Friday, August 14, 2009

Health Care Reform—What’s not to Like?

You don’t have to work hard these days to hear plenty of thoughts about Health Care Reform. Opinions abound. And the anecdotes to back up these opinions are coming out faster than cars off the assembly line in Detroit.

I am from Wyoming and we have a saying out there, “Everything in Wyoming is political, except politics, that is personal.” Because everyone needs health care at some point in their life, it is personal too. Mix health care and politics, stir in a little economics and your pocketbook, and you have achieved the kind of social critical mass that makes nuclear warfare look like child’s play.

I have also heard it said that, “Everyone is entitled to their own opinion, just not their own set of facts.” But which facts are true and which ones are just cooked up to make someone’s case? It pays to looking deeper into the facts. What was the methodology that led to the stated conclusion? What was asked and who gave the answers? We all need to exercise some due diligence before we embrace the things we hear today.

So, by now, you are wondering what my angle is. Am I for health care reform, or am I against it?

First, like everyone else, including Congress and the President, I have no idea what “it” is. And that may be the most troubling part of the debate. We are all fighting windmills.

Secondly, if you are asking me if I think we need health care reform, then the answer is “Yes.” If you ask me if I am supporting what we all think is working its way through Congress, then at this point in time, I would have to say “No.”

Let me point out a few things that everyone should be factoring into this debate:
• With all its challenges and problems, I firmly believe the health care delivery system and technology in America is among the best in the world, bar none.
• It has been said that somewhere around 45.7 million people in this country do not have health insurance. The reasons vary including: they can’t afford it, they have been declined, some refuse to buy it, others do not use available public health care, or they are here illegally. That said, nobody in America goes without health care. We are already paying for the uninsured every time we pay for health care or our health insurance premiums. A recent CNN story estimated the cost of providing health care to the uninsured at about $1,200 per household per year.
• A government run health care system would be unfair competition. You may have the right to choose your plan and your doctor, but sooner or later, only the government plan and doctors will be left standing on that uneven playing field.
• The question of how can the US economy (personal and corporate taxpayers) finance health care reform is the single most important question in this debate. When you consider that 61.6% of the President’s 2009 Budget ($2.9 trillion) is non-discretionary spending (add another 12.1% if you consider Defense spending non-discretionary), then one has to ask “How can we afford to tack another trillion dollars a year of non-discretionary funding on to that?”
• If you don’t have tort reform as part of health care reform to reduce the number of frivolous malpractice lawsuits, then you will not contain the escalating cost of health care.
• Let’s stop calling it “health insurance.” Insurance is the pooling of money to pay for an event that has less than a 100% likelihood of occurring. The fees you pay are based on mathematical analyses of the risk of a certain event occurring, factoring in the cost of remedying the event and the number of payees into the system. Insurance is for things like fires, tornadoes, hurricanes, earthquakes, etc. Because everyone needs health care at some time in their lives, what we buy when we pay for health insurance is really a pre-paid medical expense plan.

There is every reason in the world for Congress to proceed cautiously. And the American people should be wary of any new government program of this magnitude. If you think Congress will tax the rich and provide the poor with health care at no cost to the poor, the middle class, and the rich, then think again. Having majored in economics in college, there is only one thing I can say about the economy with absolutely certainty, “There is no such thing as a free lunch.” Like Newton’s Laws of Physics, the no-free-lunch principle is an unavoidable fact of life.

What we need is more portability of health care insurance (HIPAA provides some portability now), a way to insure those with pre-existing conditions, tax incentives to offset the cost of employer and individual health insurance premiums, and tort reform.

What we don’t need is another government run mega-program. History has shown government programs to be inefficient, ineffective, ripe for fraud and abuse, and much more costly than anticipated.

The subject matter is complex. The health care industry makes up 20% of our national economy, so the impact could be huge. The current proposal could add a trillion dollars to a $3 trillion budget. The wrong move by Congress could cost us jobs when we can least afford to lose them. In the end, health care reform deserves much more than a passing interest and a gloss over by our leadership.

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