Sunday, October 11, 2009

The Perfect Health Care Plan

The national health care debate at the US Congressional level and across the United States of America has reached fever pitch. People are surrounding this issue from all directions just like a tribe of Native Americans circling a wagon train of pioneers. Well, I don't know about you, but I like the plan outlined by several Representatives and Senators that has these features:

No denials based on preexisting conditions
No cap on medical expenditures each year
No rationing of care
Patients get to pick their providers
A cap on cost of premiums

What I'm hoping for is a really low cap on the premiums, say no more than $5.00 per month. But, if it's more than this I will probably not take any insurance and just jump in whenever I develop a condition expensive enough to justify having the insurance. After all, if I can't be denied coverage based on any preexisting conditions, I should be able to do this. But wait, perhaps there will be some sort of waiting period after signup before the benefits kick in. Oh, it doesn't matter anyway. I just remembered that President Obama said that everyone would be required to have health insurance whether or not they want it or can afford it. I suppose there will be help for those who can't afford it. Although if they can keep the premiums down to $5.00 a month, there shouldn't be too many needing the help.

But wait just a minute! I just had an epiphany. How can the government possibly provide or expect insurance companies to provide unlimited health care with no preexisting conditions exemptions and no rationing using premiums that are capped. I am having a hard time seeing how that will work without changing the laws of mathematics. If Congress could just make $2 plus $2 equal $1,000,000, I believe their plan just might work. But I don't know how to make those numbers work. I know they don't work at the casinos. But perhaps our noble politicians have a trick up their sleeves.

One trick I've heard is to fund some of the health care plan by cutting fraud out of Medicare. Nice! But if it is possible to cut X number of dollars of fraud from the Medicare system at a cost of less than X number of dollars, why haven't they already done this? Is cutting wasteful spending out of the budget only important when we're in an economic crisis or we're wanting to start another spending plan? Also, I have heard that Medicare is drowning in debt, having trillions of dollars in unfunded future obligations. Won't all the fraud savings have to be put towards those obligations to help keep Medicare afloat? And won't that still not be enough to salvage it?

It's beginning to look like the only way to make ends meet with the proposed health care plan is to simply limit the payout to doctors and drug companies to the amount that is taken in from premiums. But if the premiums are too low, the payouts will be too low, and there will not be much incentive for these people, especially the doctors, to put themselves through 8-10 years of college and intern hell and accumulate hundreds of thousands of dollars of debt. That means fewer doctors, which means more patients per doctor, which means the average visit time will have to drop from about 10 minutes per patient to perhaps 5 minutes. There's already people complaining that 10 minutes is insufficient time to consult with a doctor. They'll be yelling if it drops to 5. Oh well, I guess we can always get the government to force the doctors to work 24/7 under threat of imprisonment. I'm not sure who will treat them when they keel over from exhaustion.

I don't think there is any decent person who wants to see another human being go without needed health care. I certainly don't. But the harsh reality of this cold, uncaring Universe is that some things are just impossible. This may be one of those things. One thing seems certain to me. The only way we have any hope of paying for unlimited health care for everyone is to unfetter economic activity and allow productivity to increase tremendously. The increase in wealth, and the resulting increase in tax revenue may just be able to fund unlimited health care, although I am still skeptical. Feel free to comment if you believe I am missing something.

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