Thursday, July 16, 2009

Paying for Health Care Revisited – Real Choice Will Come When We Decide to Pay For It

Yesterday, in a post regarding the proposed House health care bill, I argued in favor of the bill’s payment structure.  Specifically, those making $500,000 or more annually should help pay for it.  I stand by my words, because I don’t think that somebody making that kind of money will loose their standard of living by kicking in $1,500 a year into the health care system.  Having said that, these taxes on the rich shouldn’t happen just because of health care.  They should happen on principle.  As I’ve said many times, they were doing just fine before the Bush tax cuts, and I’m confident they won’t end up like Sanford & Son when they’re rolled back.  Sadly, Congress flinches every time it comes up because they’re owned by those who have.  So there you go.

But I digress, sort of.  The truth is, if we want true choice in this country, then we cannot put the burden on the rich.  As I understand it, the House bill does not have a true public option.  The plan will insure those under a certain threshold, but folks like me, making a certain amount and have employer provided benefits, will not have that choice.  After the smoke clears and a bill is passed, I’m willing to bet that nothing will change for me.  This is because the bill asks 1.2% of Americans to foot the bill.  If we want a viable choice, that will lower costs and provide good care, then we all need to pitch in.

Here’s how I see it.  I have enrolled my family, me, my wife, and my daughter, in an HMO, provided by my employer, that costs $198.00 a month.  The same plan for an individual costs $48.00 (so much for a bulk discount).  There are just over 300 million people in this country, roughly 50 million of which do not have health insurance.  For my example, I will leave those 50 million out, and figure that 250 million people will be taxed on health insurance.  Multiply $48 by 12 months and multiply that by 250 million and there will be $144 billion exclusively for health care per year.  Take that out 10 years, and we have $1.44 trillion, which is more that the estimated cost of the $1 trillion House bill.  I should also mention that my employer offers a less expensive HMO, which runs $35 per month for the individual.  Using the same numbers as above, the country would make $1.05 trillion over 10 years.  House bill is paid.

The above assumes that everybody is in on a single payer plan.  Sadly, we’re not going to get a single payer plan this go around.  There’s just too much money working against it.  The way this is working out, there will be “universal coverage”, in the sense that everybody is covered, but there isn’t a choice.  Therefore, the insurance companies have won.  Everybody with employer provided benefits will continue to be bound to private product.  However, if there was a true choice, and I could either put my $48 towards my current plan or a public plan, then we would see real changes in efficiency, costs, and care.  Ultimately, I think we’re moving in the right direction.  That said, don’t be surprised if we’re right back here arguing for more choice in 10 years. 

Let me ask, how much would you pay for a plan that allowed you to walk into any hospital, or see any doctor, without the fear of out-of-network penalties?  How would you like to get treatment or tests without having to call and fight with administrators who’s job requires them to stop you from having that procedure at all costs?  How would you like to have a necessary procedure without fear of future bills and costs?  Those of you with pre-existing conditions, would you like to be insured?  What are these things worth?  $35 a month?  $48?  $50?   

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