Today's Seattle Times editorial page carries two op-ed columns, one local and one syndicated, touting a Democratic proposal for universal health care in our lovely Evergreen State.
At the risk of sounding like a cynic, let's compare and contrast that proposal with the state's less than appealing work on two other top-tier issues: education and transportation.
On education, Olympia still can't seem to find agreement on what qualifies a student as ready for life after high school, let alone ensure that students are regularly reaching such a standard. On transportation, one need only to look at the Viaduct, 520, and a now deteriorating ferry system as prime examples of how government isn't exactly doing a superlative job of providing citizens with essential infrastructure in a timely, cost effective manner.
To be fair, there are reasonable arguments to be made as to why the problems described above exist. Their roots are complex, the issues many, and the blame goes back years - in some cases on both sides of the aisle. Either way, Olympia's long-term track record on these issues isn't great. Accordingly, is it really wise to have faith in the following description of a proposed state system of universal health care?
The plan is simple: Employers and employees pay a modest payroll tax in exchange for full medical benefits, with no premiums. Patients never lose coverage and pick the doctors they prefer.
"Modest payroll tax...full medical benefits...no premiums." Full patient choice.
Yeah, that'll last.
Posted by Eric Earling at January 21, 2008 03:47 PM | Email ThisNothing they take from you is modest.
We are nearing a resession, and neither the taxpayer nor the businesses need to be ripped off any further.
I do give the democrats credit today however, for it was the first day I did not recieve an email that they were proposing more tax hikes in this state.
I'm sure however non of the legislators were at work, so tuesday we will get double slammed!
For as Gregoire claimed a "hold the line on spending session" It sure don't look like anyone in her crowd was listening!
I have a dream that my four little children will one day live in a nation where they will not be judged by the color of their skin but by the content of their character.
This is today's reality:
I have a nightmare that my four children will one day live in a nation where they will be judged by the color of their skin but not by the content of their character.
You haven't received an email about tax/fee increases because it is a holiday.
Just be patient...tomorrow is another day.
Posted by: Chris on January 21, 2008 03:49 PMNotice the emotional hyperbole tacked on at the end? She means you, you heartless conservative bastards.
"pool all existing health-care expenditures and then replace the middlemen with one publicly controlled, not-for-profit system", uh, huh. Some questions for said esteemed columnist:
1. Who controls this insurance pool?
2. What's the standard of care?
3. How does this plan address costs?
Let's start with #2. By going to a pool of coverage, you're essentially imposing a one-size fits all strategy onto WA state citizens. That's fine and dandy until you realize that Americans tend to be picky about their health care. Some want their homeopathy, others want their chiropractor to straighten then out once a month. Either way, you're going to have to design a plan that pays for all of it. It'll be an administrative nightmare.
Now for #3. How does this plan control costs? Answer: it doesn't. They'll (the state) have to impose a profit margin on the insurance companies...who will take one look at their books and identify the year in which they will no longer make a profit in this state. And of course at this point, they'll promptly abandon doing business here.
Liberals are great at feeling people's pain and for making creative signs at hippie marches for this or that. It's that real life thing that's where their talents leaves them wanting, that nasty business of implementing feasible solutions to complex problems.
And question #1? A handpicked career beareaucrat no doubt rigorously chosen by our queen, uh, governor.
Posted by: Steve in Queen Anne on January 21, 2008 03:53 PMSince opting out of the nice BIAW health insurance system, because I had opted out of paying taxes and reduced staff, I went to a personal major health plan that costs me $200 for me per month with $2500 deductible and no drug benefits.
Modest cost and Gregoire are inherently opposites.
Posted by: swatter on January 21, 2008 03:59 PMWhat did MLK mean by that, Tom? Not the skin part, but the judging part. What was he talking about?
Also, you are required by law to participate, and government gets further control or your money and your very life.
Again quoting Bastiat: Mr. de Lamartine once wrote to me thusly: "Your doctrine is only the half of my program. You have stopped at liberty; I go on to fraternity." I answered him: "The second half of your program will destroy the first."
Posted by: pudge on January 21, 2008 05:29 PMThe "it won't cost anymore" argument is just so much BS. It either costs more to provide added service or the service is restricted to keep costs down. There isn't any free lunch here!
Posted by: RJK on January 21, 2008 06:16 PMEach WA resident is given a few money trees. Every time they need some cash, they simply go and harvest the cash off the trees. What could be simpler?
Modest initial investment in supply of the trees, Full Cash Yield every season, No cost to taxpayers. Full choice of either 20s, 50s or 100s.
Stop laughing, this is less expensive and more realistic than universal healthcare.
Posted by: Jeff B. on January 21, 2008 07:48 PMI agree completly. That is why I will only vote for candidates that loudly advocate in their platforms that they will cut some big programs. I suggest everyone who agrees with your statement do the same.
What programs has rossi proposed we cut?
Posted by: Lysander on January 21, 2008 08:40 PMWhat did MLK mean by that, Tom? Not the skin part, but the judging part. What was he talking about?
Tom answers,(see #3)
MLK, in his classic "I have a dream" speech, was expressing classic common sense, but what has evolved over the years is the antonyming that common sense. What was accepted at that time by most thinking folks is that a person shouldn't judge another person by their skin color, but only by the content of their character. The nightmare we are having now is that some folks want to never judge people by their bad character, but only if their skin color is championed!
Posted by: Tom on January 21, 2008 09:06 PMNuff Said.
Posted by: me on January 21, 2008 09:20 PMFor one thing, there are too many mandates for alternate care such as chiropractic,naturopathic, podiatrists, psychiatric coverage, etc. Unless and until those are removed, health care in this state will always cost more.
Secondly, people are not dying for lack of health care, since no one is turned away from an emergency room. People are dying for several other reasons, such as poor lifestyle choices, associating with criminal elements of society, refusing to take prescribed medications, etc.
People without health insurance have other priorities in many cases & prefer to take their chances that they won't need expensive care. This is often true of the young, healthy individual who'd rather use the money for other things.
The poor, the divorced, the low income families can obtain Medicaid but sometimes don't know about it or don't want to enroll because they are illegals or have other issues.
The only program that might help is high deductible catastrophic insurance that will prevent people from having to declare bankruptcy or fall into long-term debt due to either a long-term illness or a short-term expensive problem.
I'm all for a private health insurance account in conjunction with catastrophic coverage. Those who want more comprehensive coverage can contribute more to the HSA and those who prefer to take care of more routine things themselves, can save the money for more serious problems.
Posted by: Clean House on January 21, 2008 10:01 PMThese are socialist plans. All goods and service are rationed by price or by bureaucrats. These plans go with the latter. Guess who will lose?
This state is on a crash course with destiny. Too bad we who do not support the current elected officials will go down with all those sanctimonious Democrats who voted in these yahoos.
Posted by: janet s on January 21, 2008 10:33 PMGS, I got a couple of e-mails from OFM yesterday.
Posted by: swatter on January 22, 2008 06:45 AMActually, after Deborah Senn devastated the market that was a negotiation the OIC had to make in order to get companies to start selling product in Washington state again because her policies basically made it not profitable for them. So now he wants to go back on that deal so he can push universal health care.
Secondly, the bigger question is why do they want universal health care since there is access to every person in the US. This is only about who pays the bills.
So if you look at what the state is paying out in healthcare already, it's staggering and they are going broke because of it. The state mostly carries those who use the ER more than any other demographic. I'm sure Army/Medic would be able to attest to those who come into the ER. I have seen many claims from the ER for such trivial things as cutting toenails because the person couldn't reach their feet. But because that person was on state aid, it was a covered benefit.
So when you have a group of very high utilizers of medical services, the obvious choice is to broaden the risk pool so that they have more people paying into the system to offset those who are big utilizers.
Couple that with the medical lobbyists for doctors who demand more money from the state in reimbursement for state programs (note I didn't say insurance companies here) and you have the real reason behind wanting to change healthcare.
There is a real misconception about insurance companies making record profits. Most companies make a small percentage of the premium. The real costs come into play when doctors call for exams and tests "just in case" when there is no medical reason for justification. But that way they get to charge for using their equipment and charge it off to the end user.
Believe me, after 20+ years in healthcare administration, you get to see all the tricks and games played by all the players, but most I've seen are from the physicians groups and not the hospitals and insurance companies.
Posted by: Ken on January 22, 2008 07:19 AMI'd say some of the local companies with very good insuarance packages such as Microsoft and Boeing would roll out a welcome mat for this.
That's not the case with the population currently on the State programs. They are generally not healthy, high utilizers and the first to use (and demand) the most expensive treatment options "just in case".
So to get the bills paid for the unhealthy, they need to get the money from the healthy people who would pay premiums to an insurance company and have them pay it to the state instead to offset the costs.
Ironically, the state is also going to a self-insured plan for it's employees 2008 to exempt themselves from universal healthcare.
Posted by: Ken on January 22, 2008 10:02 AMTo make the system work, the system needs the healthy ones the most to balance payments.
Posted by: swatter on January 22, 2008 12:26 PMOnly the relatively large companies will be able to afford a self-insured plan when the state completes the list of what you must have for insurance in this state. Currently, if you offer an insurance plan in this state, you must also include mental coverage, chemical dependency, chiropractic care, naturopathic care as well as basic medical care. So when you have to cover all of these coverages, only a large population of employees will be able to mitigate the risk of high utilization from the few that use it.
So the state will mandate that you have to carry "X" amount of coverage if you offer a plan, which means everyone else must go through the state. This gives the state a much bigger pool to draw resources from to offset the cost of the high utilizers.
BTW, along with the state going to a self-insured plan for themselves this year, they are also exempt from having to offer all of the coverages that are required for everyone else.
It's good to be the king... or queen in this case.
Posted by: Ken on January 22, 2008 01:27 PMAlso ask about the processing costs. The amount of paperwork and staff costs are added to the medical costs. My doctor has 4 people who process paperwork. A while back we came across a bill from Swedish hospital 5 days of care and delivery of friend wife in 1946. The typed bill totaled $68.45. That was about 1 week of wages (give or take). Compare that cost to todays costs for like or similar services. It will blow your mind.
Posted by: Snuffy on January 23, 2008 07:02 AMSo if you return to an individual purchasing their own health care. If this is started as a young child (by parents), we would see a few actions:
1.) All health care is completely portable from employer to employer because it is purchased by the individual and follows the individual.
2.) The risk pool is greater as it would encompass the entire US population. So Insurance companies can charge the same low rates to all customers because they would be able to offset high utilization costs.
3.) Employers can still offer benefits such as paying the premiums for the employee, but the healch care plan still belongs to the individual.
4.) It reduces layers of management in the workplace by keeping the employer out of the business. No more choosing what they can and can't afford to give to employees.
5.) Reduces the amount of oversight by the state on employers.
6.) The state can subsidize those still needing insurance at a lower rate through the plans because the risk pool is greater.
It doesn't take care of everything though. Disadvantages:
1.) Does not eliminate those from the system who refuse to pay for a plan.
2.) Doesn't foster as much creativity in the market when new drugs or treatments become available.
There could be other disadvantages, but I thought this may be good food for thought. Anyone?
Posted by: Ken on January 23, 2008 09:11 AM