Earlier today, on my way to work, the local news talk station, WMAL 630 AM had an appearance by U.S. Representative (and Senate Candidate) Ben Cardin (D-MD-3) to seek his reaction to the State of the Union. After the usual Democratic rhetorice regarding a speech by President Bush, a question about health care was brought up by host Bryan Nehman (who is also a constituent of Cardin's). Cardin responded with a, by now, discredited version of universal health care.
For those who can't remember, universal health care was a centerpiece of the Clinton first term agenda and an absolute shambles. Cardin is seeking to resuscitate a bad idea with a hope not based in fact.
In the world of engineering, engineers seek to improve matters in three ways, they want to make it better, they want to make it faster, and they want to make it cheaper. As a general rule, you can choose any two. Thus if you want to make something better and cheaper, you won't get it faster. If you want faster and better, it definitely will not be cheap. If you want it cheaper and faster, it definitely will not be any cheaper.
Health care policy has three main goals as well, universality, affordability and comprehensiveness. Universal health care means that everyone is covered, with no exceptions. The theory behind universal health care is that health care is some sort of right that must be protected by the government and enforced upon us all.
Affordability is just that simple, health care should be cheap enough that even the poorest among us, or really, the people too poor to pay their own way and too rich to qualify for government assistance can pay for care. The problem is that health care costs are rising at annual rates three to four times the rate of inflation. Double digit increases in health care costs have become the norm, not the outlier.
Finally comprehensiveness is the idea that all health care needs, from basic doctor visits, to specialists, prescription drugs and hospital stays are covered. Only the most radically new procedures and experimental protocols would not be covered by this health insurance program.
Now here's the problem, health care is a classic engineers triangle problem. If your choices are universality, affordability, and comprehensiveness, you can only choose two. If you want universality and affordability, you cannot have a comprehensive covereage. In a era of "I want it all and I want it now" consumerism in America, this idea is, simply put, dead on arrival. I get mad when I have to wait a week for an appointment for my daughters and get downright livid when I have to wait for even five minutes past my appointment time to be seen by a doctor. I certainly am not going to accept any delay because of governmental rules regarding what services are available and those which are not.
Okay, what if the health care plan is universal and comprehensive. Oh, joy of joys, you think. Think again, the cost of such a program will require one or both of two things. First, only the very (and I mean very) rich will be able to afford that kind of coverage privately. Even upper middle class America is going to need some help paying for such a plan. So, at a time when national budgets are already straining with entitlement programs taking 1/3 of the entire federal budget, we are going to add this monster to the mix? You could of course raise taxes to pay for such a proposition, but that would require a low end tax rate of somewhere near 50 or 60 percent, a rate that definitely will notsit well with Americans, even the most liberal of Americans.
Fine, Comprehensive and affordable, that is the way to go right? Well, if that is the case, not everyone will be covered, bringing more or less to where we are now.
The fact that over 40 million Americans lack health insurance is surely a problem of national significance. I don't mean to gloss over the issue, but government mandated, universal health care simply imposes too many costs, in terms of real federal monies and/or restrictions on care.
One of the best alternatives making its way through Congress is association health plans. Association health plans would allow business, particularly small businesses to use the pooling power of trade and business associations, like the Chamber of Commerce or the National Federation of Independent business to get large group health insurance rates for small businesses. As long as the association exists for purposes other than insurance, then the association can help by getting series of insurance options so that employees of small businesses (those least likely to offer health care) can get insurance at big group rates, which are often much lower.
The House of Representatives has recently passed HR 525 and it has moved to the Senate. Call your Senators and tell them to pass HR 525. By some estimates, some 20-25 million employees of small businesses, the working poor, will be eligible for health care under association health plans--a 50% reduction in teh number of uninsured Americans. Now that is a plan!!
Ben Cardin, like many Democrats, are looking backward for solutions to problems that need a forward looking solution. Universal health care is a wonderful ideal, but a very bad legislative idea. Mr. Cardin, look elsewhere, please!
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