Wednesday, January 27, 2010

True health care reform

As I have written before, Obamacare is not about health care but all about expanding the scope and power of government. The reason why most Americans rejected Obamacare is not because they don't favor reform. They do. They are just smart enough to realize that the government mismanages all its enterprises. They all lose money. Why turn one's health care over to the folks who lose $7 b a year on the post office, who lose on Amtrack, Medicaid and have bankrupted social security. No Americans realize that the government will turn what some think is a bad system to one that is worse and costs more. Americans did not oppose adding 30 million more people to the insured rolls. However, they were opposed to having to pay for the insurance of those 30 million people. So what can be done to improve the system? There is a role for the Federal government. The first is to do something akin to the Reigel-Neal interstate banking act, which removed the barriers erected by the states on interstate bank branching and acquisitions. Removing the barriers erected by the states to prevent competition in health care insurance would mean that policies could be transported across state lines when a person moves, It would mean that a person in one state could buy a policy offered in another state. States should remove all mandates from health insurance policies. That would allow persons and families to craft a policy suitable for them rather than being forced into higher cost one size fits all policies. There should be a nationwide tort reform law. Texas has shown that when there is tort reform, then doctors move in to provide services and costs are lowered. There should be a nationwide pool for those with pre-existing conditions. Those in the pool sould be able to purchase insurance and the pool policies should be subsidized by the federal government. Lastly, one item that is the elephant in the room is that no one address the problem of emergency room use and nonpayment. Lets be blunt. Health care is a good and going to the emergency room and not paying is nothing more than stealing. One would not be allowed to walk away with a TV without paying for it. The same should be true with health care. Since the Feds will go after you like a junk yard dog if you don't pay your income taxes, it should go after health care scofflaws with the same vigor. Just like with delinquent taxes, the terms of repayment would be worked out. Do all of this and costs will come down. Since this makes so much sense there is no hope that any of it will take place.


Michael Kirsch, M.D. said...

We saw the same thing in Ohio. When tort reform was passed, skyrocketing malpractice premiums cooled and physicians stopped leaving the state or retiring. For a physician's perspective, see under Legal Quality.

John in KY said...

Seems to me that this year of talk about health care has been useless. Even if we don't pass a bill, the unfunded liabilities coming due to the retiring baby boomers will bring down the economy eventually anyway unless we can produce more. An American future without the return of manufacturing businesses, seems to be headed for the same debt disaster. My opinion is that if we don't get a plan like the Fair Tax, that takes almost all taxes off of businesses, to incentivize the return of MOST of the lost manufacturing jobs, the end result will be the same. The only question left is when. What are your thoughts on the Fair Tax ? I asked my tax preparer her opinion and she had it confused with the Flat Tax except she realized it would put her out of business .

H.A. Black said...

John, I have written about the flat tax versus the fair tax before. Essentially I don't care for the fair tax since it is a VAT and often hidden. I want people to see explicitly what they pay for their government. I actually think a flat tax with no exemptions is "fairer" than a fair tax with its exemptions and exceptions. It all paid a flat tax on all income as the price of citizenship, the poor could get support from other programs and not through tax breaks. Everyone would then have a stake in America.