- Healthcare Revisited – A simple solution to 2 problems
As the Democratic contenders vie for the
nomination “Healthcare” is again one of the more significant topics. Medicare
for all, private option and other variants are being proposed. My view is that
no candidate is willing to confront the real issue with our broken
healthcare system. I strongly believe that healthcare should be a right of
citizenship and permanent residency. However, as a fiscal conservative I cannot
support a solution that adds to our out of control National Debt.
When searching for solutions to any problem I
favor two approaches. First, start by working “upstream”. By this I mean search
for the cause of the problem. Once you determine that cause keep working on
additional factors that are contributing to the it. The US has by far the
highest cost of healthcare, per capita, of any country in the world. Our costs
are almost three times the average for the EU countries without the
corresponding benefit of better quality of care. What is causing the problem
and why are we not addressing solutions?
There are several factors that contribute to out
of control costs. Among them are the role of insurance companies, drug costs,
hospital costs, physician compensation, obesity rates and legal factors. These
areas have been thoroughly addressed in several earlier posts on this topic.
The second method that I advocate for problem
solving is a technique called “base-lining”. What this means is to investigate
other systems that are yielding positive results and learning how to benefit
from the experience of others. There are several countries’ systems that are
worth investigating that have a higher quality of care at less than half the
per capita cost.
Solving the cost issue would more than cover the cost of proving healthcare for all and would also significantly reduce the out of balance national budget deficit. One solution to improve, if not solve, two problems.
Let’s Make America Great
There is nothing wrong with this slogan, but agreement on what this really
means is in question. It seems that the intended meaning is to restrict
immigration, company deregulation, reverse Roe v. Wade, shift more income and
wealth to the top 1%, alienate our former allies, reverse our trend of “free
trade” and provide support to the cause of “white” separatists.
I am not being critical, just stating the facts. Many folks completely
support the aforementioned agenda which is their right. However, when I last
checked, we still have a fairly democratic system and the majority do not support
most of these actions.
Reliable data supports the following shortcomings in our country, if
pursued, have the potential to “make America great again”:
- Quality, cost & availability of Healthcare (We have by far the highest per capita cost and rank 37th in quality of care. At the same time many citizens are not covered0
- An equitable living wage (income disparity and the lack of wage improvement)
- Climate change (mortgaging future generations for immediate gratification)
- The national debt (again we are mortgaging future generations for immediate gratification)
- Infrastructure (repair & upgrades)
- Comprehensive and effective immigration reform
The above is not a comprehensive list, but I contend that
if we pursue them and enact reasonable legislation, we will be moving in a
direction of improving our “greatness”.
The Healthcare Issue Revisited, again….
One of my top soapbox issues is the status of our
broken Healthcare system. It continues to bother me to no end. I suspect that I
will continue to revisit this subject often. Here are a few bullet points that
I hope will garner your attention:
- Our country has by far the most expensive system
among all counties
- In 2018 the cost of our healthcare system was
$11,600 for every man, woman & child!
- The average per capita cost for the EU, Canada,
Australia & NZ was about $3,800 or 3x our cost.
- According to the WHO (World Health Organization) almost
all of these countries deliver a superior healthcare product. (We rank 37th
among all counties)
- We spent $3.8 trillion on Healthcare in 2018 (over 18
% of GDP) making it by far our largest industry. https://www.forbes.com/sites/danmunro/2014/02/02/annual-u-s-healthcare-spending-hits-3-8-trillion/#17694b3a76a9
- The Government pays for less than 30% of this, $1.1
trillion in the form of Medicare & Medicaid. The remainder is paid either
by companies’ insurance benefits or by the tax payer in the form of premiums,
co-pays and for some self-insured it is simply out of pocket. I could not fund
a breakdown between what employers’ pay vs. others.
- The Cost of Medicare & Medicaid is the single
largest Budget Expense at almost twice that of what we spend on Defense and it the major
contributor to the annual deficit.
- Since there are much cheaper and better systems
available to our leaders their inaction levies a very high tax on the tax
payer. I have referred to this as a “hidden” tax since you do not realize that
you are paying it.
Many smaller industries have their hand in our very
lucrative system. For details on those I would refer you to earlier posts to my
blog. The solution is not very complicated and the reason that it will likely
never happen has to do with so much money being made in the private sector.
Again, I would refer you to prior posts on this same subject for the details.
The high cost of health
care can have several negative effects, including the following:
- When the government spends more on health care, the
national debt increases and/or funds available for other programs decrease.
- When people spend more on health care, they have
less money to spend for other things, and when health insurance is paid by
their employer, they are paid less.
- When employers spend more on health care, the costs
of their products and services increase, and jobs may be moved to countries with
lower health care costs.
- More people cannot afford health care insurance.
When people without health care insurance receive health care, they usually
cannot pay for it. As a result, this care is paid for by other people who are
paying into the health care system. Or, people without health care insurance
may not seek care when they need it and thus develop a serious disorder that
could have been prevented.
- Medical bills that are not covered by health
insurance can lead to bankruptcy. https://www.merckmanuals.com/home/fundamentals/financial-issues-in-health-care/overview-of-health-care-financing