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    Friday, August 21, 2009

    A Quick Thought on Medicare and Health Care Reform

    I spent some time recently talking to my mother-in-law (70ish) about Medicare, since I have no first-hand experience with the program and wanted to find out if she, as a Medicare user, was happy with the experience and a little about how the program works.

    Here are my 2 key take-aways:
    1. She's generally happy with Medicare, but, she still has to pay a healthy monthly premium for her health insurance for Medicare supplements, but, she pretty much has one of those gold-plated policies that covers everything.
    2. The prescription drug benefit passed during the Bush years was a very good deal for her.

    So, I wondered, if seniors are generally happy (and, a sample size of 1 isn't very good), then why can't we just extend Medicare to everyone?

    Well, the answer should be obvious to just about everyone - we just can't afford it. We can barely afford Medicare, Medicaid and S-CHIP now, and to extend such a system to every person in the country would require such confiscatory taxation as to destroy economic growth in this country. In fact, with the government in control of about 50% of the health care spending now, it is more a part of the problem than a part of the solution.

    My personal opinion is that the taxation system that rewards employers for providing health benefits is the biggest problem we have in health insurance. If we instead passed those benefits directly to the consumers of health care, we'd give a much better chance of making health care more portable, which would address some of the pre-existing conditions problems, and we'd make it more affordable, and address some of the uninsured.

    No doubt that this would still leave many uninsured, but, rather than tearing down the system completely, and remaking it in the government's image, this would retain the system of private insurance, which will certainly allow for more innovation, better allocate scarce resources, and not place health care decisions into the hands of a)bureaucrats with no stake in individual's health decisions, and b)elected officials who may be corrupt, incompetent, or both.

    Then, once we start to bound the problem better, we can begin the hard work of dealing with the chronically uninsured, and the poor.

    This is really a philosophical debate. Either you believe that the government can efficiently and effectively run the health care system, or you believe markets are the best way to manage resources. In the current debate, there really appears to be little middle ground, and I side with those who look at what government does, at the hubris of those suggesting that government can do this (if only this group of smart people run it), and agree with them that individuals, operating within a (relatively) free market, can make the best choices about their health care and how to spend their money.



    reddog said...

    Health care won't cost anything, Whiner. We'll just do the same thing we've been doing to pay for the Mid East wars, all that Homeland Security crap and all the entitlements we've been spending on since LBJ's Vietnam War and Great Society. We'll print the money.

    Sooner or later the Gov't will go bust and the dollar will inflate like Zimbabwe. Then we'll all be poor together. Nothing will stop it happening. It's gonna happen anyway. Just a matter of when.

    Hey, wasn't me that done it. I collected unemployment for a few weeks back in '78. Was like $30 a week. Since then, I ain't seen a dime. I gave them a lot in taxes and 6 years in the NAV to boot.

    I could prolly use a prostate biopsy and a urethral ream job before we hit the skids. I just wish they'd hurry up.

    Jay said...

    Red, you know how much it pains me to agree with you, but you are absolutely correct that there is no way to pay for ALL this stuff without resorting to one (or both) of these things:

    1. Print more money (leading to the Zimbabwe-ecation of the USA) or,
    2. Massive tax increases on everyone who works (in the form of a payroll tax).

    Man, I wish it weren't so, but, it is.