It is ironic that there are as many conservative arguments for health care reform as there are liberal arguments; let's review them.
Liberal argument: It is the right thing to do. People in a rich country like the United States shouldn't be in constant fear of bankruptcy due to an unexpected medical problem.
Conservative argument 1: Health care distorts the job market, keeping people in dead-end jobs because their current employer provides health insurance. As a result, we are deprived of the economic benefit of enterprising folks who might otherwise become entrepreneurs, because they are unwilling to risk not having health coverage.
Conservative argument 2: Having to provide health care coverage to employees is an economic drag on both large and small businesses, especially if it is impossible to do this economically, as in the current system.
Any health care system worth its salt should have the following characteristics:
1. It should be universal and independent of employment.
2. It needs to be regulated tightly to prevent the shenanigans that are so familiar to us today, and to provide a widely agreed upon standard of care.
3. Costs must come down. (Why should a medical device functionally equivalent to a $100 Wii balance board cost $18,000?!)
4. People down on their luck should be provided for.
In the Democratic proposals before Congress, business will still be responsible for providing health coverage, but small businesses and lower-paid employees will get more of a break. The worst abuses of the insurance industry will be brought under control and the requirement that everybody have insurance will make it harder for freeloaders to impose their costs on everybody else, just as with automobile insurance. Health insurance exchanges will level the playing field between insurance companies and individuals. Families struggling to make it will get help with their health coverage.
Republican ideas aren't necessarily bad; they just seem small bore, like trying to stop a charging elephant with a BB gun. Limits on medical malpractice awards are OK, but states that already have them (like New Mexico!) don't seem to do any better in health care costs than other states. Being able to buy health insurance across state lines might help produce coverage worth buying if insurance were required to meet national standards; otherwise many employers would shop around for the cheapest deals (“cheap” in more ways than one) in poorly regulated states.
Health savings accounts are unattainable for lower-paid workers.
If the Republicans can't contribute more to the discussion than this, they need to get out of the way.
There are many different cost-effective health systems in countries around the world. However, they all share one characteristic; government sets the rules. To pretend we can do otherwise is howling at the moon.
The cost of the current proposal before Congress needs to be put in perspective; the whole thing could be paid for by 20 percent of the defense budget. Its cost also has to be weighed against the costs of doing nothing. Witness the huge increases that the insurance companies are currently imposing on New Mexico -- 25 percent for Blue Cross, 14 percent for my daughter's New Mexico Tech COBRA plan! We are getting clobbered when we can least afford it. It is time to tell Congress to get this job done.
Sincerely,
David J. Raymond
Socorro
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