BHO Health Care Speech of 09/09/09

What he said well (from a Constitutionist's view):

Tort reform is necessary.

Expansion of competition is necessary.

What needs work and clarification:

"...against the law to deny coverage based on pre-existing conditions...": As one transfers from one insurance platform to another (due to age, such as rolling off the parent's healthcare, or changing jobs due to opportunity or RIF), I agree. To those who refused the opportunity to buy health insurance available from their employer, and only sought the same when something serious came up, they well should be on more tenuous grounds (if they do not invest in the system, why should they reap from it?)

What I oppose on principle:

Any public option: BHO claimed health care costs rose 3x faster than incomes; Medicare has grown 4.5x faster (after 10 years, Medicare costs 50% more per year than the private option). The public option as Canada operates it was promised to be a modest 7% increase in taxation. It now averages 25% for all Canadians (and those that can come to the USA for on-demand care). Why? People abuse what they perceive to be "free"; and certainly desire volume for that which they are already paying. As long as there is a public option, more and more people will find they cannot afford to provide their own insurance -- this is human nature (welfare has worked this way; it did not become the "bootstrap solution" as advertised, it became a means of enslaving people in poverty by taking away personal responsibility).

Forcing employers to offer healthcare, and forcing individuals to buy healthcare insurance is wrong, just un-American. Likewise, let them live with the outcomes.

Forcing one group of Americans to pay for the healthcare of another group of Americans is morally wrong and un-American, too. Americans freely donating to healthcare entities so they might provide care for the less fortunate is quite American (most hospitals in America and the world began as the result of charitable organizations).

Those in this country without legal immigration process should not receive the "government/public option" (which is another reason to not have it, since it will become a political tool).

What is naive:

"The only thing this plan would eliminate is the hundreds of billions of dollars in waste and fraud..." Medicare/Medicaid are poster children for such, just as Fannie and Freddie are poster children for the mortgage debacle -- both government run and sponsored. There is just too much opportunity for "sideline wealth" and too little accountability, and the necessary accountability only drives up the costs without offering more/better services. Remember, by the government's own admission, it costs them $1.50 to $2.00 to deliver $1.00 in goods/services.

Medicare, left unchanged, will break this country financially, or it will default and most boomers will not see it. There are no good outcomes for government run healthcare at any level. All government bureaucracies become political pawns and self-perpetuating in short order (What was the last expensive government program YOU saw terminated by our Congress? There will be no government cuts to pay for this thing.). And who will pay for it? It will not be the savings he indicated...

The CBO is non-partisan, and says any public option is more expensive; the math and accounting do not agree with BHO's words.

Possible Outcomes:

Insurance companies will be forced to compete across state lines, I hope. This will bring down prices somewhat, especially for individuals.

The fact that businesses will be required to provide insurance will create a captive audience for insurance companies and fuel inflation of goods in general.

Companies may find it more profitable to not offer health insurance at all, paying the fines, and therefore putting more people on the "public/government option" (if it comes to pass, and another reason to not have it). After all, the fines will not be high enough to sink the company and should not be. And the companies and its employees pay lots of taxes, so their continuance is more important than whether or not they offer health care insurance.

My View:

(it would be best if the following came from the states with the endorsement of Congress)

Let's try tort reform, clarification (with fairness for all parties) of the "pre-existing condition" coverage, and expansion of competition, first, and see what affect that has on health care costs. Also, recognize that there are those who do not take advantage of their employer's offered healthcare -- it is not that they cannot afford it, it is a matter of priority. We all make lifestyle adjustments for the price of goods and services, and those of us who take responsibility for providing our families healthcare should not be penalized by paying for those who choose otherwise.

The next step (after two to four years), should costs not come down nor coverage grow, is more draconian, and I do not like it, but there is a reality about the matter: put it to the states to pass legislation for individual minimum health care insurance requirements (just like auto insurance), whether privately purchased or obtained through their employer. Again, it is another boom opportunity for insurance companies, and the opportunity for employers for rolling back what they offer, and this is why it should not be pushed too early.

We do not have to rush into a perceived "grand solution" (which are usually fraught with unforeseen errors in analysis and judgement, driving up costs and reducing service, and the path of all government programming I have known), but we should take it in steps, and small steps are best. In no way should the government ever, ever provide health care insurance -- Medicare/Medicaid should scare us away from that option.