The polls show a clear consensus in America. Our people want affordable and available health care. Our people also don’t want the federal government operating the health care system and deciding who gets what services.
The two major parties differ in their approach, as we have seen over the past few months. Even the House and Senate differ. In Pennsylvania’s 15th District, the three top candidates also differ in approach to some extent. We know from the statements of Jake Towne and Charlie Dent where they stand. We infer it from the association of John Callahan with SEIU. In a continuum from “Don’t Get Sick” to “socialized medicine,” the three men probably rank in the order I have listed them.
In a press release this week, Towne made his position clear. The release states:
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“Jake Towne, independent candidate for US House in Pennsylvania's 15th district, signed Club for Growth's Repeal It! pledge to sponsor and support legislation to repeal any federal health care takeover passed in 2010 and instead sponsor true reforms that lower the cost of care without growing government.
Towne points out that Medicare is insolvent with $85 trillion in unfunded liabilities and Pennsylvanians are already taxed far too much by DC -- in addition to the state mandates that contribute 15-40% of each premium. “Government-run health care is an unsustainable idea and is an erosion of personal freedom. Health care is much too important to be run by the government. The services and products that are most abundant and affordable in America are those that are produced and exchanged in a free market. We need to return control over health care back to the people, instead of granting state-sponsored monopolies to the insurance lobby like the HMO Act of 1973 did.””
Towne has pledged to not enlist in the elite congressional health care plan, and will only accept the median household income for a salary. The remainder of the $174,000 salary will be donated to local non-profit hospitals.
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A Towne supporter who frequently comments on my columns wrote earlier this week about not wanting to pay for the health care of others. That probably sums up the extreme in the debate. There are those out there who don’t want any of their money paying for the health care of others. This goes beyond not wanting to subsidize health care for the illegal aliens or even welfare cheats and says that the working poor or those holding down three part-time jobs with no enefits need to fend for themselves.
There are those who simply believe that, yes, government should help remove barriers that inflate costs and pursue tort reform that drives up cost, but beyond that health care should be free market and you should get what you are able to pay for on your own. They will point out that there is no U.S. Constitutional right to health care and they’d be correct. It is not a right that we derive from the federal government but one must question if it isn’t a right we derive from civilized society.
A bit more toward the middle, Charlie Dent has supported tort reform and rejected government socialized medicine in the form of the public option. He has favored interstate competition (which I think does very little to drive down costs). He also has endorsed an end to pre-existing exclusions and he would support a state-run high risk pool like we see with automobile insurance where high risk people can get affordable coverage. Like most on the right, he’d make self-purchased insurance as tax advantageous as employer-provided insurance. It is crazy that the tax code drives employers to make insurance available via tax advantages. Make it deductible to all.
The Dent position, which is pretty much the moderate Republican position, addresses availability of health care. The elimination of pre-existing condition exclusions is the major part of that concern. Many who cannot now get health insurance would in theory be able to, so long as they can pay. What it does not do as well, as it must, I believe, is address affordability. Making health care available means nothing if it isn’t affordable. There are several 7 series BMW cars on the lot. They are available. They are not affordable.
Even if we drive out costs with tort reform and interstate competition and even if we eliminate pre-existing condition exclusions, health insurance will still cost the average person several hundred dollars a month. For many, that is not a possibility.
And it has nothing to do with being lazy and not wanting to work. Put in 40 hours at an $8 an hour job and tell me how you afford health care or health insurance.
We get back to the fundamental question of whether government should make health care affordable for those who cannot otherwise afford to pay. This is not the same as saying that government should take over health care or run the medical system. That is where the Democrats have failed. They go beyond what is needed to make the system available and affordable for all and seek to create yet another federal government program that will be bloated and inefficient. It is no wonder that the SEIU supports it and by implication so does John Callahan.
It isn’t the answer when a majority of the population opposes the “public option.” Remember the polls paint an interesting picture. They show that a majority want to see everyone be able to get health care but they don’t want the government to run the system. We couldn’t manage a few hundred thousand cars under cash for clunkers, how could the government manage the billion or more claims a year for health care.
When you talk to people who support the public option, you learn that they don’t necessarily think government needs to run health care. They support the option because it promises to make heath care affordable to them. They favor it because they think that coverage will be greater and fairer without arbitrary insurance company denials. They favor it because they trust insurance companies even less than government.
It is possible to meet all of these concerns without the specter of the public option.
So, it still appears as if the American public (or at least me) is squarely between the two parties and the two extremes. Meaningful health care reform will require both sides to move.
The right has to accept the role of government in assuring access of all Americans to health care. Yes, it is not an enumerated right. Nor is public education. The same arguments were made against public funding of schools some two centuries ago. Today, we accept public education (run by the states) as a given.
I think most Americans also accept the fact that those who can pay for health care should and that the government has to step in for those who can’t. Yet, we don’t want a system of socialized medicine for all.
For those who don’t accept it and complain of subsidizing others, I suggest that is the price of civilized society. Get over it. Get over the greed. Accept the fact that in our society some redistribution of wealth must take place. I can see that even though I favor a free market and I am a Republican.
The Democrats have focused on the end-result better than the Republicans by focusing on making health care available to everyone regardless of financial means. Where they may have failed was their focus on the delivery vehicle---the much-maligned public option. The opposition in their own party to government-run medicine shows this.
The experience in England shows the problems with fully socialized medicine. Our own experience with emergency room abuse shows what happens when the patient has no skin in the game. An efficient health care system requires some financial contribution even if it is just a token co-pay and disincentives for use of expensive emergency rooms to replace a family doctor. Of course, many people do that today because the emergency room must take them and they don’t have insurance for a family doctor.
So, once we accept that everyone should have access to health care regardless of financial means and we accept the fact that we don’t want government running health care; the solution is clear and requires both sides to move.
I suggest looking at the Dutch system (if my Dutch reader still reads this he has convinced me). You require everyone to have health insurance (and as with car insurance, I’d make provision for those who can financially self-insure and just want a catastrophic coverage policy). You have very strict standards as to what can and cannot be excluded from coverage and the insurer prices according to those standards. For people earning below a certain level, you subsidize the cost of the insurance through the payroll tax or other means.
It is, in the word of the Towne supporter who comments a transfer of wealth but then so is all government. The school tax transfers wealth from those without children to those with them. Those who don’t use police services subsidize those who do. To the extent not paid for by fuel taxes, non-drivers subsidize the roads that drivers use.
What makes us a civilized society is that we take care of the less fortunate. Just about every civilized society does so in the provision of heath care.
If we strictly define coverage and require insurers to honor that coverage in order to do business, we can eliminate the concern that insurers simply deny claims. Put teeth into it and allow licenses to be pulled if claims are denied in violation of the black letter of the policy. We also put payment administration and price negotiation in the hands of those who are good at it, the insurers.
Most Americans, an overwhelming number, favor private insurance. They just fear the cost and the denial of claims. Address those issues. All candidates need to move toward the center on this one. They have all missed the bull’s-eye.
But doing nothing is not an option in a caring society. Far too many are uninsured. Far too many have ailments that go untreated at an early stage out of fear that they will establish a pre-existing condition. Action is needed. The Senate bill doesn’t go far enough in some respects. The House may go too far. What it will take for the perfect compromise is for the Democrats to drop government-run medicine and the Republicans to accept the basic human dignity right to health care. Once we do that, a solution will be easy. Meanwhile as politicians posture, people suffer.
Comments
Thanks for the post. "Most Americans, an overwhelming number, favor private insurance. They just fear the cost and the denial of claims. Address those issues. All candidates need to move toward the center on this one. They have all missed the bull’s-eye."
Well, the bull's eye is no government involvement in health care beyond addressing fraud, and that does mean private insurance, so I think we are in agreement. Here are the proposals I have, feel free to comment:
1) I would introduce tax relief legislation to allow individuals and families to reduce their federal income tax nearly dollar-for-dollar by the amounts they spend out-of-pocket on private health care premiums.
2) I would seek to remove the insurance state portability barriers that Congress has erected to protect the insurance cartels and raise costs.
3) I would seek to provide a sound currency to halt rampant price inflation, so health care costs take up a smaller percentage of household income.
4) I call for the state legislatures to remove state mandates that add 15-40% to Pennsylvania's health care premiums, and to pursuit tort reform to reduce the costs of defensive medicine.
5) I would introduce a bill to suspend the obligation of individuals suffering from terminal illness or cancer to continue paying the Social Security tax on their income.
6) I would introduce a bill to reduce federal income taxes dollar-for-dollar by amounts spent out-of-pocket by parents for their children with terminal illnesses, major disabilities or cancer.
7) I have pointed out the dangers of state restrictions - via licensing and restricted seats in the medical school system - artificially restricting the supply of doctors just when the baby boomer explosion will need them the most.
8) Supporters of mine have also sent in great ideas such as Health Care Sharing Ministries that voluntarily pool risk.
towneforcongress.com/economy/health-care-solutions
Affordable health care for all is the goal; this Obamacare is not the answer -- it is based on tainted and corrupt politicking. There is now more openness to starting over, even among a few Democrats who want to be transparent, and do the right thing. Dump this crooked bill, and work on issues important to Americans in a transparent respectable manner; otherwise this mess can only create more greif.
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