Scott Adams is right again ... nobody really understands all the ins and outs of Obamacare or Trumpcare ... "confusopolies" -- laws designed to confound voters with complexity ... see: Dilbert Blog. However, there are some Occam's razors that can cut through some of this complexity. Let me offer a few that I think clarifies things a mite:
- In 1980, healthcare costs consumed 10% of the US economy. Today, after over 36 years of "solutions" this sector has grown to almost 18% ... see: Commonwealth Fund. So, none of these schemes, including Obamacare, has bent down the cost curve. And, it seems problematic that Trumpcare will succeed where other confusopolies have failed.
- One reason for such a large share of our GNP, that healthcare consumes, is the false notion that healthcare insurance (including Medicaid and Medicare) equals healthcare. For years every American, including immigrants ... legal and illegal ...have been guaranteed healthcare. When you insert a middleman between a patient and a doctor, you by definition increase costs. The bill of goods that liberals have sold to Americans is that everyone needs healthcare insurance (i.e., a middleman). Why? Since this is one major reason for our inflation in healthcare costs?
- Flash ... the liberals ultimate solution to this confusopoly, single-payer healthcare (i.e. socialized medicine), does not eliminate these insurance middlemen ... it just replaces them with government bureaucrats. When was the last time that government was more efficient and effective than private industry? Conservative Charles Krauthammer believes that, within 7 years years, we will be forced into having a single payer system ... the sotto voce goal of Obamacare. This will mean the ultimate distruction of what was once the world's premier healthcare system.
- Another reason that U.S. healthcare costs are so high is that, because of the insertion of insurance companies between patients and doctors, free-market forces have disappeared. A patient who gets a knee replacement does not know (nor care) if it costs $2,000 or $20,000 ... and, in fact, seldom actually sees the ultimate bill? So, what do you think the cost turns out to be?
- To make matters even worse, liberals have sold Americans on the notion that, even without mandated healthcare insurance, people can wait until they are sick to buy such insurance ... or what has been known as "no denial for pre-existing conditions." This is like allowing you to buy home fire insurance just when the fire engines are on their way ... clearly fiscal insanity.
The real resolution for run-away healthcare costs, if the American people want a solution, would be disintermediation ... the elimination of the healthcare middlemen ... and the unleashing of free-market forces. Trumpcare takes baby steps in this direction. Will it, or its Senate remake, continue on this path? The 2018 midterm elections will be determinative. Let's hope Krauthammer is wrong for a change.
An easy way to tell whether the American consumer will be the winner when the Obamacare fix is finished ... watch to see if the stock prices of the healthcare insurers tank. If so, we win.
11 comments:
In his meeting with the Australian PM: "It's going to be fantastic health care," Trump said, referring to Thursday's passed health care bill. "I shouldn't say this to our great gentleman and my friend from Australia because you have better health care than we do." Australia spends less than 10% of its GDP on health care – compared to near 17% in the US. The Australians have the world’s 4th longest life expectancy – 27 places above the US.
Mexico (since 2012) and Canada (since 1966) both have universal health care. It's one reason Mexicans like the idea of auto manufacturing in Mexico.
Yet the world comes to the US when they are seriously ill. Perhaps if Australia had Chicago-like murder rates or New Hampshire-like opoid deaths or Texas border-like drug cartel mayhem?
And besides Australia does not welcome hoards of third world immigrants. It puts them on a island and then sends them to us. I would wager that 10 to 20 million illegal immigrants getting free health care here has to add at least 5 percentage points to our national healthcare percentage. Australia does not have the equivalent burden.
Germany has universal healthcare since 1880(!) and they have an immigrant flood far heavier than the USA. But they have a system of private or state insurance that gets every citizen a valid and monitored healthcare card. If you don't have card, you get to the back of the line, getminimal treatment and then are booted out the door.
Granted the billionaires have to give up a bit more of their inflated income to support this generous humanitarian system that stilleats up less than 11% of their robust GDP.
When you get to root of the American problem it is unbridled greed (banking, insurance, pharma) combined with the untenable drive to be the predominant military force in the known universe. The wealth is there. It is just wildly misallocated.
See https://en.m.wikipedia.org/wiki/Medical_tourism. More Americans go overseas than foreigners come. Granted that the high-profile wealthy foreigners often make news by coming here for 5-star treatments but the flow is generally in the other direction. http://learningenglish.voanews.com/a/americans-traveling-to-other-countries-for-medical-care/3648328.html
Medicare for all. Medicare tax capped for employers, no limit for any and all other income (in other words, adjusted gross income) even if you route through capital gains or sub-s. Same for Social Security. What are the negative arguments to that modest proposal?
Should we have "citizen" cards here in the US? Sounds good to me ...
A Pakistani flies into Lgan airport, takes a cab to the Mass General emergency room and gets his brain tumor treated free of charge. This scenerio is repeated thousands of times across the US.
Medicare and Social Security should be limited to those who have and are paying in to the pool. However, payout limits at the top might also be progressively limited to amounts paid in. SSI should be severely policed.
I was on a different tack. If you make $10 million a year, you pay 6.25% on all of it ($625,000.) instead of a mere $6,000 or so. BUT there is a cap to what you can get when you draw your retirement monies, say $6,000 a month in today's dollars.
Maybe not so radical, but yes I could agree to something like that ... as could most Americans.
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