Monday, March 22, 2010

Health Care Reform?

The more I procrastinate from starting my Lithium report, the more I keep thinking about how this new medical reform is just going to skyrocket prices for health care and make more people pay insurance companies for coverage. Let me start by saying that I 100% believe we needed a giant change in the health industry. It's ridiculous that America considers itself so high above everyone else, yet all those socialized nations in Europe and beyond have far superior health care systems than the most powerful nation on Earth. What's wrong with our bottleneck political system that can't accomplish anything productive? Are we still such victims of a Red Scare that we can't just copy the most successful and cheapest options that have worked so well in other nations? Why is it so easy for us to spend outrageous amounts of cash to fund far away wars, yet to care for our own people at home, we enter a big mess in Washington and across the country?

From what I can tell, here's what the new bill will dictate. Poor people will be obligated to pay just under 10% of their incomes on coverage, a quantity that seems ridiculous. If people fall into this category, they are at the poverty line and thus not able to afford basic daily needs already and surely can't afford to pull out a tenth of their salaries on insurance -- watch for a continuing divide in our country as bills like this help the poor get poorer. Yes, after 9.5% the rest of their health costs will get subsidized, but health costs are still way too large a portion of their incomes to mandate coverage. On top of all this, the people actually below these earning amounts, more than 30 millions Americans, still won't be covered. Maybe this is getting lost in translation with the whole Spanish/English thing while I'm in Bolivia, but does "Universal Coverage" mean "everybody but the 30 million poorest?" It reminds me of "all men are created equal"...except for black slaves (-- maybe an extreme comparison, what I'm getting at is that "Universal" and "All" are not as encompassing as they suggest.)

Now let's look at the middle class. Insurance premiums for middle class brackets are expected to increase. If you don't qualify for subsidies and your work doesn't buy an insurance plan for you (which will be a continuing trend to cut costs now that marketplace options are available), middle class and self employed persons will see their health care premiums jump 10%-13%, according to the Congressional Budget Office estimates. This sounds like the opposite of reeling in health care costs and border lines a gift to insurance companies -- no caps on premiums nor on what insurance companies can charge, plus these giants now will have the security knowing that more people have to sign up and pay higher fees for coverage. If I was in the health care industry, I would be popping open the champagne and celebrating around the office. This is a guaranteed pay-day.

If any of you have the answers, please help me understand this. I hope to God that I am missing something big in what I've been reading, but I still haven't seen anyone say anything about how this will curb costs in the medical industry. To me, this sounds like a big handout to everyone involved in medicine, without any real benefits in costs.

The Republican propaganda push long ago killed any possibility for a government sponsored plan, which would have competed insurance prices down and lowered costs (by not having to pay out profits to private investors) and would have been self sufficient after the initial investment. In turn, without any real change being made, the American people settled for a convoluted bill that will result in failure to achieve its original goal -- diminish health care costs, which for some reason has been ignored in the recent discussions. The focus of conversation has also been shifted away from universal coverage, because this bill also fails to accomplish this goal. Yes, as a political battle it looks good that Democrats finally won something -- finally. And yes, this plan started with the best intentions
.

As I have always argued, I don't see what positive effects an overhaul looking like this can actually have without any market based incentives to lower costs or without sweeping government guarantees for universally expanded and superior coverage; this just prettily rounds out some minor details on the periphery. Other than the meager inclusions of slightly expanding Medicare and Medicaid, does anyone know what health overhaul will actually accomplish? Are any preventative health measure included in the bill (taxes on junk food, subsidies for healthier eating, or increased incentives for people to stay active)? What are the market incentives to lower costs? Will a "marketplace" really encourage competition? The insurance industry is already a powerful oligopoly who will most likely pass any newly added costs onto the consumers. With an industry structured as such, companies don't need to collude to know how to manipulate the market -- they're all statisticians who are masters of game theory -- openly transparent listings can only help facilitate this. The month Obama was elected, prescription drug prices jumped 10% in response to the President's threat to restrict future price increases. These restrictions aren't in the current bill, but the prices haven't dropped to previous levels. Do any of you think that it's a coincidence that the prescription drug companies support the current bill? Where are the price controls to keep this mess contained?

If any of you can enlighten me and inform me of the benefits of this plan, I dearly hope that I am missing some big chunk of the discussions from this the current round of health reform. From afar, it only seems that congressmen have stipped down the bill so much that it only contain the least offensive clauses (thus having dropped the largest reforms) so as to make every private interest happy. Please tell me that I'm wrong and that Obama's health care plan will change the country for the better. Right now, I'm afraid that the current distractions will cause the public to settle for this "sufficient" option without ever addressing the true shortfalls of our country's health care system.


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2 comments:

Anonymous March 28, 2010  

hey greg, hope youre doing well. i like your insightful comments. one thing that does encompass "preventitive medicine"in the recent bill was the mandate for fast food restaurants to post caloric content of their foods. of course this still relies on the consumer to make the better decisions, and might not be as effective as an economic tariff on bad food, but is definitely a welcome start, in my opinion.
-Tim

Nathan J. Randall March 30, 2010  

They're also taxing tanning salons. There go my plans to look gorgeous before this summer...

Here's an article, if you're curious.

http://money.cnn.com/2010/03/24/news/economy/tanning_tax/