Can we afford Obama’s health care plan?
ByJune 19, 2009
One can’t help but think there is considerable danger in Barack Obama’s unswerving determination to alter the nation’s health care landscape at what may be a cost most Americans can’t even fathom.
The president’s zeal is impressive. It is the passion of a true believer who sees a country in which no one is without medical insurance as key to restoring the economy even as the national debt approaches unimaginable dimensions and some of his most ardent supporters are beginning to wonder how to pay for such an ambitious goal.
Should employer-provided health benefits be taxed as regular income to those receiving them? Should Medicare and Medicaid payments to hospitals and doctors be curtailed? Should there be an overall income tax increase, not just one aimed at those who are in the top one percent bracket? Should there be a national value added tax on goods with revenues earmarked for health care? Or is it possible that all of the above will be needed to support what easily could amount to a multi-trillion dollar expenditure over the next decade and apparently still not reach everyone now uninsured?
As the Congress wrestles with competing plans and ideas, one thing seems certain — the impact of a final solution without the utmost care easily could be catastrophic, leaving us struggling for generations to find the wherewithal to meet the rest of the country’s needs from the schoolhouse to the battlefield. As Federal Reserve Chairman Ben Bernanke warned recently, the resulting impact of spending on the debt could dramatically interrupt economic recovery. And the Congressional Budget Office has reported that the White House proposals are likely to dig us further into debt without some very painful spending controls.
Obama has been running around the country plugging his initiative and using his personal charisma to assure Americans that while it won’t be easy to manage, in the long run overhauling the hugely complex system that supplies this most basic of needs — viable health care — is absolutely necessary. His is a "Dr. Feel Good" lecture, which includes large doses of "everything will be just fine" medicine. No one is arguing about the nobility of his proposals just their viability in the face of high cost bailouts, two overseas battlefronts and the possibility there quickly could be a third if North Korea’s nuclear saber rattling becomes more than that.
But the White House believes — despite all the growing signs of doubt — there may never be a better time to accomplish what several past administrations could not, that this president’s approval ratings and overwhelming majorities in the Congress will make it so. They may be right but from a political standpoint, the fact that this and other domestic spending plans are expected to cause us to borrow $9 trillion over the next 10 years has begun to raise alarms among Democrats at both ends of Pennsylvania Avenue — Capitol Hill and the White House.
The president’s continued hold on long term approval ratings will undoubtedly depend on how he deals with the spending questions and whether his party in Congress can add to a succession of election victories in next year’s midterm balloting. A recent vote in the House on funding for Iraq and Afghanistan was much closer than expected with 32 Democrats voting against it even after House Speaker Nancy Pelosi strongly pleaded the president’s cause.
There is, of course, another problem when it comes to raising money for the health care plans. Republicans are likely not to support major tax increases, although some, including Sen. John McCain, have been among those suggesting taxing insurance benefits. Democrats don’t want to go it alone when it comes to paying the bills for all this new spending. Then there are the older folks who might see some decline in their Medicare benefits if doctors and hospitals get their payments cut. Their lobby is still politically potent.
The president wants to have this all wrapped up and on his desk and signed by mid-fall. Well, he may have the votes to do it, but the ultimate cost to his political fortunes could give him a headache. But why should he be any different than the rest of us?
(E-mail Dan K. Thomasson, former editor of the Scripps Howard News Service, at thomassondan(at)aol.com.)
10 Responses to Can we afford Obama’s health care plan?
pondering_it_all
June 19, 2009 at 6:49 pm
Over 50% of Americans are already on a single-payer plan of one kind or another, in the form of Medicare, military, VA, or government employee insurance plans. The one thing all of those systems have in common is that they are much more efficient in terms of health care dollars actually spent on health care, than any standard health insurance plan.
The health insurance plans most of the rest of us have divert a very large percentage of those health care dollars to the insurance company, the drug companies, and for-profit provider corporations. Thats why we have the most expensive health care system in the world, but something like 47th best in terms of outcomes!
Even the business community has recognized that our stupid health care system is rendering the US uncompetitive, compared to other countries. We have to fix it, to regain our competitive position. And when we do get it fixed, we will actually end up spending less and getting more for the money we do spend.
But Big Insurance, Big Pharma, and Big Medical are going to threaten, whine, scream, and fight every inch of the way…
ClassicLiberal
June 19, 2009 at 7:17 pm
Only active duty military personnel and the limited number of veterans with service-connected medical needs served by the VA have single-payer medical coverage. Medicare part B relies on individual private insurance (or medicaid for the indigent) and federal government employees are also insured by private plans subsidized by govt in the same manner as private industry.
Carl Nemo
June 19, 2009 at 9:29 pm
Once the government hatches this medical plan; we will all have less than before as a nation, both financially and surely less medically speaking.
Those that currently have plans through their corporations either as active or retired employees will find that their plans will provide far less coverage with possibly many losing their functional plans with the corporate apologia that they now can acquire insurance through the government sponsored plan which will surely be substandard. There will be lots of red tape along with belligerant government employees to interface with, no differently than those found at the SS administration, IRS, and VA and all after being on hold for thirty plus minutes or more.
There will be extreme, byzantine paperwork to complete along with mandatory quarterly questionnaires, surveys etc. and all linked to sub-standard medical care to boot.
Why do people think that their now broke and broken government seemingly being run by overpaid “village idiots” will somehow provide them with viable, functional medical care?
We’re flat, dead broke as a nation. It’s amazing we’ve not gone publicly bankrupt as yet. With each T-Bond auction more deep pocket lenders are backing off from their purchase, while billions of T-bonds are being redeemed forcing long term rates everso incrementally higher.
In the world of market savvy bond investors, “the full faith and credit of the United States” no longer means diddly squat. In fact the major bond rating agencies are on the verge of downgrading U.S. government debt!
We’re now in the sweephand mode to midnight of a national financial collapse, yet people refuse to acknowledge this fiscal tsunami is looming on the horizon. It’s time the U.S. needs to join the line and file for bankruptcy because that’s the way it is and no amount of lying to ourselves will turn this collapsing wavefront from our shores.
Carl Nemo **==
bryan mcclellan
June 19, 2009 at 10:13 pm
The sweep hand, beats imagery every time +.Thanks…
woody188
June 21, 2009 at 12:38 am
Ohio’s state government just lost it’s AA+ rating. I think they are some $4 billion in the red. Not as bad as California, but we also don’t have the population California does.
pondering_it_all
June 19, 2009 at 7:46 pm
ClassicLiberal: I think you are confusing “single payer” with “National Health”. Only military and VA receive health services from a National Health-type service provider (the military and VA clinics and hospitals), but all of those I listed are classified as “single payer” because the government is paying even if the providers are not government employees.
As for poor Carl: I think you better just dig a deep hole and climb in. If everything is going to go to Hell in the coming months, then it will make little difference what sort of health care system we have. They will all be bankrupt.
On the other hand, just in case things work out a little better than you predict, maybe we should try to create something that works better ands costs less. A large chunk of my healthcare dollars go to pay huge executive bonuses, and a large chunk of my taxes go to pay for indigent care at the most expensive of facilities: Emergency Rooms. We can fix that, if we try.
Everybody on an employer’s group plan is just a layoff away (or a cost-cutting decision away) from an individual insurance policy. And everybody on an individual policy is just a single claim away from having it cancelled, followed by medical expense-driven bankruptcy.
We can choose to let the insurance companies screw us over (and over and over): Just don’t change anything.
gazelle1929
June 20, 2009 at 4:23 am
Pondering:
May I suggest that you do some basic research before casting out definitions, particularly of what a single-payer plan is?
A single payer plan is one in which there is only one entity that processes and pays claims for services. This is from the wiki article on the subject:
Single-payer health care is a term used in the United States to describe the payment of doctors, hospitals, and other health care providers from a single fund. It differs from typical private health insurance where, through pricing and other measures taken by the insurer, the level of risks carried by multiple insurance pools as well as the coverage can vary and the pricing has to be varied according to the contribution of risk added to the pool. It is often mentioned as one way to deliver universal health care. The administrator of the fund could be the government but it could also be a publicly owned agency regulated by law. Australia’s Medicare, Canada’s Medicare, and healthcare in Taiwan are examples of single-payer universal health care systems.
I can assure you that Federal employees are not part of a single payer plan. There was a discussion here a while back about it, and this is what someone posted about the Federal Employees Health Benefit Plan:
“As I have pointed out before, the Federal Employee Health Benefit Plan is a good place to look for a relatively inexpensive (in terms of overhead) highly competitive marketplace in which to buy medical services. The Office of Personnel Management runs the service by providing a marketplace for practitioners of all kinds to in effect advertise their services. They have a really big pool of insured people, running into a couple of million people, so they can attract offers from a wide spectrum of medical providers, who typically organize themselves into a group to offer a competitive package of services.
“OPM functions mainly to require certain coverages from these groups so that the employees can compare apples with apples and bananas to bananas. (Note, both of these fruits are pretty good for you.) They also serve to collect the premiums and pass them on the the provider organizations and they they do some monitoring to make sure that the providers actually provide the services they advertise.
“In the major employment areas particularly the competition for enrollees is nothing short of fierce. In the areas without a lot of employees there is admittedly less choice, but the competition among the national providers is still pretty intense.”
http://www.capitolhillblue.com/node/6302
The Government does not pay any claims under FEHBP. All it does is act as a facilitator for getting the insurance provider and the customer together.
Carl Nemo
July 9, 2009 at 7:33 pm
Hi pondering_it_all,
“As for poor Carl: I think you better just dig a deep hole and climb in. If everything is going to go to Hell in the coming months, then it will make little difference what sort of health care system we have. They will all be bankrupt.”…extract from reply
Fortunately I’m better off in health care areas than 99 percent of the American public including Congress, but that doesn’t abate my concern for these slimeballs doing a “job” on the ever hopefuls for something better to come along.
Rhetorical question:
Has anything good come from Congress in recent memory?
They hypothecate trillions of dollars of our future national GDP and wealth via a tax system that’s already failed, having been plundered by duly elected knaves then giving the money to proven banking and insurance criminals…!
What I predict doesn’t mean diddly, it’s linked to the base reality of the business of financing national debt; ie., the T-Bond market and how things are slowly, but surely devolving into a national rout.
I didn’t reply to you in an upset, disparate manner. It’s my wish that your hope turns to reality, but I have my grave doubts based on my knowledge of debt and how it’s linked to risk vs. reward. Seemingly our government along with the Federal Reserve is soon to get their comeuppance when the debt chickens come home to roost…! /:|
Carl Nemo **==
bryan mcclellan
June 19, 2009 at 10:19 pm
Indeed, (Harrumph!)
the blindness,
not the dark,
is what is in Question!
roallan
June 30, 2009 at 3:02 am
If you need to know more about your medicare health benefits, here is a good place to start: http://medicare-benefits.com
Knowledge is power.