Gerson Echoes Brooks
Consistent with memes given voice in David Brooks’ column yesterday — ref. here and here — the WaPo’s Michael Gerson writes:
It is difficult to imagine that an overwhelmingly Democratic Congress will do nothing on health reform. But as deadlines slip, and moderate arguments gain in momentum, the legislation is likely to disappoint liberal Democrats in several ways. William Galston of the Brookings Institution — who kept an eye on moderate congressional opinion as part of the Clinton White House — predicts that centrists “are not going along with a bill that isn’t genuinely revenue neutral, without tricks.” Taxes will need to be “sensible,” which “takes the House approach (boosting taxes on the rich) off the table.” Moderates, he says, “won’t support a version of the public option that weakens or eviscerates the private sector in the provision of health insurance.” And “there is broad agreement that any bill that is 90 percent expanded coverage and 10 percent cost control would be a disaster in the long run.”
Some may accuse such moderates of lacking in boldness or ambition. It is better than lacking in responsibility and good judgment.
If you care, this “moderate” largely agrees, especially on the points about being “genuinely revenue neutral, without tricks” and “any bill that is 90 percent expanded coverage and 10 percent cost control would be a disaster in the long run.” In fact, my sole material difference with Galston’s summary of the moderate mind is this: I could argue that a modest incremental tax (1% or less) on the genuinely wealthy ($1M plus annual household income) — for something as important as expanded access to health insurance — is “sensible,” although given the choice, I’d probably favor the “Conor Friedersdorf Alternative” over any new tax.
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2 Responses to “Gerson Echoes Brooks”
AMERICA NEEDS HEALTH CARE REFORM.
Ockham’s razor states the easiest solution is usually the best solution…
Is there an easy solution?
COVERING ALL AMERICANS WILL BE PROHIBITIVELY EXPENSIVE AND DOOM ANY HEALTH CARE BILL.
Should we believe the accounting cost stats of Congress or the administration or believe the accounting cost stats of the Office of Budget and Management?
A majority of Americans have shown they care more about the financial success of government than the benevolence of government.
The lesson most of America has taken from California is that extreme benevolence in government will eventually lead to financial ruin of government;
preventing financial ruin is more important than extreme benevolence.
Believers in benevolent government running our daily lives are unintentionally sabotaging any health care bill because of the cost.
When they say ALL Americans should be covered, are Republicans like Senator Judd Gregg of New Hampshire intentionally sabotaging any health care bill because of the cost?
Which Americans could be excluded from the health care bill to make it more affordable?
How about the eleven million or so who are not citizens of the U.S.?
This means the U.S. will have to amend it medical care policy for Americans who are not citizens of the U.S.;
so Americans and American hospitals will not be in financial ruin when they pay for health care;
NOT SO American citizens who belong to ethnic groups that include Americans who are not citizens of the U.S. will vote for a particular political party.
How about providing catastrophic health care, minimal health care for vigorous, affluent, and single young Americans?
Some politicians have said unmarried Americans between the ages of 20 and 30 who make at least $70,000 a year, are the largest and fasting growing group of Americans who are without health care;
this group is also one of the least likely to need health care.
Heck, let's use techniques used by insurance companies for years; let's use actuarial tables and statistics.
More health care coverage for those who need it; less health care coverage for those who don't.
Because of a need to lower health care costs, government-run health care coverage will ration care and lower the quality of health care in America.
Because of a need to lower health care costs and it's problematic that laws to limit “frivolous” lawsuits will be upheld in higher courts,
private health care coverage will also lower the quality of health care in America.
We could possibly see different private medical insurance categories and costs of plans dependent on risk and quality of coverage.
You could have a high or low deductible dependent on your risk factor and desired coverage.
Limiting “frivolous” law suite awards could possibly be contested all the way to the Supreme Court; would that contention be considered “frivolous” by the courts?
SINCE THE SUCCESS OF ANY PRIVATE PLAN IS DEPENDENT ON ELIMINATING “FRIVOLOUS” LAW SUITES,
test cases should be proposed to determine the viability of limiting “frivolous” law suites, now.
What happens if law suite amounts can't be limited? Who could afford the medical insurance premiums?
Who could afford the judgments? Who could afford to pay the health care of someone without medical insurance?
In the past when costs were high, an oligopoly devolved and then the government monitored the oligopoly's “profit taking”.
The oligopoly was a willing participant because the company knew it could make a profit.
It's not as easy to make a profit in the medical insurance field.
That's why premiums are high. Why medical insurance is not as affordable. Why there is a crisis.
We have three choices: Pay for medical insurance ourselves. Most are against that because of the cost, or because someone else can pay for it.
Have employers pay for it: Small businesses say it's too expensive to cover “higher risk employees”, while even more are unemployed in this job market.
Have the government pay for it: The government is willing and able to pay premiums, afford judgments, and pay for health care for someone without medical insurance.
America will have high deficits.
Mistakes will be made as long as doctors are human. Maybe the finest result of the health care crisis is robotics taking over the medical field. Less mistakes, less judgments because of mistakes, and unfortunately, less of a human touch.
Mark Fruehling
Des Moines,Iowa
This is the bottom line on the health care crisis in America as I see it:
Health care has become so expensive that only the federal government can afford it, yet if the federal
government were to take on the debt caused by health care, the federal government and the American people would be greatly weakened.
So, what do we do? We need time that's for sure. Time not to delay and eventually reject any health care bill, but time
to come up with the best bill. The best bill doesn't have to be agreed upon this year (as many Democrats using the politics of fear are saying).
We don't need another moon shot or mission to Mars right now, we need a “mission” to create the best health care program.
Politicians may not be the best equipped to devise this “mission”. Why aren't private insurance companies heavily involved in
this “mission” to create the best health care? Why aren't other private individual “experts” heavily involved in this “mission”
to create the best health care? Why aren't shmoes with active imaginations, like me, included in this “mission” to create the best health care program?
The best bill doesn't necessarily have to be government-run or private but could be a combination of both.
Let the American citizen provide a portion of health care (individually and/or though an employer) and have the government provide the rest.
Should a certain percentage of private health care coverage be required? What percentage should that be?
Should a worker be required to match the contribution of the employer?
Should an employer be required to match the contribution of the worker?
Should tax breaks be given to those individuals and/or employers who provide private health care coverage? No more than now, I believe. Again, we don't want to bankrupt the government…
Unless someone can brainstorm a better way… We need time and research to produce the best plan. Let's solve it, not make it worse.
In the future, the medical field will probably use more robotics to eliminate the costly mistakes of the human doctor.
An emerging new technology?
What is the value of a human life anyway?
It is, and should be high. Should it be so high that we have a health care crisis?
What is the cost benefit analysis on this?
Mark Fruehling
Des Moines, Iowa