The U.S. House of Representatives has just passed a health bill that will provide for transformative changes in the American health care system, and the efforts of those who oppose such reform have been equally as momentous. The bill’s congressional opponents have beaten the dialogue down with ideological fervor in an attempt to filibuster the issue until 2010 election-weary Democrats are reluctant to take a stand. If these actions were based on sound reasoning, they would be justifiable in my mind, but the facts say otherwise.
Some of the major arguments of the anti-health reform movement — which is the dominant stance taken by the current congressional Republican membership — are that a public health insurance option would be too costly to taxpayers, would produce agonizing waiting times for patients and weaken individual autonomy over health care decisions, and would be unnecessary because America has the best health system in the world. However, there is ample evidence that strongly suggests all of these oppositional claims are wrong.
Let’s start with the taxation claim. We know that any government activity will cost money, and the government’s form of revenue is taxation. The bill just passed in the House proposes a 5.4 percent surcharge tax applied to all Americans earning at least $500,000 annually, or families earning $1 million annually, according to Lori Montgomery and Shailagh Murray (The Washington Post, Nov. 8, 2009). Conservatives in Congress almost unanimously balk at any suggestion that raising taxes is acceptable, but this is particularly true when, as is the case with the current health bill, the tax increases would be applied to the rich largely in order to provide for the payment of other people’s health insurance. But, as will be shown in more detail, the health care system is failing, and it threatens to bankrupt this country over the long term.
Opposing taxes at every turn and disregarding the entitlement payments (like Medicare and Medicaid) that are bound to rise to completely unsustainable levels in the near future would effectively mean condemning the nation to a permanently weakened financial state. No one complains about the incredible governmental investment of the national interstate system implemented by the Eisenhower administration in the 1950s; well, this was only made possible by the fact that the wealthiest citizens in the highest income tax bracket were paying over 90 percent of their annual income in taxes (as opposed to just 35 percent today, and most exploit loopholes and tax shelters to pay even less). Yet somehow the current proposals for slight tax increases on the wealthiest Americans are met with congressional vitriol.
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The government cannot afford the social programs it has now and you want to add half a trillion dollar program on top of that. We could also talk about the record deficit that we are currently in and have no plans to pay for. The taxes in this country are too high and it is too easy to vilify the rich. They don't need the government taking more, some already have the government taking 60% of their income. These are the people that you want to have income so they can invest it and provide jobs to poorer people. It's called trickle down economics. The fact is you don't have a right to health care and the government cannot afford it.
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60%? Maybe if you have penalties for not paying your taxes to begin with. In 2009, millionaires paid 35%. In Denmark (63%) and Sweden (59%) you are paying that much.
57% of US companies pay no federal taxes at all. Yes, they are investing in poorer workers OVERSEAS.
http://www.reuters.com/article/newsOne/idUSN1249465620080812
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Oh the deficits are not a result of liberal spending programs, but rather trillions of dollars in tax cuts by Reagan and Bush while government spending still somehow increased under both of those Republican administrations. It was never a problem to have higher taxes on the rich until supply-side dogma was unleashed in the 80's. Since then we've seen a terrifying disparity of wealth, over 10 trillion dollars added to the National debt, and a health care system marked by overwhelming financial inefficiency. This isn't fixed by cutting a trillion dollars in taxes and deregulating everything. Bravo to the House of Reps for passing this bill and here's to hoping that the Senate follows suit.
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The numbers you mention are certainly cause for concern, and I don't disagree that reform is needed, but I don't agree that the reform needed is being proposed. One of the largest problems is lack of individual accountability for expenditures. People don't "comparison shop" for the best prices or question potentially unnecessary procedures, and often, it is very convoluted to even attempt to understand what you'll be charged, even if you ask the doctor's office itself. Until there is an incentive for consumers to reign in costs, it's foolish to expect them to go down, unless the government bullies health care providers into artificially reducing prices.
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The single reform which, if enacted, would do the absolute most good for everyone involved (except for insurance companies, but I'll get to that in a moment) would be for individuals to refuse to purchase insurance and instead pay out-of-pocket for all medical expenses. The whole point of insurance is to defray risk among a large section of people - the idea being that you bet that you will wind up utilizing more health care than you actually pay for. That's why insurance companies deny coverage for certain pre-existing conditions - it keeps individuals from draining a system into which they haven't paid anything. An out-of-pocket system is much more efficient because it requires no paperwork, no approval, no nothing - you show up to your doctor, he treats you, and you pay him for his service. You even get to shop around for the best rate! Compelling people to buy health insurance is one of the great crimes perpetuated upon the American people by both the insurance industry and state and federal governments.
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The one big problem with out-of-pocket paying is the malpractice. Unfortunately we live in a sue happy society and the medical bills are much higher because the doctors have to pay crazy amounts to malpractice insurance.
If we can get better protection for doctors and bills can come down then I agre with you 100%.
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High malpractice insurance premiums are certainly a problem, and you are correct to point out that we live in a litigation-happy society. . .but I think the real driver behind increased medical costs is the sheer number of people needed to operate insurance bureaucracies. Physicians now require someone (or more than one, depending on the size of the office) to handle submission of insurance claims, dealing with the companies, etc. And insurance companies have to hire claims adjustors, actuaries, representatives, salesmen, etc. . . all of a sudden, each trip to the doctor's office (when it involves insurance) has to cover the cost of employing hundreds of people.
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In a very timely discussion with my mom, who is an RN for a home health care agency, she told me that the number of people who are employed full-time to work on state and federal regulations compliance is poised to top the number of actual nurses in her small agency. I agree with Kyle's point about refusing insurance, though I doubt it will happen on a large scale anytime soon. Unfortunately, the Health Savings Account option, which is coupled with a High Deductible Health Plan and constitutes a reasonable compromise between carrying extensive insurance and paying solely out-of-pocket, is likely to disappear if the government mandates a minimum level of coverage for everyone.
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Looks like there are only three possible tiers of responses, so I'll respond to Jason here. The basic argument the Obama administration has made justifying mandatory coverage for all individuals (that is, "we do it for car insurance, so we ought to do it for health insurance") is fundamentally flawed based on the fact that the mandatory part of auto insurance coverage is that which pays people you hit for the damage you do to their property and their persons. It's not a preventative insurance; it's there to prove to the other drivers on the road that, if you hit them, you can pay for the damage you cause. Health insurance is totally different - if I get sick, I'm the only one responsible for dealing with it. Nobody else needs to be 'protected' from my potential inability to pay for the medicine and treatment I may need.
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To make one more quick point, the author suggests that health CARE in America is weak based on the particular statistics he provides. However, it's worth pointing out that health CARE is provided by physicians, who are then paid either by individuals or by insurance companies. To suggest that the quality of CARE will improve measurably on account of INSURANCE reforms is a highly dubious claim because the two are only tenuously linked - my doctor's abilities to employ the skills he learned in medical school are wholly unrelated to the place from where his paycheck is coming. What's more, if I understand the legislation correctly, doctors will actually have to accept cuts in their payscales for certain procedures. My last, and most blunt, point is that people who assert that health care is a RIGHT demonstrate an inability to understand what constitutes a RIGHT. I can't walk up to my grocer and say "I'm hungry, so you will give me your food." He has a service he provides, at a cost to me. Doctors are no different - I should not be able to walk up to a doctor and say "I am sick, so you will heal me" if I don't have the resources to compensate him for his skill. Compelling such assistance is nothing more than slavery with a pretty face.
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Ok...
Look, the whole point of this debate is that health is not currently treated as a right but as a comodity, and a lot of people are questioning whether this is fair to the poorer individuals in our society. Proclaiming that health care is not a right simply does not address the issue in any way. Additionally, comparing government controlled health care to slavery is ridiculous. The idea isn't that they aren't paid at all, its that the entire society helps to fund the health care costs of the entire society(through the government), providing a safety net for everyone.
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Whether or not my claim is 'ridiculous' is really contingent upon your view of ethics. From my point of view, it is always wrong for the government to compel an individual to provide a service that he, for whatever reason, does not want to provide. Doctors, lawyers, grocers - it really doesn't matter what skill set or commodity you're talking about, it's never ethically justifiable to compel individuals to make transactions that they don't otherwise want to make. The fact that the government will compensate doctors 'fairly' for their services doesn't really affect the central point of the discussion, which is that the government will compel doctors to work for less than they might have otherwise wanted to work.
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Ultimately, the point of 'fairness' isn't really relevant in any way, shape, or form to this discussion. Our government exists in order (ostensibly) to protect the rule of law, which in a very basic sense means that it makes sure that individuals play by the rules. It has nothing to do with fairness, and it certainly has nothing to do with outcomes - in health care or in any other realm. The fact that some poor people can't afford to have proper preventative care is horrible, to be sure, but is something that can and ought to be addressed by charities and charitable individuals. When the government points its finger at me, though, and says "someone needs this, and you have the means to provide it to them, so hand it over," there's something wrong with that. People have to make choices every day about how they use their money, whether they are rich or poor. It only makes it more challenging to make those choices when the government starts making some for us.
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Sounds like a great idea to steal MORE money from those who've earned it and can help an actual recovery to pay for a program that will make our nation's health worse.
When, if ever, have the government's estimates on cost been accurate?
That's right, never. Costs always increase exponentially whenever the gov't is involved b/c there is no accountabiliy, it's not their money, what do they care.
This is another worthless social program that America as a whole would be much better without.
Other programs include:
-Medicare
-Social Security
-Welfare
These programs are none other than wealth re-distribution schemes and that wealth is being transferred to the politicians and their friends who put them in office.
Repulbican / Democrat, doesn't make a difference.
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Reagan closed hospitals, Bushs' wouldn't deal with healthcare, any reform can't seem to get past media frinzy funded by insurance companies and wealthy republicans. There's a basic divide: insurance companies don't want to pay for the sick, republicans don't want to pay for the poor, and most democrats think basic good health is a right. Opposing interest will maintain the status quo. Our cost will skyrocket; Medicare, Medicaid, TriCare, any government funded healthcare will have to slash benefits and payments to providers--all because we weren't willing to look at the future.
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Stop conflating health insurance with health care. Insurance is a method of distributing risk amongst a population and over time. The basic premise of insurance policies is "if I spend the money to buy this policy, one day I'll wind up pulling more out than I put in, and at that point it'll be worth it." Insurance doesn't provide health care - you can't cure your cancer with an insurance policy. Doctors provide health care, and do so excellently. Insurance actually gums up the works by setting arbitrary price points for the services doctors provide. It makes a lot more economic sense to get rid of insurance in toto and just use a fee-for-service system. Just like you do at the grocery store - if you want bananas, you go to the store and pay for your bananas; if you get the flu, you go to the doctor's office and he treats you. There is, fundamentally, no difference between the two.
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And one more thing - when you say "we weren't willing to look to the future," it's an obvious euphemism for the insinuation that "the rich aren't willing to pay their fair share." First off, I'd like to know what one's "fair share" is contingent upon - I firmly believe that a "fair share" is based on the cost of operating government divided amongst the total populace. That is, if it costs, say, $5 trillion to run the government per year, and there are 5 billion people in America, then each American owes the government $1k. That's a fair share. If the insinuation is that the rich ought to be more charitable, that's fine - but the government is not a charity, and it is ethically unsound to compel people to donate to charities against their will. It's not a very persuasive argument to contend simply that "the rich have more than they need, so let's take what we assess them as not needing and use it for what we feel is good." If that's the point here, then you have advocated for economic socialism - you don't earn money; you create wealth for the government to bestow, or not, upon you at its discretion.
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Let me put this as simply as I can--
A healthty society starts with its citizens.
"and" to the point of health insurance vs healthare; see if the boundaries aren't blurred if you lose your job and lose coverage, and worse have a pre-existing condition. Cost of bananas would rival diamonds.
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well, when the have nots grossly outnumber the haves, this is what happens. they can use their votes to legislate money taken from the haves. its all part of the pendulum of America. once enough people steal money from the haves, the have nots are not so many anymore and lose that voting power. then its back to the hopeless life they had before
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Why is it that NO ONE has brought up the fact that unemployment is higher than uninsured?? Even if you took the government's overstated 45 million uninsured, you're still talking about nearly the same number of people unemployed as uninsured. Why aren't we talking about addressing unemployment??
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Since when has it become acceptable to start a sentence with the word and? This is not the only article which I have seen this used lately. Also, starting a paragraph with this word implies that the writer is not changing the subject and therefore has no need for a new paragraph. I always felt that I was not the best writer but I think that this level of writing is shameful for a college newspaper regular columnist.
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So the placement of one word constitutes an entire article being "shameful for a college newspaper regular columnist"? Hahahaha. You, sir, cannot possibly be serious. Try analyzing content and leave the semantics aside.
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The government can't even get us H1N1 vaccines do you really trust them to run a public option. That's not even getting into the fact the the premiums for the public option would be higher than the private insurers.
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The government doesn't get us H1N1 vaccines, a group of four companies that the government contracted with were supposed to develop them. They failed to meet the deadlines.
I'm against the public option too but use facts to make your arguments.
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This Kyle Minor fellow may be the most knowledgeable and well-thought out person this paper (columnists and commenters included) has seen. It's a shame more people don't spend as much time as he has in thinking about and constructing his points. Most tend to go along with the blind "REPUBLICANS SUCK!" and "LIBERALS ARE EVIL!" arguments.
And another minor point from the article. A hernia surgery statistic was quoted. As a person that has had two hernia surgeries, I can with 100% confidence say it should be an outpatient practice. Unless the patient is of considerable age or has a history of allergic medical reactions, there is no reason why a person would need to stay overnight. Word of advice to the author, next time pick a more serious condition than hernia surgery.
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Thank you Kyle Minor for sharing your opinion of yourself with us.
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