RSS Feed MenuTens of millions of Americans lack health insurance. Extending coverage to them has been a core goal of health reform proposals since the 1960s. President Richard Nixon offered a universal health plan in his first administration, but since then Republicans have hesitated to commit the nation to so costly an undertaking. Is it time to rethink? Should Republicans accept universal coverage as a goal? We posed this question to NewMajority’s contributors.
Those of you who follow my blog know that I rarely discuss politics. This is because I try following the advice of the old Irish prayer:
God, grant me the serenity to accept the things I cannot change, courage to change the things I can, and the wisdom to know the difference.
Or, as Bogey said to Ingrid Bergman in the farewell scene of Casablanca: “ . . . it doesn’t take much to see that the problems of three little people don’t amount to a hill of beans in this crazy world . . . ”
Having said all that, Frum Forum asked me to comment on a political issue that I do know something about – government healthcare – OK here’s the deal:
America already has government healthcare, of course. We have Medicare for the old folks, and Medicaid for the people who can’t help themselves. We have the SCHIP program, and all sorts of government programs for Indians on reservations, the folks who live in the Marianas Islands, and then of course there’s prison medicine. Ask those folks how they like their government healthcare.
The program I’m personally familiar with is Tricare, which is the healthcare program military dependants are covered by. I pay $460 a year for Tricare coverage, which is pretty good as far as health insurance goes, but believe me, you get what you pay for.
How it works is like this: when you’re active duty, you don’t pay for healthcare. You get sick, you show up at the TMC – Troop Medical Center – and whatever you’ve got they take care of. Or try to. The old saying about Army medicine goes: “Foot powder below the waist, aspirin above.”
Tricare is for dependants; i.e. the spouses and children, and the retirees (like me). When you’re on active duty, it’s practically free: $40 a month, you don’t even notice it coming out of your LES (Leave & Earnings Statement).
Healthcare used to be free to vets for life, but Bill Clinton changed that when the WWII generation started requiring more and more care for their needs. I remember the outrage when the government started charging the vets for healthcare; that was the same crowd that was trying to ram Hillarycare down our throats.
Go to Clark Clinic on Fort Bragg on any given day and see how government medicine works. The place is always packed full of G.I. wives & children. A lot of them are there for things that normally you’d take care of on your own, at home.
Item: if healthcare is free, everybody becomes a hypochondriac.
In fact, there are so many dependants laying siege to the place, they make it inconvenient and slow, just to discourage people from going there.
Item: the government throws up hurdles between you and the doctor, so they don’t have to dish out.
It gets even better when you’re a retiree, or if you live away from a major military installation. In that case, Tricare looks like this:
There is a schedule of benefits that Tricare will pay for, and the price they will pay to providers. That price is generally 30% less than what that provider normally charges, so doctors do not like to take Tricare patients. But every area and region has a Tricare provider – somebody the government has their hooks into – their paying his tuition or whatever – and he has to take you.
Item: doctors do not like government healthcare.
When you show up, your Tricare provider is not happy to see you. He is taking a 30% cut in pay every second you are there, so all he wants to do is throw whatever pills at you it takes to get you out of there so he can get back to the paying customers.
I would tell you the nightmarish story my family went through with the birth of my first child, but it’s intensely personal. The results were a tragic disaster, they are permanent, my wife is permanently scarred and my daughter’s health has been affected for life. Take my word for it; the military’s mission is not to take care of your wife and family. Regardless of what they tell you otherwise.
What I will tell you about is this weird rash I’ve had since 1997, something that appeared after traipsing around the toxic battlefields of the former Yugoslavia. They are unable to cure it. At one point they had me scheduled to report to surgery, six weeks out, of course. When I showed up at surgery, the doc asked “What are you doing here?” I showed him my rash. He said, “What do you want us to do about it here at surgery?”
I went back to my TMC and asked the bureaucrat in charge why she had scheduled me to go there. I was on active duty at the time and I was a busy guy. Her answer? “Oh, I thought they could cut it off.”
“What, are you practicing medicine now?” I felt like picking up the paperweight off her desk and throwing it at her.
Item: government bureaucrats will instinctively behave in a manner that is counter to any kind of logic or common sense. When this phenomenon intersects with your health, look out.
To read other contributions to this symposium, click here.
doormat18 // Aug 27, 2009 at 8:18 am
This is a great argument against government run healthcare… so it’s a great thing that not one of the bills in congress currently establish government run healthcare. The bills in congress establish government run healthcare INSURANCE. I think if the government provided insurance to GIs so they could go to their local hospital, they would be happier.
ConArtist // Aug 27, 2009 at 9:41 am
Well, when you’re already in a socialized entity (the military), I assume it’s fitting to continue the pattern. The socialists in the military have become complacent and dependent on their government for everything. Health care, paychecks, jobs after service, acute directions for tasks, even how to style their hair. Unfortunately, it’s no wonder they’re ill-equipped to embrace capitalism – they never have. Most service members, from the age they’ve been able to work, have relied on the government. Zero autonomy or accountability. The government has been a crutch.
What is quite fascinating is to hear the irony in their complaints. What would prevent any member of the military for supplementing their health care with private insurance? If private insurance has no bureaucrats and they give you wonderful service and a lollipop afterward, what’s stopping anyone from procuring? There should be an elective American option that insures children and poor and the rest can fend for themselves. As our taxpayers dollars go directly to fund the men and women of the military, they’re acting rather audacious to complain so incessantly about coverage that is, ‘practically free.’ It’s this sense of entitlement and socialism that Republicans are supposed to detest.
Churl // Aug 27, 2009 at 10:30 am
conartist: Military income levels, the cost of private insurance, the inability to carry a policy from one state or country to another when transferred, and the exclusion of pre-existing conditions from coverage when changing carriers might have something to do with military families not getting private insurance.
And, before you get started, the transferability and pre-existing condition problems with private insurance could be solved without nationalizing health insurance.
liv&win // Aug 27, 2009 at 10:53 am
Do we need to intellectually dismantle every government program to make the point that government interference between buyers and sellers ALWAYS produces imbalances in supply or demand and ALWAYS produces unintended consequences, and the management of these programs are ALWAYS retrospective rather than prospective, and often destructive?
Unintended Consequence, Imbalance of supply and demand, and poor management:
“Critics of the biofuels boom say government support helped create the mess in the first place. In 2007, biofuels including ethanol received $3.25 billion in subsidies and support — more than nuclear, solar or any other energy source, according to the Energy Information Administration. With new stimulus funding, this figure is expected to jump. New Energy Finance Ltd., an alternative-energy research firm, estimates that blending mandates alone would provide over $33 billion in tax credits to the biofuels industry from 2009 through 2013.
“Not all biofuels may be worth the investment because they divert land from food crops, are expensive to produce and may be eclipsed by the electric car. One fact cited against biofuels: If the entire U.S. supply of vegetable oils and animal fats were diverted to make biodiesel, production still would amount to at most 7% of U.S. diesel demand.”
“But the industry is already falling behind the targets. The EPA, which implements the congressional blending mandates, still hasn’t issued any regulations to allow biodiesel blending, though they were supposed to start in January. The mandate to blend next-generation fuels, which kicks in next year, is unlikely to be met because of a lack of enough viable production.”
“Obama officials defended the delay in biodiesel mandates. The EPA in May proposed rules that penalize soy-based diesel under the blending mandates, because deforestation from soybean cultivation is thought to offset the fuel’s environmental benefits. Obama officials say the EPA must perform a thorough environmental review before it can issue rules. ”
http://online.wsj.com/article/SB125133578177462487.html
Where did the savy consumer go? I feel like I am living in The Matrix. WAKE UP NEO!
Cforchange // Aug 27, 2009 at 10:56 am
I do not find this article to be an accurate view of Tricare.
Conartist, I find your remarks about the military disgusting. You speak of them as they are on welfare. Do you think for a second that the military are compensated well enough to purchase private insurance? You are “practically free” because of their sacrifices and you are the one that sounds like you are entitled to the benefits they provide at no cost to you. You are the one with the entitled attitude and I’ll add bitter.
“The socialists in the military have become complacent and dependent on their government for everything. ”
Why just pick on the military – how about every kid coming out of an average public education that can’t even balance a check book. So they cruise along acquiring huge debt for cars, college and overpriced housing – then default….. What, that’s not government dependency??? Tisk, tisk – even Republican’s have been at this trough. Conartist, you need to be drafted.
I’m so sick of the useless fingerpointing – we the US of A are fundamentally broken and there is plenty of blame to spread around and around. Continuing to do so will do nothing to remedy our ills.
SFTor1 // Aug 27, 2009 at 11:18 am
Conartist says: “The socialists in the military have become complacent and dependent on their government for everything. Health care, paychecks, jobs after service, acute directions for tasks, even how to style their hair. Unfortunately, it’s no wonder they’re ill-equipped to embrace capitalism – they never have. Most service members, from the age they’ve been able to work, have relied on the government. Zero autonomy or accountability. The government has been a crutch.”
I think the biggest problem decent conservatives have these days is the company they keep. Or perhaps you do claim this character as your own?
Also: the article states that “when everything is free, everybody becomes a hypochondriac.”
Frankly, that is a bunch of rubbish, and is one of the canards often heard from opponents of universal health care. With few exceptions people don’t want more to do with doctors and hospitals than absolutely necessary.
ConArtist // Aug 27, 2009 at 11:48 am
Churl: Many thanks for refuting yourself. The ‘public option’ is the only way – insurance companies mandate quotas for denial of coverage. Surely, the government option should be elective and offer competition, there’s nothing more capitalistic than that. Citizens have the right not to purchase public insurance, if reform passes. If you’d prefer to pay unbridled premiums for lackluster results, continue paying into your private plan. Reform doesn’t connotate anything more than increased capitalism.
CforChange: The socialists in the military actually make us less free. The reason America was attacked was in response to imperialism. Not to mention the abridgment of freedoms via Patriot Act and other governmental oversteps. Plus it comes at a cost to me. A cyclopean cost. Not only when I travel abroad, but through my taxes. I’m paying for my friends to be shipped away so Obama and his cohorts can revel in the guise of national security. That, is what’s disgusting.
To mention conscription is tantamount to your ignorance. I’m bucking the trend of losses of freedom, safety and socialism and you want to promote that cyclical disease. Mind boggling.
Churl // Aug 27, 2009 at 1:01 pm
conartist, I wish I could believe that a “public option” – at present completely undefined – would foster competition among the government and private insurers. But I don’t see how the government, which sets the rules, would allow itself to be beaten in competition by private entities who must live within the rules set by their main competitor.
I do think that uncompetitive or fraudulent behavior by private insurers should be forbidden by laws and infractions of such laws should be punished, but I maintain that further federalization of health care is unnecessary to accomplish this.
sinz54 // Aug 27, 2009 at 1:29 pm
conartist: True competition implies the possibility of losing. Those competitors who do well in the marketplace will flourish; those who do poorly will fail.
By that standard, a government-run “public option” is not true competition. Because it’s designed NEVER to fail. (When has ANY Government social program gone out of business due to insolvency?) It’s designed with government subsidies enabling it to charge unfairly low premiums and co-pays.
It won’t be up to you or me to decide whether to accept the public option. Rather, employers will dump their private insurance and force the public option on their employees as a cost saving measure, whether their employees like it or not. And the public option will come armed with new regulations that hobble private insurers as to how much they can charge and who they can accept as new policyholders. That is unfair competition, designed to ultimately force the private insurers out of business and result in a government monopoly single-payer system.
That is EXACTLY what liberals are saying amongst themselves are the true nature, goal, and purpose of this “public option.”
We conservatives are NOT going to let you get away with this duplicity anymore, using the public option to move us to single-payer while simultaneously lying to America that this couldn’t possibly happen.
Polls show that 62% of self-described Democrats favor a single-payer system. So why should we believe ANY of them when they tell us that the public option won’t move us to a single-payer system?
Thanks to YouTube, you can’t get away with that type of duplicity anymore. The public option as a steppingstone to government run health care is now the Dems’ “macaca” moment. We caught them on videotape, and we’re going to keep using it.
sinz54 // Aug 27, 2009 at 1:32 pm
conartist asks: “What would prevent any member of the military for supplementing their health care with private insurance?”
Well, for one thing, being wounded in combat would constitute a “pre-existing condition.”
liv&win // Aug 27, 2009 at 2:06 pm
Sinz54, don’t be ridiculous, being injured in combat is a treatable condition at the VA. That’s what they do, treat war wounds. they don’t do anything else. They specialize. Tri-care is separate coverage for non-combat conditions. I think it is also HIPAA compliant coverage and provides guaranteed coverage else where if desired or necessary.
I know we try and stay at 60,000 feet on this, but you need at least a reasonable degree of knowledge about the terrain
Cforchange // Aug 27, 2009 at 2:32 pm
Conartist – I believe that I misinterpeted your original last paragraph – if you’re complaining about this author’s complaining – I agree. This article is flat wrong about Tricare and maybe his opinions too were blurred by the death of a child – which yes is painful but can happpen anywhere.
But I stand firm that the military need worry free care. It’s a special person that steps up and agrees to a life of being ordered and expected to execute. The same goes for all law enforcement and doctors for that matter – another article here today that cites $98k for a salary, I say too little. Who cares within reason, the salary of a doc. If you don’t agree, you’ve never really needed one.
We will never be without need for a prepared military so we must be prepared when they need care.
ConArtist // Aug 27, 2009 at 2:46 pm
I believe you have it backward. The insurance companies have done an excellent job lobbying Congress, not the other way around. In fact, if Obama’s resolute on his statement that a public option is inessential, it will directly result in reform that requires people to purchase private insurance. Thereby exacerbating a system already in disarray. What a scam the liberals have cleverly disguised.
What limits has the government set on insurance companies to inhibit it’s massive, exorbitant profits? The proof is in the pudding. My hypothetical is to set no limits on private insurers and let government have its own plan and let people decide which one works best. Based on motivation (greed will lead to the demise of the private industry), I believe you’re right, that ultimately, insurance companies will suffer. So long as insurance providers aren’t facing an uphill battle (let’s be real they’ve got billions of dollars) let the free market decide.
Additionally, many government programs over the years have been disbanded and diagnosed insolvent. Remember social security? Government programs are consistently stripped and dissolved, to say otherwise is untrue.
jamberry // Aug 29, 2009 at 12:10 pm
Churl – lay out it brother. You have the answer, yet spend more time poking holes at other solutions. The horse has left the barn on rapidly rising health care costs. Tell us how we can bring those premiums down within my lifetime without a public option. My car insurance is fairly affordable, because I don’t get into accidents and the government requires everyone to buy insurance. In that market, spreading the risk to all drivers and not allowing the safest drivers to opt out contributes to lower premiums. Plus, dinging at fault drivers and riskier class drivers (youth) for high premiums, keeps my insurance low. Of course, one catch is that you can opt out by not driving a car. But, let’s focus on a solution here and see what we can learn from government mandated auto insurance. Lets require everyone over 18 to buy health insurance from private industry. (That will need a lot of exceptions probably, but we need a private only starting point.) If you go to the emergency room, let’s say more than twice a year, and no trouble is found, then your insurance premium goes up. How about a schedule of behaviors that create cost when ultimately no trouble is found which result in higher premiums? This isn’t sounding like a great idea (I mean that math won’t pencil most likely, I don’t mean politically), but lets be fearless in the debate for a solution – rather than making everyone else do the legwork and then taking pot shots at them. Let’s throw our own spaghetti against the wall. How about, means testing as part of the premium calculation. If two people, same age, health etc, are to be insured, private insurers will factor in their income and charge a higher premium to the person with the higher income. That sounds like a political problem, but who is doing the math on this problem before us and trying to build a system that reigns in these costs. I’d like to get it done in my lifetime. You, Churl? Hey, once we have some sound solutions , just brace yourself that politicians and voters may retreat to their liberal and conservative corners and question each others underlying motives. But, should we just stand by as health care costs soar? Even if the quality of our health care is the reason it rises faster as a % of GDP than other countries – is that acceptable to smart and capable society? One thing that concerns me is that this problem has been considered and studied for some time with solutions offered from all corners. Are we standing by, because we have retreated to our corners? Churl – either get in the room and solve it, or stand in your corner and let others do it. If you do that, and it would be unfortunate for anyone to do that, we have to tune them out and solve the problem because it matters to us.