RSS Feed MenuAs healthcare passions rise, let’s keep in mind reforms that Republicans and conservatives can and should support. Here’s my (non-exhaustive) list:
* We should favor national health insurance exchanges to permit the self-employed to buy insurance with untaxed dollars, just as employees do through their employers.
* We should favor the creation of non-government health cooperatives – provided that they truly are non-government, i.e. no government subsidies and no government guarantees. More Blue Crosses, yes; a healthcare Fannie Mae, no.
* We should favor the creation of government bodies to compare the effectiveness of different healthcare practices. It really is true that some doctors and hospitals spend radically more than others without getting better results. The government has supported such research in the area of agriculture since 1914 without plunging the US into death-dealing totalitarianism.
* We should respond to proposed new federal insurance regulations on a case-by-case basis.
For example: We should oppose federally required community rating (although of course insurers should be free to adopt community rating themselves if they wish). Community rating destructively forbids insurers to offer incentives for healthier behaviors, and it can price younger workers out of the insurance market.
On the other hand: The practice of imposing a “lifetime cap” on health coverage is outrageous and should be banned. The idea that a cancer patient might be told by an insurer: Sorry, we’ve reached our limit, the rest of the cost falls on you, violates the very purpose of insurance and exposes Americans to intolerable risk and fear.
* We should work where we can to move away from employer-provided care to individually purchased care that can follow the insured person from job to job. Extending the length of COBRA benefits could be a good way to start, but the health care exchanges are likely to be the ultimate answer.
* We should demand tort reform and medical malpractice reform. As the Senate Finance committee’s white paper notes:
Medical malpractice insurance premiums have risen steadily over recent decades, at times increasing an average of 15 percent a year. Some states have seen even more dramatic increases. Pennsylvania, for example, experienced increases ranging from 26 to 73 percent in 2003.
* We should endorse the Obama administration’s plans to shift Medicare away from fee-for-service medicine to payment-by-the-case and to seek other money-saving reforms within Medicare.
* We should of course fight against any so-called public option. Direct government provision ought to be the conservative red-line; No deal at all is preferable to a deal that includes a bigger government entry into the insurance business.
barker13 // Aug 11, 2009 at 2:29 pm
Re: Jim Pier // Aug 11, 2009 at 10:09 am (#45) –
“Just as we have cops to keep us safe, we need a health care system to keep us healthy.”
OK…
So my village has X cops on the payroll making anywhere from ABC to XYZ per year plus benefits, retirement, etc.
Town cops… we have Xa number making… (blah, blah, blah…)
State Troopers…
County Sheriff’s Deputies…
…and so on and so forth across the board.
Here – quick and easy as an example:
http://wiki.answers.com/Q/How_many_police_officers_are_employed_in_the_United_states
So let’s say 800,000 cops. (*SHRUG*)
(Then of course we have as “back-up” the national guard… ultimately the military… we have Homeland Security, the FBI, U.S. Marshall’s Service, Secret Service…
In other words we have quite a few (*SMILE*) folks directly employed by local/state/federal government who have either a badge and a gun or a patch and a gun. Right…??? We’re all on the same page?
So… what’s gonna be STARTING SALARY for a “government doctor” – employed by the government just as a cop is?
Hmm… and are we gonna have ONLY “federal doctors” or are we going to have “village doctors, town doctors, county doctors, state doctors” and if so which governmental body is responsible for paying each of these (plus benefits and retirement)?
A brand new cop can start as low as the “teens” (under $20K) in some small poor localities in poor states… what are we gonna start his doctor “employee peer” at?
At the other end of the scale with overtime a cop/detective can make a couple hundred grand a year in Suffolk County (Long Island, NY) if memory serves.
So… what are we gonna pay a senior surgeon working for “the government” in the same local?
How many doctors will be employed by the federal government when we change the healthcare system so it looks more like the policing system?
I’m pretty sure we have something like two and a half million doctors practicing in the United States. What’s it gonna cost to put ‘em all on “the payroll?”
Nurses too…??? (I mean… makes sense, right…???)
In fact, I suppose if all doctors are going to work directly for the government everyone in the medical field should become a government employee… right…???
I don’t know, Jim; I’ll go back to reading your posts, but this whole comparing the provision of healthcare to the provision of policing seems a bit… er… problematic.
(*WINK*)
BILL
barker13 // Aug 11, 2009 at 2:57 pm
Re: Jim Pier // Aug 11, 2009 at 10:09 am (#45) –
“I believe what we need to be doing is forcefully and persistently making the case that the reason the US health ’system’ is on an unsustainable path is NOT because of the little bit of free enterprise that has survived thus far, but because of the massive distortions that have been introduced and have metastasized through government interventions beginning with WWII employer-provided health insurance incentives, then accelerating with Medicare/Medicaid, and perhaps most significantly the pervasive regulation of the health insurance market which grossly inflates the cost of coverage and so bastardizes the market the the product cannot accurately be called insurance. Any solution that fails to eliminate these interventions, and particularly one that introduces even more, can do no more than prolong the long, painful decline of the quality of US health care products and services, and the long, painful increase in the relative costs of the ’system.’”
OK. So you ARE on the right side of the debate!
(I gotta admit… you had me all confused, Jim! I must have misread your RESPONSES to something Sftor1 or someone else wrote to be what YOU believed. That was the context of my #51 comment.)
“What is needed is the very same thing that works everywhere else – food, housing, clothing, transportation, communications, etc. – and that of course is the free market.”
Exactly the point I keep making on all these health insurance/health care threads! Yes… a social safety net must be provided… but the MAJORITY of health insurance/health care provision simply CAN’T be nor SHOULD it be “provided” as a sort of social welfare program – either directly or through tax code subsidization.
“It bears noting that the US has generated by far the greatest number of advances in treatments, procedures and medications for decades, advances possible only because of free enterprise — a fantastic gift to the socialized-medicine world that cannot generate similar innovation but happily adopts it once the US has paid for its development. These advances have contributed immensely to the improved quality of life enjoyed thanks to Western medicine over the last 60 years or so. It is highly unlikely that this leadership would survive a significant shift further toward socialization.”
Yes.
YES! YES! YES!
Jim… thank GOD you’re here…!!! (*GRIN*)
“…“47 million uninsured!” when the number in question ought to be closer to 12 million.”
(*THUMBS UP*)
“We conservatives need to get away from the concession that health insurance is something that by rights ought to be provided by fellow citizens through taxes. We ought to call Medicare what it is, a welfare program. And we ought to challenge the notion that somehow it is the free market that is responsible for the high and accelerating cost of health care in the US. This notion is the opposite of the truth, and we are doing the nation and the world a disservice to permit the left to get away with that characterization.”
http://www.youtube.com/watch?v=-yWCzhhpZ2c&feature=PlayList&p=2360F9634CA6D85D&playnext=1&playnext_from=PL&index=53
God bless Jim… GOD BLESS FRANK!
Thank GOD… someone besides me finally GETS it!
BILL
Brian Lilley » Blog Archive » The Great Debate – Health Care Roundup // Aug 13, 2009 at 12:08 am
[...] to have answers on health care in his 2008 book Comeback: Conservatism That Can Win Again. Luckily he sums up some proposals he says Republicans should support on the blog, but I still recommend the [...]