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Jan
23

Bush’s blithe ignorance

So a lot of folks are finding good things in Pres. Bush’s plan to use tax policy to help uninsured people get health insurance.
Not me. I see it as the worst kind of incrementalism, on a par with consumer-directed health care. To the naive, it promises a quick solution using financial gimmickry that will not cost anyone very important much of anything, and may help a few folks get coverage thru a state program.
But it won’t do anything to fix the underlying problem – people who need insurance can’t get it, and if they can, many can’t afford it, leaving the rest of us to pay for their health care. Meanwhile, insurance companies compete not on the basis of how healthy they can keep us, but on how good they are at denying coverage to anyone who may have a claim.
Arrggh!


Bush’s plan relies on the incredibly screwed up individual health insurance market. You know, the market that won’t cover your eyes if you had pink eye, or your ankles if you sprained one a few years back, or your heart if you take Lipitor. I’m not blaming the insurance companies; they operate in the Alice-in-Wonderland system as best they can. And if they start acting altruistically they go bust.
Bush proposes tax credits to help poor folks buy coverage. This when the average cost of family health insurance is above $11,000. To quote Karen Davis of the Commonwealth Fund; “Ninety-five percent of the uninsured wouldn’t get a significant amount of money from this deduction because they earn so little,” (newsday, 1/22)
If there isn’t supply, creating demand won’t solve the problem. And if there is supply, it has to be at a price level that consumers can afford.
Two points which Bush’s plan blithely ignores.
The best thing about this plan is it doesn’t stand a hope in hell of passing.


4 thoughts on “Bush’s blithe ignorance”

  1. I have to agree with most of your comment. I will take exception on one statement. Many of the uninsured in our country are that way not because of income status but rather the insane insurance sytem. Myself and many others cannot get insurance no matter what the cost. Pre existing conditions this Government states that the small business owner is the backbone of the economy but many of us go bankrupt because we cannot get health insurance. The tax payer will not pay for our health needs (we make too much money)they will pay for the poor the welfare people but not the upper middle income ones. It is sad that reportedly the wealthiest nation in the world cannot take care of their own but can send billions of dollars to third world countries to boost their standards. We are the only developed indusrial nation in the world without universal health care this is a crime and our representatives should have to answer for it. Thank you for your great blog as I stated I agree with you 100%. If enough of us make this an issue (48 Million uninsured) they will have to do something and only the fat insurance company crooks will suffer.

  2. I totally agree that the system makes money precisely the wrong way: off illness rather than health. Here’s a simple way to fix it: give the VA back to the Public Health Service, whence it came in 1921.
    Then let the two systems compete on outcomes, something that no health plan currently wants to mention. Let the private sector keep 80% of patients, and the newly reconstituted US PHS the other 20%. Patients will leave the private sector for the free PHS, unless the outcomes in the private sector are at least as good.
    Little known fact: the VA will start shutting down facilities big-time in 2010, when the last of the WWII and Korean War vets will die off. So if we’re going to save several trillion dollars’ worth of taxpayer-funded infrastructure, we need to act in the next Congress.

  3. “the underlying problem – people who need insurance can’t get it”
    So that’s the underlying problem, huh?
    Anyway, this illustrates yet another problem – there’s precious little agreement on what the underlying problem is, never mind solutions.

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Joe Paduda is the principal of Health Strategy Associates

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