I won't return to previous ground or the bigger picture questions, but this paragraph struck me:
The second part of the subsidies, estimated to cost $466 billion during the next decade, would limit out-of-pocket expenses for deductibles and co-payments. This help, for individuals with salaries of $27,000 and families with income of $55,000, would be significantly more generous than any version of the legislation Congress has considered.
Cut out or limit the second part of the subsidies, at the very least. I found the article as a whole to be a very useful discussion of which subsidies are contained in the current bill.
Do you feel they are entirely unnecessary, or just ill-targeted?
How can anyone talk about improving the bill now? Clearly they haven’t been interested in improving the bill for a long time, only passing it.
Why don’t we just abolish the mortgage interest deduction and replace it with the cost of health insurance deduction. (and tax employer provided health insurance) We would solve two problems at once…the over investment in real estate and increasing cost of health care.
When 40-45% of the people elected to serve the people reject all entreaties to do what they were elected to do, “improvement” is impossible.
Unless you consider preserving the failed, failing, and increasing failure of the status quo as serving those who elected them.
Serving the people should be driven by some reasoned, evidence driven debate, evidence of the problems with the existing system, and evidence driven solutions.
On the solution side, the evidence is clear that the greatest efficiency of the system occurs when everyone is fundamentally entitled to the society’s minimal level of medical service.
US law mandates a minimal level of health care. The trick is gaining access to the US health care system by any means possible to have that mandate come into effect.
I have yet to see one politician say, “I will repeal the law that prohibits health care providers from dumping patients on the street because no one in the US has a right to health care they can’t pay for. Further, I will provide legal remedies for providers stiffed on services that allow them to recover their costs just like all other tradesmen, including taking title to the property the services to sell or salvage as the provider sees fit.”
Given the minimum standard of care providers are required by law to provide, the only solution that makes sense, and that works, is to ensure that all providers will be paid for delivering the services they are mandated to provide.
Lots of ways are possible, and many are used. In some cases, the government pays with funding provided by general taxation. On the other extreme, everyone is required to buy private insurance, with assistance provided for those without the income to pay for insurance.
But in any case, the only logical system is one with universal coverage of basic health care costs.
Once the commitment is made to pay for life preserving care, the next logical step is prevention.
The battle today is not the one Obama wanted as he assumed that paying for a universal system of coverage was consistent with the claims of those on the “right” or “left” of a “right to life.” What he didn’t expect was a reaction to his election in which Republicans would as a block oppose any program that actually pays for the things that some many seek legal mandates for, or that exist as legal mandates, or that reflect their claims value of “right to life”, or that they have actually worked to pass into law. Romney and Brown for example, are opposing the solution that the worked through to a solution which is virtually identical to the current plan.
Ultimately, the issue the Republicans have is with paying for the things they support as policies and mandates. Again, not one Republican has called for changing the law to allow kicking sick patients out of hospitals, nursing homes, doctors offices, to die on the street.
In fact, in many cases where terminating life to safe pain and suffering and the needless cost of living beyond the point of reason, Republicans are in the majority in opposing those possibilities, calling such actions murder. This is a case where the patient wants to control his medical treatment, but Republicans are dominated by those who seek to deny them that right. While Democrats in some cases oppose abortion, assisted suicide, etc, they don’t demand others pay the financial costs of their desired mandates.
(And for the claim that Democrats are mandating people pay for their mandates with taxes, my response is: I am anti-war and so I call for the principle be applied to the soldiers, they should pay for their own weapons, bullets, food, transport in battle, like in the Revolution. Stop socialized defense.)
And let’s be clear. The US health care system is the most inefficient one in the world, and that is a consequence of its fragmented system of trying to deny coverage to major portions of society.
Once universal coverage is established, Republicans certainly be interested in changing it. Some will actually be interested in controlling costs, but the question is whether they will outnumber those interested in increasing costs, as was the case of the Medicare drug plan. Then the debates can begin about “improving the bill”
Nylund, thanks for calliing me juvenile. I’m sure Obama likes that his reforms be named after him. Now since I’m supportive of the decision-making processes of a constitutional democracy, I believe anything approved using Banana Republic tactics should be named after the dictator (btw: why do you think that yesterday, after I asked Tyler for the reference, there was a change in process? It reminded me of my own country, Argentina).
First-time commenter here. I’ve not been reading the blog all that long–what’s your specific problem with the subsidies? My wife and I both work full time, but in jobs that don’t offer affordable health insurance. With individually-bought insurance costing around $1,000 a month, do you have a different idea for a way to provide low- and middle-income people with health care?
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