The federal government, including both the crony capitalists and the progressives, has made a mess of our health care system. In the private sector, premiums and deductibles are rising. Employers are dropping coverage. Health insurance companies are canceling both individual and employer policies.
In the public sector, Medicare enrollments are increasing as the baby boomers retire and more people than ever are becoming disabled. Medicaid enrollments are also increasing as more people are out of work and taking lower paying jobs.
In Georgia, Medicaid is not expanding as much as in some other states. This is because, to date, Governor Deal has joined 21 other states to make the courageous conservative decision to save taxpayer money by refusing to participate in the Medicaid expansion of ObamaCare.
The expansion advocates criticize this. They say that by not participating, Georgia will lose almost $5 Billion and 650,000 eligible people will not get coverage. There have been protests at the state capital and Democratic state legislators are proposing legislation to force the expansion.
Governor Deal is proposing to alleviate some of the problems by the state giving increased monies to charity hospitals like Grady Memorial.
1. The stepchild is the five percent of free market medical care. This is where individuals own their own health insurance policies and pay for most of their routine care out-of-pocket.
2. The 1000-pound gorilla is the 49 percent crony capitalist system of job-based health care. It enjoys tax subsidies and this gives insurance companies unhealthy profits.
3. Many believe that the goal of progressives is to move us to a single payer system. This is where government pays the private providers. Today, the government through Medicare and Medicaid pays for 29 percent of health care.
4. The final sector is the 16 percent of uninsured. This sector is driving the health care reform movement.
The private sectors of free market medical care and job-based health care is decreasing while the public sector and the uninsured are increasing. What does this mean?
It means the progressives are winning. Conservatives at the national level respond by advocating national laws to allow individuals to purchase health care across state lines. This is fixing the problems that government caused with a Band-Aid. They also advocate malpractice reform at the national level. This abandons the principle of federalism.
What should be done? For starters, conservatives need to develop a policy to move the private sector from the crony capitalism of job-based health care to individually based medical care. The problem started with tax subsidies to job-based health care in World War II.
Ending these subsidies would create a tax hike so further adjustments in the income tax codes would also be necessary. Of course, this just further complicates our byzantine income tax codes. Another solution would be to end the subsidies by ending the income tax. This would give job-based and individually based insurance the same tax treatment. It would also give out-of-pocket payments the same tax treatment as insurance premiums.
Another benefit is that replacing the income tax with a consumption tax would allow workers to get all their pay and save tax-free. Increased savings would allow individuals to pay for more easily pay for more of their care out-of-pocket. This would give patients more control of their health care choices.