Sunday, February 04, 2007

If you’re American, the President thinks you’re too healthy!

In a recent column, Paul Krugman discussed the “new” Bush administration health care system reform. He referred to it as “gold plated indifference.” The line that stands out to me most in his column is: “Wow. Those are the words of someone with no sense of what it's like to be uninsured.” Truly, this new series of tax cuts is nothing but a not so subtle attempt to land the death blow to our employer provided health care system. There are many people, including myself, who have wanted this to happen for many, many years. But this group is incredibly diverse and brings together people with many different rationales for wishing for the collapse of this system. They include the George Wills of the world who refer to President Bush’s proposal as “revolutionary” as well as proponents of universal coverage who see the current system as being so fundamentally flawed that it needs to be totally destroyed and rebuilt. This latter group includes the likes of E.J. Dionne, Paul Krugman and Hilary Clinton (though good luck getting her to admit it after she took such a severe beating back in the early 90s).

The Bush administration has, simply stated, never identified a problem that couldn’t be repaired with a “well placed” tax cut and the invisible hand of the free market. But let’s take a closer look at what this proposal would do. It would essentially treat the health insurance industry like the home ownership industry and create a health insurance tax rebate of $7,000 per year for an individual and $15,000 for families. The problem with this is that many of the uninsured are not paying that much in taxes.

The President talks about taxing people who have, what he terms, “gold plated coverage”. The flaw in this reasoning is that he won’t just be taxing the rich but just about every blue collar worker who is a union member. Just about every electrical worker or day laborer or any collectively bargained worker has traded at least some pay for high quality health insurance. The President’s approach will punish these workers most of all.

Let there be no illusion, this plan is not designed to fix the problem. If individuals are given the same tax benefits as business, there will no longer be an incentive for employers to provide coverage. This will leave people to buy their own individual plans. If you have ever been covered by an individual plan, you know how bad that is. No coverage for pre-existing conditions, no employer’s HR department to help you navigate all your choices. The flaws with this logic go on and on.

Of course there are problems with the health care system, but this plan doesn’t try to deal with any of them. This is just an exercise in cost shifting. The real challenge is how to control the spiraling costs of coverage. This won’t happen by tossing everyone out on their own to fend for themselves. Everyone agrees that people should be more proactive in ensuring their health. Individual responsibility is a virtue and one that should be included in all facets of life, but we need to equip people with the tools that they need to take responsibility. You can’t just say: Individual responsibility and then throw everyone into the fire.

If we put everyone in one pool and set rates for everyone at the same level then we could, in essence, control costs for individuals. Then we need to look at the health care system and eliminate waste and fraud. There are a lot of middlemen in the health care system now. A national health system modeled on the Veteran’s Administration would cut down a lot of the administrative red tape.

This system does not need subtle change. It needs revolutionary change and we should remember that this President isn’t good at starting revolutions, but civil wars.