Tuesday, September 16, 2008

The Wizard Analyzes: Health Care

One week ago I promised to take a close and honest look at the seven issues most Americans think are most important this election year. For all you who actually think the big issue is Sarah Palin's tanning bed or Joe Biden's rumored ability to become invisible, you are about to be sadly disappointed.

We need instead to pick our next President on his proposals on the major issues and his ability to actually implement those proposals.

I will look at all the following issues between now and November 1st: [1] Health Care, [2] the Economy, Taxes and Spending, [3] Education, [4] Iraq and Afghanistan, [5] Environment, [6] Civil/Women's/Gay Rights and finally, [7] Style of Governing.

Today I'm looking closely at Health Care for two reasons. First it's the easiest to pick the best plan and candidate. Second, it's the single most important issue facing most Americans today.

I cannot possible analyze the two competing plans in 750 to 1,000 words and, no matter what I write, many will disagree with my conclusions and say I've misrepresented the facts. Good! Let's have a real debate on the issues.

I know this will be hard for you all to believe, but there are some real reporters working on this issue. Be sure to read these two articles: Reports criticize Obama, McCain health plans and New Studies Report Wide Disparity in Health Care Plans

Health Care and Health Care Insurance in America are both seriously broken. Costs are completely out of control. I personally was in an Emergency Room in Atlanta for 5 hours last spring. No major surgery or major tests were involved. I was released and was, thankfully, alright. The bill was (and I an neither joking or exaggerating) $17,000.00.

Any serious illness means almost certain bankruptcy for any American, even if they have health insurance. But 46 million Americans have no health insurance. These folks are clogging Emergency Rooms and further driving up health care costs. And they receive substandard care. A level of care that all too frequently means death.

To summarize in a sentence or two, Obama wants a rather complex layering of health care plans that would be coordinated by a huge federal bureaucracy. McCain would replace the current tax exemptions for employer provided health care plans in favor of tax breaks for every citizen.

On a simple or even a detailed reading, McCain's plan would seem to make more sense. Except it will never work. McCain might be on the right track, but his plan will never insure virtually any of the 46 million currently uninsured. His economics fall apart for all middle and lower income families. And independent analysts agree. McCain's plan would likely make matters much worse, not better. In fact most Americans might actually lose benefits.

Barack Obama is really on the right track. By most all independent accounts he would cover an additional 34 million people. It doesn't get us to universal health care, but it gets us closer. Obama's problem is that his plan is so expensive it cannot be sustained. He will need to simplify the plan and reduce it's scope. But it will help and it's likely to be implemented.

In my opinion, if Health Care is the deciding issue in determining your vote, you should cast your vote for Barack Obama.

But, there are six more issues to discuss.


shoo said...

The real problem with health care is costs, not who does or does not have insurance. In fact, insurance is a large part of the problem.

Consider all medical procedures not covered by health care: the have consistantly both improved and gone down in price over the years. Things like cosmetic surgery, vision correction, and orthodontics.

When insurance pays for things, people do not care about the costs, because its not their money. When people spend their own money, they will make appropriate value decisions.

At one point I had a MSA: that was awesome. To insure my entire family would have cost about $6,000 for full coverage, or $3,600 for a $3,000 deductible policy. That difference of $2,400 takes care of most of the deductable. If I needed $3,000 or more in health care, then it was about break-even. If I used less, which I almost always do, it was a huge win, because I got to keep the money I didn't spend in my MSA.

If everyone had MSAs, they would be spending their own money, and health care costs would drop dramatically.

The 46 million uninsured is a huge overstatement. A huge amount of that number are illegal aliens. Another huge amount are young people who can afford insurance, but choose not to get it (I did that for a few years too when I was in my 20s). This leaves a much smaller number who are actually uninsured.

I would be all in favor of a food-stamp like program to help out the low income people so they would have some minimum level of insurance.

We also have a serious issue with people without insurance going to emergency rooms, because by law, the emergency rooms have to treat them. The laws involved are really stupid. They should be able to go to medical clinics or private urgent care facilities and be treated at a far less cost.

Bob Keller said...

shoo You are a breath of fresh air! What a pleasure to have you contribute here and to read your blog (which I recommend to everyone).

Your analysis is really insightful. Congress could easily do things at no cost what-so-ever to the taxpayer that would help solve the problem. And, you are also correct in pointing out that virtually every consumer controlled cost has dropped except insurance covered medical care, which has skyrocketed.

But the problem is much harder to solve than simple MSA's or McCain's tax credits. The bandaid approach we've followed for the last 16 years (Clinton and Bush) isn't helping. It's making matters much worse.

One of the two articles I linked pointed out that neither plan would probably pass Congress. That is also a big part of the problem. One of the issues I'm discussing soon is style of governing and ability to get things done.

Unknown said...

Wizard, possibly you should amend your Obama choice with 'none of the above'

Although, that kind of side steps what your attempting...

My understanding that Tort reform is needed as well, I have not heared that being addressed.

Wiz-ziW said...

As technology drives the cost of "Walmart: goods and food down... that leaves more money to chase health care (and housing, etc). This drives prices up.

More dramatically, technology continually invents more very expensive techniques. The growth is progressive.

Finally, every time we save a life -- and we are getting a LOT better at this -- you know we will need more health dollars in the future.

This is counter-intuitive, but, the rising costs are great news! I mean, you could get 1970 level care at a very reasonable rate.

Now, what kind politician could deliver this message? I guess maybe a retiring politician. But take it from me: health care costs are going to go up and up and up... and its a good thing.

The best plan allows for the fastest progress. What the rich have today I'll have tomorrow. Its awful that some will die when they cannot afford something, but since technology is exploding with great new expensive techniques, the only cure for this would be to stop technology. If you limit profit, you slow technology.

That's my 2 cents