On Politics: States should take charge of health care
October 10, 2017
In last week's column, I opined on the U.S. health care situation, briefly reviewing options and costs for Congress.
After discussing alternatives, I found that each option is going to make some cohort of voters unhappy, so the quest should be to find the "least bad" health care system. I concluded that more people would be less unhappy if Congress delegated the health care policy decision-making and funds to the 50 states.
It's a lot easier to tailor health care, which displeases the least amount of people on a state-by-state basis, than for big government to try to cram a one size fits all plan down 325 million American throats. That's pretty much the nub of the Graham-Cassidy
Last Friday, Oct. 6, President Trump called on Senate Minority Leader Schumer (D–N.Y.) about cooperating in crafting a bipartisan health care measure. Schumer responded that anything that would repeal Obamacare is "off the table," so it looks like anything they come up with is going to be a fight.
Outside observers point out that of the 10 top economic powers, nine have single-payer ("socialized medicine") health plans which cover all their inhabitants. So why can't America?
Any plan in which a significant percentage of beneficiaries does not contribute financially yet takes the benefits is going to require some sort of subsidy.
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Obamacare, which derived from Massachusetts' "Romneycare," is structured to rely on young and healthy beneficiaries subsidizing older, sicker beneficiaries, which is just a variation on free market insurance driven health care. The devil is in the details, which include the sweetheart deals powerful lobbyists snuck into the bill to benefit their well-heeled clients.
Between those details, court decisions, and still more sweetheart deals written in by those drafting the implementing regulations, the law bears little resemblance to what its authors intended. The poor and underprivileged plead that they can't contribute, so the law expanded single payer Medicaid, which added to the federal deficit. But it's the details that seem to account for the wheels starting to come off Obamacare with premiums and copayments skyrocketing.
Leftists like Sen. Bernie Sanders (I–Vt.) are waiting in the wings with a single-payer plan, in which health care including doctor visits, drugs, home care, specialty care, dental care, and vision care are all paid for by Uncle Sam with no co-payments no deductibles and no payment caps.
The Urban Institute estimated the cost of Sanders' plan at $32 trillion. Considering that it took 230 years to run the nation's deficit to $20 trillion, it's unlikely that even Schumer would want to more than double it in a single year, much less each year thereafter.
Skeptics ask: Are single-payer programs really that wonderful? CNN recently conducted an in-depth study of European single-payer health care programs. They found that they all did an "OK" job delivering emergency medical services, but that they are otherwise characterized by rationing, long waits for elective surgeries and financial difficulties.
How about Canada's single payer system? Toronto Sun Columnist Candice Malcolm recently wrote that the Canadian system is "more restrictive than communist China's."
She stated that although medical providers are independent from the federal government they are compelled to accept Canada Health Act insurance, and nothing else. The result: "Canada lags behind most other developed western nations … in quality of care."
And, "Canada's single payer system is made possible only (because) it is propped up by the US health care industry next door which provides a parallel private system for very sick and very rich Canadians."
So there's no perfect system. Wouldn't it be better and more cost-effective if individual states allocated health care dollars based on the needs of their constituents rather than having it dictated by the Washington swamp?
Jim Clark is president of Republican Advocates. He has served on the Washoe County and Nevada GOP Central Committees. He can be reached at email@example.com