Simplifying the Health Care Debate « NEOAVATARA

Simplifying the Health Care Debate « NEOAVATARA

I have had a lot of friends ask, “What the heck are they talking about?”

Health care, even for physicians like myself, is a very complicated issue. There are so many intricacies involve, many that our political leaders don’t comprehend at all.

1. Universal coverage.

This is a moral issue for many, including myself. I don’t think health care is a right, but many do. Fine. In the end, most of us want everyone to be able to afford health care insurance if they want it.

Obama and the Democrats would like you to believe this is the hard part. They are wrong. Anyone can solve this part of the equation. Write a check, and it is done. It is extremely easy to cover everyone; either you provide a socialized care system, or refundable tax credits with a mandate to force people to buy insurance. The problem is solved.

Of course, there is the question of cost (anywhere from $1.2 Trillion -$2 Trillion, depending on whom you listen to). But cost has never been an issue for this Democratic President, has it?

2. Cost control

This is the the really, really hard part.

This is a multifaceted problem. Insurers have not been able to responsibly keep cost increases down. Physicians order too many tests. There is too much litigation. And patients demand too much.

Here is the bigger problem: of the above issues I describe, NONE of them are really being discussed in the halls of Congress. Why? Because each has solutions, but those solutions are painful…and politicians do anything to avoid pain. This includes the President.

Right now, Democrats would have you believe that a public option would magically solve these problems. It would solve the universal coverage problem; I think everyon admits that. But no one, including Barack Obama, can explain how it would answer overall costs, which is the big enchilada.

Mr. Obama continually says that the public option would create more competition that would drive insurers to reduce costs. This is, in my mind, ludicrous. There are right now 1,300 or so health plans that are competing. You really think a public plan would dramatically increase competition?

There is a bigger problem. Let us say that they do compete. The private plan cannot compete with a government plan that has a virtual monopoly, has a tax advantage (they don’t pay taxes; they are the government, after all, and have no intent to make a profit)….in the long run, private plans simply will disapppear. Profit margins right now are slim…what do you think they will be with this?

The other half of the cost debate is where is the new funding for this extra coverage going to come from. Democrats would like this to be budget neutral…and they can only do that with massive new taxes. And unfortunately for them, taxing the rich won’t be enough. Democrats will have to impose a broad range tax increase, likely on all people’s health benefits. That will not be popular, because it will raise taxes on a large segment of people that Obama promised would not have tax increases.

So this is the big picture. Covering everyone, reducing costs and increasing tax dollars. The problem is, they have guaranteed the first part; are not discussing the second; and third part is almost universally despised.

Democrats surely can pass a bill covering all Americans. I don’t doubt that for a second. Whether they can actually reduce health care costs right now seems highly questionable, especially since they are not even discussing the issue properly.

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UPDATE: Obama held his 1 hour infomercial (or whatever the ABC News equivalent is) on Wednesday Night.

Frankly, Obama’s arguments make less and less sense over time. First, his argument was that a government bureaucracy would decrease waste and red tape…um, huh? On top of that, he is using even scarier scare tactics, which convinces me that the is getting more and more fearful of failure.

There were a few pointed questions. Dr. Orrin Devinsky, a neurologist and researcher at the New York University Langone Medical Center, asked the president pointedly if he would be willing to promise that he wouldn’t seek such extraordinary help for his wife or daughters if they became sick and the public plan he’s proposing limited the tests or treatment they can get. The president refused to make such a pledge, though he allowed that if “it’s my family member, if it’s my wife, if it’s my children, if it’s my grandmother I always want them to get the very best care.”

That really gives you confidence in his plan, doesn’t it? A common phrase that doctors use when trying to convince their patients? “If it were my wife, or my mother, this is what I would do.” Apparently the President can’t make that promise.

John Sheils, senior vice president of The Lewin Group, a health care policy research and management consulting firm, estimated that up to 70 percent of those with private insurance would end up on the public plan.

Another neurologist, Dr. John Corboy of the University of Colorado Health Science Center, asked the president, “What can you do to convince the American public that there actually are limits to what we can pay for with our American health care system and if there are going to be limits, who’s going to design the system and who’s going to enforce the rules for a system like that? “

Obama, however, didn’t directly answer the question. Once again, avoid the toughest question, Mr. Obama.

“There are a whole series of ways that we could design this,” the president said, arguing that employers would be given a “disincentive” to shift their employees to the public plan.

Numerous people asked Mr. Obama how he would pay for the plan. He gave no specifics, and criticized CBO and other organizations that discounted his prevention plans and health IT effects on decreasing costs. Of course, there is no proof anywhere, in any scientifically researched way whatsoever, that either would reduce costs. But as long as Obama believes it, it must be right, right?

Ultimately, I think ABC did a mediocre job. And that is being polite. There were at least a few tough questions, but I still would have preferred some conservative political voices. Others there did raise valid questions. Below you can see the breakdown of the ABC audience…not exactly representative.

But Mr. Obama did nothing to bolster the public support for his plan. Maybe instead of pushing for more media outlets, he should actually work on the nuts-and-bolts of the plan itself. When push came to shove, he could not answer how he would pay for it, what he would restrict, how he would determine how to restrict care; basically, every important question. And most important, he wouldn’t even promise that his own family would be taken care of under the plan he is proposing…which should make every American fear this public option.

By the way, the Cato Institute has a great article comparing different worldwide systems, that can be seen here.

And Michael Ramirez of IBD...genius: