There is something very wrong with that kind of thinking.
Public sroads and health care are not the same
The roads are the same for everyone, health care insurance is not. I don't smoke, but I am overweight. Why should I pay for the increased risks of smokers, and why should thinner people pay for my increased risks due to weight?
A more fit analogy would be food. I can choose to eat beans and rice or Porterhouse steak. But if food is going to cost me the same either way, I'll eat steak every night. So will everyone else, so the Nationalized Food Service will have to ration steak to keep costs down.
Those problems do not arise in a free market. Fixing health care should provide us more freedom and more choice, not burden us with the poor choices of others while imposing bureaucratic rationing.
Don, should I pay for your street,
your water and sewage treatment, your fire department, your local police. After all, if your house has no water, burns down or gets burglarized, that is not my problem. How about vaccines for communicable diseases? If all those who couldn't afford measles protection opted out, then we are all at risk, but is that my problem? A few generations ago, fire departments were private, sort of an insurance company, and only those citizens who paid would get help if their home or business caught fire. Should we return to that era? As our country evolves into a more urban society, aren't there certain services that are beneficial for everyone to have that also better the community? I know Libertarians believe only in defense and courts, but I still would like to know if that system actually works, or is it just theory? Has anyone actually run a country that way?
tabor
What makes you think elected officials should have free health care when they are no better than anyone else. People like you aren't interested in offering medical assistance to people in this country, but I'm sure you beleive it's Ok to spend billions bombing the heck out of country all in the name of lies and then turn around and spend billions more rebuilding that same country. Don't you now?
It is not....
It is not my responsibility to fund anyones health care but for my own family. No, it is not my responsibility to fund anyones bad choices in over extending themselves in credit. No, it is not my responsibility to pay for people that add no value to our economy. The only thing that I might agree on in this market correction is to renegotiate the interest rates to reasonable levels for mortgages. I do not agree on giving people property that they knew they could not afford in the first place. I would also think that credit must be reigned in so that people that cannot afford luxuries cannot buy them just because the next door neighbor has one. People on government assistance live just as well as people that responsibly paved their destiny. That is socialism that deflates value in living an honest lifestyle. Enough!!! NObama!!!
Gertz, please point to the place in the Constitution
which gives the Government the power to tax me to pay for your health care.
Just because you believe everyone should have something does not make it the proper role of government to obtain that thing for them by force, which is the only way government does anything.
If you think everyone should have thew same level of health care, then take up a collection from like minded individuals and pay for it.
everyone deserves
Everyone deserves the same health care as our eleted officials all the way up to the WH. Anything less is unacceptable! Maybe if we didn't spend a fortune on wars based on lies, this could have been affored years ago.
Neither Plan goes far enough
Neither plan goes far enough to solve the problem. Insurance for basic preventative and emergency care should be mandatory, just like auto insurance. Likewise, there should be rebates for policyholders who have good health habits, and policyholders who make poor choices and therefore are a higher risk for more health care costs, should pay more.
Making bare-bones preventative and emergency care mandatory would make insurance more affordable. A government run pool should only be available to those that are not otherwise insurable, like with other types of insurance (home, auto). I support more market choice.
Furthermore, a national health plan is the sure way to raise costs, lower quality, impose rationing, and remove choice. As a Canadian with experience with both the Canadian and UK systems, I vehemently oppose any movement to socialized medicine.
Non-Partisan Tax Policy Center??!!
Compared to the Daily Kos maybe. I am unaware of a single time TPC has supported a conservative or free market position.
The basic reason our health care system has become so expensive and unresponsive is that our tax code has distorted the market forces, which keep the cost of everything else, from oil changes to newspapers, in line, by giving employer based plans an overwhelming advantage over other group plans. Though McCain's plan falls short of fixing these problems completely, it does address the major problem. Obama's plan will only further separate market forces from health care costs.
The result, perhaps intentional, is that health care would be come so expensive that there would be even more pressure for socialized medicine. The end result will be either enormous cost or Draconian rationing by bureaucratic whim.
Insufficient At Best
While Obama's plan is better than McCain's disastrous idea, neither comes close to being sufficient or as good as the national health care of any modern industrial nation. Mandating health insurance as we do for auto insurance is a ridiculous idea -- especially in a failing economy. Children, like the elderly at very least should be covered through government programs because not doing so in developmental stages will only be more costly down the line. What kind of nation can spend trillions on aggressive militarism and corporate bailouts but skimp on healthcare?