Once you filter out the hyperbolic and toxic comments of what passes for political discourse these days, you come up with the only thing that really matters in the recent health care debate…the truth.
To expect politicians to tell the truth is an exercise in misplaced optimism. At its heart the health care debate, however it was couched, was simply a matter of distorting the perfect science of mathematics since there is absolutely positively no way to pay for it without raising income taxes or cutting spending bloated by entitlements and subsidies created by political manipulators on both sides of the aisle.
Why oh why do they lie to us most of the time, perhaps all of the time? Worse. Why do we believe them?
Of course, most of us want health care for all. We are a compassionate people. We do not want a previous health condition to keep any citizen from getting health insurance.
We are not as stupid as most politicians think. We understand that putting thirty million more people on the health care insurance rolls, whether they want it or not, will cost a fortune in subsidies.
We understand that the concept of health care is based upon “just in case” payments meaning premiums, which are paid in advance of any health problems.
We understand the actuarial calculations that means that the young pay for the old, the healthy pay for the sick, that insurers need maximum participation since they pay the costs based upon keeping the spigot of “just in case” funds open and flowing.
We understand that doctors must practice defensive medicine to protect themselves against those sharp fanged lawyers who work their own wiles to extract more funds in malpractice cases and cause insurance premiums to explode for doctors who can easily be wiped out by a malpractice suit.
We understand that the Medicare program for people over 65 will go broke sooner than later and that the States will have to really trim expenses elsewhere if they are to keep funding Medicaid. We know that if you cut five hundred billion out of Medicare services will diminish. Who are they kidding?
The truth is that there is no way on God’s green earth that the health care bill just passed will not result in a massive, yes massive, upward spiral of taxes unless it is accompanied by an equally massive cut in spending. Forget that last part happening. The current crop of politicians haven’t the courage to slice entitlements and you don’t get votes by taking things away.
You don’t have to be an accountant to figure it out. An eighth grade education in arithmetic will do it. We are on life support financially.
Did you know that nearly fifty percent of Americans pay no income tax? Of course, they will howl like mad if they didn’t get what they deem as their fair share of goodies from the government. Why don’t our politicians tell us that a huge tax increase is looming? Why don’t they tell us that the five hundred billion that will be extracted from Medicare will result in diminished services and still not be enough to fund the thirty million people that will be put on the health insurance rolls.
Why don’t they tell us that few, if any, politicians have the political courage to pare entitlements and that includes agricultural and corporate subsidies as well as union perks and a plethora of double dipping pensions scattered throughout the system.
So where will the money come from to fund this so-called reform? Surely, from higher taxes on the fifty percent who pay income tax and raising of all manner of taxes, from capital gains to estate taxes and beyond. Someday you may have to pay a tax to sit on a park bench or walk a particular path or sidewalk. Expect your public transportation costs to go through the roof and crossing a bridge might cost a mint.
It won’t be long for a push for a national sales tax to gain momentum as well as hundreds of other creative tax gimmicks to help carry the load. It won’t. Politicians will find ways to provide more and more expensive perks and giveaways to buy votes. You can be sure it won’t come from the Social Security pool. That has long been raided and will go broke a lot sooner than we thought possible. And do you really think those who receive their government largesse will take their cuts without ugly protests. Take a look at Greece. How many of Greek workers want to give up their four-day week? Or France or the rest of the European nanny States.
As for the American States, they will be hounding the Federal government for more and more funding while they sink deeper and deeper into the slime of debt created by bad decisions, political chicanery, stupidity and very bad arithmetic. California is on the verge of financial ruin and New York is sliding downhill fast. At least three quarters of the other states are in financial trouble with the new health care bill threatening to impale them further.
Everything is based on postponement. By postponing the moment of truth, meaning when we simply run out of money and taxation gimmicks, the responsibility of keeping the ship afloat will be the job of our grandchildren and their children who will see their taxes go higher and higher to keep up with spending. We are lousy grandparents by bequeathing them such a burden.
This is not to say that those who voted for health reform didn’t have their heart in the right place. Their problem is that they are either illiterate in arithmetic or they want to financially punish those who by their creativity, hard work and risk have been the motivators of prosperity for themselves and a vast chunk of the American people.
From a purely selfish perspective those people of my generation meaning those of us who lived through the Great Depression and the terrible wars of our era and survived, had the best of it and will not suffer as much as our progeny. We were lucky. We got as close to the American dream as possible. We grew up with the old values and verities, before the onslaught of technology and the scattering of our families, before credit cards, consumer excess and drugs.
It was far from a paradise but, even in memory, the good times seem better than the bad. We grew up with Ben Franklin’s proverbs ringing in our ears. A penny saved is a penny earned. God helps those who help themselves. Well done is better than well said. If you would know the value of money go and try to borrow some. When the well is dry they know the worth of water.
And the one that seems to speak for our future:
It is hard for an empty sack to stand upright.
Categories: Politics
Tags: Benjamin Franklin, Bill, Health Care, Obama, Washington
I think maybe what is left out of your mathematical consideration is the cost of carrying sick people who cannot afford to pay for their medical bills. The child with asthma that will never be able to grow up to be a healthy contributing member of society; the family that ends up on the welfare rolls because the breadwinner wasn’t able to get the care of a doctor; a child motherless, and with all the cost to society that entails, because of a lack of affordable healthcare.
It is really very simple: if you do not pay to insure the health of your citizens now you pay later in all kinds of other way. Life costs money and someone will always pay the cost and it isn’t necessarily going to be the poor schmo who has no health coverage. He or she may already be dead but the costs that are left will have to be paid by someone.
Once again, you have written an incredible article. Very succinct and accurate.
Politics seems to, these days, run off the impetus that by the time the consequences of political action come crashing down, the people who took those actions will have already moved beyond our ability to politically punish them for those actions.
When our children are paying tomorrow for the mistakes of today, who will bear the brunt?
Nobody seems to have an answer for that.
Unfortunately, I think you are very wrong that people, as a general rule, understand the truth of the Healthcare debate, or how the system currently works. In fact, I’m afraid your post suggests that even you do not really understand how it works. It is far more complex than you appear ready to admit or imagine.
It’s not that politicians are lying, stupid, or mathematically illiterate. It’s that the real truth is far too complex for anybody to understand.
Case in point: a friend of mine recently detailed what happened when she received medical care for an emergency ailment. The hospital forgot to run her insurance, so she received a bill for the full amount. She pointed out the error to the hospital, and they advised her to discard the bill, and they re-ran it with her insurance. She received a new bill with the insurance portion deducted. However, the new bill was for an amount almost twice the original amount – ostensibly for the same procedures! Her “portion” was for only slightly less than the original amount she was billed for. The ensuing discussion between us, our professor, and other students over dinner revealed several interesting facts worthy of note.
The first is obvious: this story amply demonstrates the hidden truth that those with health insurance are ~already~ subsidizing the health expenses of those who do not have health insurance. This is a fact that was not given ample coverage during the “debate”. The difference between the way things were and the way things will be post-reform is that now those subsidies will be transparent and explicit instead of hidden. Which makes people angry because they’d rather problems stay hidden from their view: having to confront them face on makes many people profoundly uncomfortable. The fact is, though, that uninsured people are already using the healthcare system (insofar as we can call it a “system”, which is a vast stretch of the imagination), and they cost the rest of us who are paying into it via “insurance” a lot of money.
The other facts we uncovered are even less obvious: each insurance company negotiates a rate with each doctor separately for each procedure. Stop and consider that for a moment. How many insurance companies are there? More than a few. How many doctors? How many different possible procedures can a give doctor perform? The result is that there is a mathematically staggering number of payment schedules. The combinations are effectively infinite. Managing and administering that behemoth sucks up huge amounts of resources. How much of each each dollar spent on healthcare in this country actually goes to someone’s medical care? The answer is a vanishingly small portion. Yes, medical malpractice insurance takes up an aggressive bite from that dollar. But the larger bite, by far, comes from wasteful administrative expenses that are a direct result of the over-complexity we’ve introduced into this system by virtue of our “private market”.
There’s one more fact that isn’t talked about much: for all we like to believe we have the “best” healthcare system in the world, the fact is we’ve been lying to ourselves for a very long time about that. We do have the best ~research~, but we quantitatively and qualitatively do ~not~ have the best healthcare system in the world. We know this because we do not achieve the best healthcare results in the world. We have more sick people suffering a lot more than those in other countries, and we pay a lot more for these suboptimal results. Other countries are much, much healthier than we are. Consider, for instance, our infant mortality rate: among the highest in the developed world. The same is true of our mortality and morbidity rates for countless other health measures. If we have such a great system, why do we achieve such terrible results? Because it is native the American mindset that everything America does is great, and by virtue of having been the American way of doing things, it had to be great. It was a fallacy.
But that same fallacy prevented us, throughout this debate, from considering seriously what alternatives other countries were using to achieve better results. But that had nothing to do with facts, and everything to do with American pride.
One final thought I can’t help but share: you point out that the nature of insurance is predicated on the idea of paying now against the possibility of a future negative outcome. For car insurance, for instance, you’re paying against the risk of getting in an accident. For health insurance, you’re paying against the risk of needing medical attention of any kind in the future. However, throughout this process, very few people ever stopped to consider what actual chance of needing future medical attention actually is. For car insurance, it’s very low: it’s very unlikely you’ll get into a seriously bad accident on any given day, and over time that likelihood remains low. This is what allows car insurance to work (that, and the fact that everyone who drives – everyone with any risk of being involved in a bad car accident – carries insurance). With health insurance, that risk approaches 100%. In other words, the probability of you dying at some future point is certain, and the probability of you needing medical attention at some future point, either related to your nearly dying or not, are almost just as certain. The lesson from this is one that the Americn people are not yet prepared to admit: Health Insurance as a model for funding the collective medical needs of our country is a fundamentally flawed model. There is no long-term profit in it. As long as we perceive it as a profit-driven venture alone, it is a venture doomed to insolvency.
The comment saying we already pay for the uninsured through our insurance and our health fees is true and many of us know that. We aren’t happy about it, but we accept it because it is still a good system and we are satisfied with the product/service we get. However, if you turn all that over to government bureaucrats the costs will not go down, the service will not be better and our satisfaction rate will be much lower. Many people who go without health care in this country do not do so because they cannot afford it or don’t have insurance; there are many ways to receive healthcare without paying. They don’t like doctos; they wait too long to ask for medical care; they don’t want to spend their money on doctors, medicine or insurance, they have drug addictions, or alcohol addiction or mental problems (that go untreated because they cannot be forced to receive treatment). The healthcare problems in this country are not due to insurance companies or doctors or hospitals or mean-spirited citizens. We glady donate to charities, we pass legislation to provide all sorts of care, research, clinics, subsidies, you name it. Many doctors donate their time and skills to help the needy here and abroad. But you can’t make people buy insurance; you can’t make people make healthy choices, you can’t make people get medical care when it’s needed, you can’t make drug addicts use birth control, you can’t prevent the stupid from being stupid, you can’t save everyone. And, most assuredly, this plan is not the way to save everyone. We need reform to provide coverage,like flood insurance, for those with pre-existing conditions and “expensive” illnesses, we need to stop runaway lawsuits against medical caregivers, we need to eliminate fraud in Medicare and Medicaid and other programs, we need to educate people on how to take care of themselves, how to know when they need medical care, how to get off drugs and alcohol and stay off them. we need to set good examples for parents to love, cherish and care for their children. These are all things we have tried to do, but we are failing. We need to put more energy in these directions; not in setting up another entitlement program that will guarantee our children and grandchildren will never enjoy the happy, healthy, successful life we loved and enjoyed ourselves. But I feel like my words just fall on deaf ears.
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