Saturday, March 20, 2010
Health Care Bill 2010
Employer based insurance and centralized payers, especially Medicare and Medicaid, pose a fundamental problem. How can a distant third party influenced by political and financial interests, be entrusted to decide the necessity or value of medical services? Health decisions should be made by patients guided by their doctors, and insurance should be a mechanism to reduce financial risk, not eliminate it.
If patients and families had direct control of how money was spent on their health, and which providers or medical companies received it, there would be competition and cost control. Instead, hospitals, medical device/drug companies and select doctor interest groups lobby government or corporate bureaucrats for payments. The more centralized the bureaucrats (Medicare, followed by larger insurers) the easier it is to weasel the system without regard for innovation or efficiency.
More government in health care is going to make matters worse, particularly when the government can't generate adequate tax revenue to pay for all the entitlements. More people may have coverage, but there will be rationing of care, less innovation, less efficiency and an even wider tiered health care system. College students will avoid going into medicine if they know they will have little or no control over their professional or financial future, and the doctor shortage will worsen.
For those who hope to benefit from this ill-conceived plan, it is yet another great ponzi scheme. And if your suffering is reduced temporarily, it will be on the backs of future Americans who will end up suffering later in your stead. Our country will flounder with lost opportunity, lost talent, lost private sector jobs, lost credit, and even fewer taxpayers left to pay for all the entitlements.
If patients and families had direct control of how money was spent on their health, and which providers or medical companies received it, there would be competition and cost control. Instead, hospitals, medical device/drug companies and select doctor interest groups lobby government or corporate bureaucrats for payments. The more centralized the bureaucrats (Medicare, followed by larger insurers) the easier it is to weasel the system without regard for innovation or efficiency.
More government in health care is going to make matters worse, particularly when the government can't generate adequate tax revenue to pay for all the entitlements. More people may have coverage, but there will be rationing of care, less innovation, less efficiency and an even wider tiered health care system. College students will avoid going into medicine if they know they will have little or no control over their professional or financial future, and the doctor shortage will worsen.
For those who hope to benefit from this ill-conceived plan, it is yet another great ponzi scheme. And if your suffering is reduced temporarily, it will be on the backs of future Americans who will end up suffering later in your stead. Our country will flounder with lost opportunity, lost talent, lost private sector jobs, lost credit, and even fewer taxpayers left to pay for all the entitlements.
Saturday, September 5, 2009
2009 Health Care Debate
Many seniors are satisfied with health care provided by Medicare. Who wouldn't be satisfied with semi-convenient benefits mostly paid by someone else? Especially considering that before Medicare, 40% of seniors went without health insurance. Proponents of Govt entitlements claim Medicare provides better care with lower administrative costs than the private sector. So why not just expand Medicare to cover everyone? Unfortunately, I have failed to find any specific analysis to support such administrative cost savings under Medicare.
Conservative analysts conclude the opposite, outlining several factors that demonstrate an increased per capita administrative cost to Medicare over private insurance. Total costs caring for the elderly are higher than the average population covered by private insurance. Administrative cost per patient therefore appears as a smaller percentage. The cost of collecting premiums (taxes) is not compared. Govt doesn't pay taxes on profit. The cost of capital (debt) is not included. Medicare has more fraud and waste. Therefore it is difficult to accurately compare the administrative costs. Govt has never been more efficient buying commodities compared to individuals or the private sector as a whole. Why would paying for heath care be different? In reality, Medicare has tremendous debt liabilities, fails to control costs, limits access to care, and faces Govt bankruptcy within years.
More Govt paid health care will reduce access, quality and innovation. There will be no negotiation. The Govt would control prices and access to care with a politically appointed medical review board of Govt doctors. The wealthy and middle class insurance markets would be drastically reduced with loss of coverage for new and expensive treatments and diagnostics. There would be much less incentive for private entrepreneurs and researchers to innovate. The Govt will choose winners and losers based on bureaucratic, financial and political influences. Right now the Govt already controls 50% of all health care (Medicare, Medicaid and VA) and has not proven to be more effective or efficient than the private sector with these huge govt programs.
The United States is still a world leader in health care research and innovation. Loss of US talent will not be so easily replaced elsewhere. At least in Canada, the wealthy can come to the US for rapid access to high quality health care. If our system becomes more like Canada's, where will the best doctors and wealthy patients go? Perhaps we will simply have fewer wealthy people and many doctors will retire without being replaced. How would enough eager new doctors be incentivized to fill the void of all those retiring early?
The United States should fully privatize health care, and costs should be driven by consumer choice. Tax incentives could be made for health savings accounts and insurance to promote shopping around for preventative care and prescription drugs. Medicare should be abolished as unsustainable. Patients and families should be responsible for obtaining their own, portable insurance. There should be no more tax incentives for employer based insurance. Insurance should be regulated, but not mandated.
Health care should not be considered a right. Those who do not have adequate insurance, or who choose to be uninsured, would be exposed to great physical and financial loss. This would place the burden of finding affordable and adequate insurance on the individual and their families. To improve access and competition, insurance should be sold nationally and regulated with a basic health care bill of rights that the insurance sold is understandable, enforceable and with financial transparency. Doctors and hospitals should have the right to accept or reject insurance payments at will. More competition would then be infused into a private health system fostering more innovation and reducing costs.
Conservative analysts conclude the opposite, outlining several factors that demonstrate an increased per capita administrative cost to Medicare over private insurance. Total costs caring for the elderly are higher than the average population covered by private insurance. Administrative cost per patient therefore appears as a smaller percentage. The cost of collecting premiums (taxes) is not compared. Govt doesn't pay taxes on profit. The cost of capital (debt) is not included. Medicare has more fraud and waste. Therefore it is difficult to accurately compare the administrative costs. Govt has never been more efficient buying commodities compared to individuals or the private sector as a whole. Why would paying for heath care be different? In reality, Medicare has tremendous debt liabilities, fails to control costs, limits access to care, and faces Govt bankruptcy within years.
More Govt paid health care will reduce access, quality and innovation. There will be no negotiation. The Govt would control prices and access to care with a politically appointed medical review board of Govt doctors. The wealthy and middle class insurance markets would be drastically reduced with loss of coverage for new and expensive treatments and diagnostics. There would be much less incentive for private entrepreneurs and researchers to innovate. The Govt will choose winners and losers based on bureaucratic, financial and political influences. Right now the Govt already controls 50% of all health care (Medicare, Medicaid and VA) and has not proven to be more effective or efficient than the private sector with these huge govt programs.
The United States is still a world leader in health care research and innovation. Loss of US talent will not be so easily replaced elsewhere. At least in Canada, the wealthy can come to the US for rapid access to high quality health care. If our system becomes more like Canada's, where will the best doctors and wealthy patients go? Perhaps we will simply have fewer wealthy people and many doctors will retire without being replaced. How would enough eager new doctors be incentivized to fill the void of all those retiring early?
The United States should fully privatize health care, and costs should be driven by consumer choice. Tax incentives could be made for health savings accounts and insurance to promote shopping around for preventative care and prescription drugs. Medicare should be abolished as unsustainable. Patients and families should be responsible for obtaining their own, portable insurance. There should be no more tax incentives for employer based insurance. Insurance should be regulated, but not mandated.
Health care should not be considered a right. Those who do not have adequate insurance, or who choose to be uninsured, would be exposed to great physical and financial loss. This would place the burden of finding affordable and adequate insurance on the individual and their families. To improve access and competition, insurance should be sold nationally and regulated with a basic health care bill of rights that the insurance sold is understandable, enforceable and with financial transparency. Doctors and hospitals should have the right to accept or reject insurance payments at will. More competition would then be infused into a private health system fostering more innovation and reducing costs.
1 comments:
Captain Gabe said...
- Only the uninitiated believe government administrative costs could ever be lower, or equal to, private sector costs. First order of business of a bureaucracy is to protect the bureaucracy. I know of an army base with 5000 men that had a 70 man HR office. When 2000 civilian workers moved in they brought with them 300 HR personnel. Every government operation works hard to maximize it's administrative load. It's a fact of history. So, with the administrative angle gone, what's the big sell, again? Oh yes, control.
Tuesday, September 1, 2009
The Elephant in the Room
Our Government is growing and spending out of control. Much like a cancer invading healthy tissue, the public sector is gradually destroying the private sector, diminishing the nation's work ethic, eroding the middle class, and stifling individual motivation, innovation, opportunity and wealth. Ironically, our Government is counting on taxes from a wealthy, growing private sector to pay it's salaries, entitlements, deficit and debt.
Most Americans have become detached if not discouraged participants in democracy. Without adequate oversight from the People, our Government consistently demonstrates poor judgment and political corruption, as illustrated most recently by the financial crisis of 2008. Like most individuals and corporations, Government self-promotes. Politicians, bureaucrats and other public servants often embrace interest groups who finance their campaigns or dole out lucrative, post-term trophy jobs if they follow the prescribed agenda.
There are many hard working, honest, Government employees. But compared to the private sector, the Government will always provide less incentive to work overtime. Government has intrinsic inefficiencies due to political corruption, poor design, inflexibility, poor accountability, and often incompetent bureaucracies. The central Government directly employs about 2% of the work force. But if you include state, local and shadow government, this totals more than 14% of the work force. The average government job pays better than the average private sector job which is unsustainable.
Our Government should limit its scope, abolish entitlements that can be regulated into the private sector, and focus on judicial and national defense roles. Central power should be monitored and regulated by the states and communities, while encouraging local, private, democratic participation.This country needs to give financial and political power back to the states, and more importantly, the private sector. The Government should focus on what the constitution states specifically, "that all powers not expressly assigned to the federal government are reserved to the states or to the people."
Most Americans have become detached if not discouraged participants in democracy. Without adequate oversight from the People, our Government consistently demonstrates poor judgment and political corruption, as illustrated most recently by the financial crisis of 2008. Like most individuals and corporations, Government self-promotes. Politicians, bureaucrats and other public servants often embrace interest groups who finance their campaigns or dole out lucrative, post-term trophy jobs if they follow the prescribed agenda.
There are many hard working, honest, Government employees. But compared to the private sector, the Government will always provide less incentive to work overtime. Government has intrinsic inefficiencies due to political corruption, poor design, inflexibility, poor accountability, and often incompetent bureaucracies. The central Government directly employs about 2% of the work force. But if you include state, local and shadow government, this totals more than 14% of the work force. The average government job pays better than the average private sector job which is unsustainable.
Our Government should limit its scope, abolish entitlements that can be regulated into the private sector, and focus on judicial and national defense roles. Central power should be monitored and regulated by the states and communities, while encouraging local, private, democratic participation.This country needs to give financial and political power back to the states, and more importantly, the private sector. The Government should focus on what the constitution states specifically, "that all powers not expressly assigned to the federal government are reserved to the states or to the people."
2 comments:
- Rob said...
- http://federaljobs.net/ http://www.liveleak.com/view?i=730_1207774609 "Put all the government employees together - federal, state and local - And government accounted for 115 per 1000 employed in 1996 making it the second largest employer in the nation... When the shadow (indirect govt contractors) is added... totals rise to 17.9 million... just under 14% of employees... larger than any other govt studied" The true size of government By Paul Charles Light
- Rob said...
- http://www.westandfirm.org/blog/2009/07/brook-why-are-we-moving-toward.html
