Healthcare in America
Healthcare has become my great white whale over the past week or so. It seemed so simple at first, dash off a quick column about the need for a single payer system to bring the United States up to par with the rest of the industrialized world and then move merrily along to my thoughts on Rudy’s chances at the Republican nomination. Then, like Ahab, what seemed like a run of the mill fishing expedition became an intractable dilemma, that dilemma became an obsession.
The problem with me for writing about healthcare in America is the numbers. At its core, the healthcare debate is all about numbers. Virtually all Americans realize that a system that will cost 20% of our GDP by 2010 and yet provides mediocre care at best for most of our citizens needs to fixed. We all know that there is something not quite right when the richest country in the history of the world is unable to provide basic health insurance for 47 million of its citizens. In short, the systems is broken and needs to be fixed, but what happens next?
Well if you are the President, and if you are you really shouldn’t be wasting your time reading my opinions, then you think the problem can be solved with capping malpractice awards and healthcare savings accounts. Setting aside for a moment that doctors make hundreds of thousands of mistakes every year, not a few of which wind up in serious injury or death for their patients, the fact is that malpractice insurance accounts for less than one percent of the annual increase in healthcare spending is meaningless to you. Also, the fact that one needs to have money to put in their health savings account is lost on you as well. Generally speaking, the administration’s ideas on healthcare are much like their ideas on most things, useless and possibly harmful.
So what is the answer? I’m not sure, but it seems to me that there is one entity in this country that has the scope and experience to provide a basic healthcare option to all of its citizens. The United States government has massive purchasing power that could literally dictate prices to healthcare providers and drug manufacturers. The administrative costs for Medicare run on the order of 2% of its budget, making it far and away the most efficient insurer in the country. So I would think that the obvious answer is national health insurance.
“But wait,” you say, “Won’t this mean my taxes will go through the roof?” Well they will probably go up if national health insurance is implemented. But since the average premium for a family of four is nearly $12,000 a year, split between employers and employees, taxes would have to go up quite a bit before it actually cost more to cover everyone in the nation. For instance that $12,000 premium amounts to a 12% tax on someone earning $100,000 a year. It accounts for a nearly 24% rate if you earn $60,000 a year. From the plans I’ve seen the tax rate would be in the seven to ten percent range for universal coverage. So national health insurance for all would actually cost less than we are currently spending.
If nothing else it is time to have a real debate on national healthcare Let’s get all of the pros and cons on the table and make a decision based on reason and fact, not half-baked assumptions and fear.