Paying Doctors to Not Treat Patients

Want national health care? Well, be careful what you wish for:

Dozens of incentive schemes have been uncovered which allow GPs to profit by slashing the number of patients they refer for hospital care.

Under one scheme, GPs stand to gain £59 for every patient not referred to hospital, if they cut an average referral rate by between two and eight per cent.

Torbay care trust in Devon will pay up to £15,000 to the average-sized GP practice if it hits a swathe of targets, including reducing hospital referrals.

NHS managers say referral rates, which rose 16 per cent nationwide during the first quarter of this year, have to be cut to save money. They claim many patients can receive equally good care from community NHS staff, such as physiotherapists and nurses.

But critics fear that patients could suffer if GPs’ decisions are swayed by the prospect of a cash bonus.

A leading surgeon said that patients’ cancers had already gone undiagnosed after they were denied specialist care under two such “referral management” schemes.

Orthopaedic surgeon Stephen Cannon, former president of the British Orthopaedic Association and a consultant surgeon at the Royal National Orthopaedic Hospital, described the cases as an “absolutely terrible” warning that decisions by non-specialist doctors could have devastating consequences.

He said: “I recently encountered two cases in which patients referred to physiotherapists later turned out to have a malignant tumour. If they had been sent to a consultant the outcome may have been very different.

“In one case a young man was referred to a physiotherapist because of sudden knee pain. Had he come to a specialist the symptoms should have been recognised and he should have been urgently referred to an oncologist. In this case, after the delays, the outcome was amputation. It was devastating for the patient and his family.”

If we could find a way to staff a national health service entirely with Saints, we’d be ok - but as we’re going to staff any health service with human beings, we’re going to have to deal with the fact that human beings will act, well, like humans.

Think of it like this: the bureaucrat in charge of budget matters wants to find a way to cut costs because the government is pleased when costs are kept low and money is freed up for new initiatives which make it look like things are constantly advancing - now, the bureaucrat can cut costs by cutting bureaucracy, or by cutting services to patients. Which way do you think the bureaucrat will go? Cutting the bureaucracy means you’ll have a bunch of people you work with shouting at you and threatening to go out on strike, which will make your elected bosses look bad, and they won’t like you as a result…cutting patient care means that people you don’t know won’t receive treatments you don’t know about with results you’ll never be made aware of. Its a no-brainer - unless the bureaucrat is a Saint along the lines of Francis of Assisi…and just as soon as the socialized medicine people find thousands of Saint Francises to staff our health care system then I’ll find it in my heart to support such a scheme.

Tags: health care

11 comments October 20th, 2008

McCain’s Health Care Plan

Its been the subject of a relentless campaign of lies and fear-mongering by the Obama campaign (if you’re not in a Battlegroun State, count yourself lucky - seems like you can’t spend 20 minutes watching TV or listening to the radio without an Obama ad attacking McCain’s health care plan; come November 4th, I beg of you!) - but, meanwhile, the truth is (as usual) different from whatever Obama happens to be saying at the moment, as the Weekly Standard points out:

Over the past few weeks, in a series of television ads, in stump speeches, and in the presidential and vice presidential debates, the Obama campaign has sought mightily to attack John McCain’s proposal for health care reform. It’s vehemence and tenacity have been striking, especially given how little McCain himself has actually had to say about his plan. Ironically, their misleading critiques actually hint at the strengths of McCain’s proposal, and point to the serious vulnerabilities in Obama’s own approach to health care politics.

At the core of the McCain health care agenda is the most important conservative policy innovation since welfare reform: the transformation of the benefit now given to employer-provided health coverage into a health insurance tax credit made available to all. For almost 70 years now, the federal government has given a significant tax preference to employer-provided health insurance. When your employer takes money out of your wages to purchase coverage on your behalf, the money is not counted as part of your gross income, so you don’t pay any taxes on it. But if you purchase insurance yourself, not through an employer, the money you use to do so gets taxed.

This makes employer-provided insurance vastly more appealing and places a serious burden on those to whom it is not available or who prefer coverage other than what their company offers. It has prevented the development of a genuine market in individually purchased health insurance and therefore artificially keeps insurance costs high. It has kept consumers from having a clear sense of what their health care costs, and so has inflated the price of care itself as well as the price of coverage. It has severely reduced the options available to families, making it more difficult to find insurance that meets their particular needs. It has tied health insurance to employment, leaving people uncertain about career moves and insecure about the future of their coverage. And it has vastly increased the number of Americans without health insurance, since not every business can afford to provide coverage, and those whose employers don’t offer it cannot readily find affordable options on their own.

And yet, for all its troubles, the employer-based system is quite popular with the people it serves. Nearly 90 percent of them, in a recent Kaiser Foundation poll, rated their insurance as good or excellent. They would certainly like to see costs go down and to feel more secure about their coverage, but they do not want their existing coverage taken away from them. This obviously poses an enormous challenge for reformers: How can the problems of the current system be addressed without displacing the millions of Americans who are satisfied with it?

The McCain solution is to change the incentives for consumers, but not for employers, so that people find themselves with more options, but are not forced out of their current insurance arrangement. Rather than exempt from taxation all the money used by employers to buy insurance, he would treat it as income but then provide individual taxpayers (regardless of how they obtain their coverage) with a credit that more than covers the taxes. The effect of this, from the point of view of individuals and families, would be to make employer-provided coverage just one option among many.

Do read the whole article - but central to McCain’s plan is that the people will be more and more able to decide what is best for themselves and their families. No need for a complex, expensive and ultimately self-destructive government run and/or mandated program…just allow people the flexibility to figure out what their health care needs are and then allow them the largest number of choices possible to fill those needs. Once again we see the grand paradox of American politics - the supposedly “pro-choice” side of the aisle is desperate to keep people locked into mandated programs, while the people supposedly all about control are on the side of allowing people the widest possible personal choice. As I’ve noted in many places, we live in an Age of Lies, and “pro-choice” is a many-faceted lie.

At any rate, there are many things needing reform in this nation and in John McCain and Sarah Palin we will have a chance to enact reforms. If, on the other hand, we elect Obama then we’ll get a man who will mandate more things, spend more money, raise more taxes, fail to do anything which might harm the income of the trial lawyers (so, if you’re thinking that Obama’s plan would in any way, shape or form limit the amount of malpractice a doctor can be forced to shell out, think again) and, in the end, make matters worse because they don’t attack the real problem with health care, which boils down to a lack of consumer choice and insurance and medical competition to bring down prices and improve services (please note, also, that Obama proposes to make health care “affordable” - what that means is that the price won’t go down, because that might harm trial lawyer income and DNC fundraising, but if he has to bankrupt the nation to provide health care to people who could better get it on their own, then so be it, as far as Obama is concerned…we have to have our priotities straight, and any Democrat will tell you that means advancing the power and wealth of Democrats, come what may. Ok, so they won’t actually tell you that, but actions speak very loud and we do detect a pattern here).

Tags: health care, liberal lies, Obama Deceptions, Sarah Palin

21 comments October 13th, 2008

Senator McCain in Albuquerque, NM

I heard our next president, John McCain, was fantastic earlier today in New Mexico… I’m posting his prepared remarks in full in the extended entry.

In less than a month, the American people will make a choice on where they want this country to go, and who they trust to lead us in a time of war and economic crisis. The time for debating and electioneering is drawing to a close. Soon it will be the time for choosing.

Today we have seen a reminder of the importance of that choice. The action Congress took last week to address our financial crisis was a tourniquet, but not a permanent solution. Today we are seeing the stock market fall, and the credit crisis spread to other parts of the world. Our economy is still hurting — working families are worried about the price of groceries, the price of gas, keeping their jobs and paying their mortgage — further action is needed. We need to restore confidence in our economy and in our government.

Washington is still on the wrong track and we still need change. The status quo is not on the ballot. We are going to see change in Washington. The question is: in what direction will we go? Will our country be a better place under the leadership of the next president — a more secure, prosperous, and just society? Will you be better off, in the jobs you hold now and in the opportunities you hope for? Will your sons and daughters grow up in the kind of country you wish for them, rising in the world and finding in their own lives the best of America? And which candidate’s experience — in government and in life — makes him a more reliable leader for our country and commander in chief for our troops? Who is ready to lead? In a time of trouble and danger for our country, who will put our country first?

I set out on my own campaign for president many months ago. I promised at the beginning to be straight with the American people, knowing that even those who don’t agree with me on everything would expect at least that much. I didn’t just show up out of nowhere, after all — America knows me. You know my strengths and my faults. You know my story and my convictions. And though familiarity in politics can be both helpful to a candidate, or not so helpful, it does at least fill out the picture and answer the essential questions. You need to know who you’re putting in the White House — where the candidate came from and what he or she believes. And you need to know now, before it is time to choose.

In 21 months, during hundreds of speeches, town halls and debates, I have kept my promise to level with you about my plans to reform Washington and get this country moving again. As a senator, I’ve seen the corrupt ways of Washington in wasteful spending and other abuses of power, and as president I’m going to end them — whatever it takes. I will propose and sign into law reforms to bring tax relief to the middle class and help to businesses so they can create jobs. I will get the rising cost of food and gas under control. I will help families keep their home, and help students struggling to pay for college. I will make health care more accessible and affordable. I will impose a spending freeze on all but the most vital functions of government. I will review every agency of the federal government, improve those that need to be improved and eliminate those that aren’t working for the American people. I will confront th e ten trillion-dollar debt that the federal government has run up, and balance the federal budget by the end of my term in office.

This is the agenda I have set before my fellow citizens. And the same standards of clarity and candor must now be applied to my opponent. Even at this late hour in the campaign, there are essential things we don’t know about Senator Obama or the record that he brings to this campaign.

We have all heard what he has said, but it is less clear what he has done or what he will do. What Senator Obama says today and what he has done in the past are often two different things. He has often changed his positions in this campaign, and the best way to determine where he would really take this country is to examine where he has tried to take it in the past.

My opponent has invited serious questioning by announcing a few weeks ago that he would quote — “take off the gloves.” Since then, whenever I have questioned his policies or his record, he has called me a liar.

Rather than answer his critics, Senator Obama will try to distract you from noticing that he never answers the serious and legitimate questions he has been asked. But let me reply in the plainest terms I know. I don’t need lessons about telling the truth to American people. And were I ever to need any improvement in that regard, I probably wouldn’t seek advice from a Chicago politician.

My opponent’s touchiness every time he is questioned about his record should make us only more concerned. For a guy who’s already authored two memoirs, he’s not exactly an open book. It’s as if somehow the usual rules don’t apply, and where other candidates have to explain themselves and their records, Senator Obama seems to think he is above all that. Whatever the question, whatever the issue, there’s always a back story with Senator Obama. All people want to know is: What has this man ever actually accomplished in government? What does he plan for America? In short: Who is the real Barack Obama? But ask such questions and all you get in response is another barrage of angry insults.

Our current economic crisis is a good case in point. What was his actual record in the years before the great economic crisis of our lifetimes?

This crisis started in our housing market in the form of subprime loans that were pushed on people who could not afford them. Bad mortgages were being backed by Fannie Mae and Freddie Mac, and it was only a matter of time before a contagion of unsustainable debt began to spread. This corruption was encouraged by Democrats in Congress, and abetted by Senator Obama.

Senator Obama has accused me of opposing regulation to avert this crisis. I guess he believes if a lie is big enough and repeated often enough it will be believed. But the truth is I was the one who called at the time for tighter restrictions on Fannie Mae and Freddie Mac that could have helped prevent this crisis from happening in the first place.

Senator Obama was silent on the regulation of Fannie Mae and Freddie Mac, and his Democratic allies in Congress opposed every effort to rein them in. As recently as September of last year he said that subprime loans had been, quote, “a good idea.” Well, Senator Obama, that “good idea” has now plunged this country into the worst financial crisis since the Great Depression.

To hear him talk now, you’d think he’d always opposed the dangerous practices at these institutions. But there is absolutely nothing in his record to suggest he did. He was surely familiar with the people who were creating this problem. The executives of Fannie Mae and Freddie Mac have advised him, and he has taken their money for his campaign.

He has received more money from Fannie Mae and Freddie Mac than any other senator in history, with the exception of the chairman of the committee overseeing them. Did he ever talk to the executives at Fannie and Freddie about these reckless loans? Did he ever discuss with them the stronger oversight I proposed? If Senator Obama is such a champion of financial regulation, why didn’t he support these regulations that could have prevented this crisis in the first place? He won’t tell you, but you deserve an answer.

Even after he refused to lift a finger to prevent this crisis, when the crisis hit, he was missing in action. He didn’t start making calls to round up votes until after the rescue bill failed in the House and the markets crashed. We continue to see the price of delay today as the markets continue to fall. Today the DOW has fallen below 10,000. And yet, members of his own party said they felt no pressure to vote for the bill. Why didn’t Senator Obama work to pass this bill from the start? Why did he let it fail and drag out this crisis for a full week before doing a thing to help pass it?

Again on taxes, we see a difference between what Senator Obama says today, what he said yesterday and what he has actually done. Over the course of this campaign, he has had many different plans to raise your taxes. During the Democratic primary, he promised to double taxes on every American with a dividend or an investment. He promised to raise payroll taxes. He promised higher taxes on electricity. Now, Senator Obama claims he will give 95 percent of Americans tax relief. He actually promised the same thing when he was running for Senate in Illinois, but once elected he never introduced legislation to do so. Instead, he voted for the Democratic budget resolution that promised to raise taxes on people making just 42,000 dollars a year. At the time, he even said his vote was intended to get “our nation’s priorities back on track.” If he’s such a defender of the middle class, why did he vote to raise their taxes? Whatever ha ppened to the tax relief he promised them when he was a candidate for the Senate? And why should middle class Americans trust him to keep promises he has already broken?

Senator Obama and I both have differences with how President Bush has handled the economy. But he thinks taxes are too low, and I think spending is too high. The government’s out of control spending has resulted in a weaker dollar, raising the cost of groceries and gasoline, and killing jobs.

I will veto pork barrel legislation and cut wasteful government spending. Senator Obama has a different plan. According to third party estimates, he will increase government spending by over 860 billion dollars. He has denied it, but he has refused to tell you how much he does plan to spend. What is the total of his increased spending? Americans deserve to know just how much more of their money Senator Obama intends to spend, and how much more debt he plans to burden them with.

Senator Obama has also criticized earmark spending, those wasteful pork barrel projects stuck in spending bills behind closed doors. And yet, despite his talk on the campaign trail, his actual record is full of requests for earmark projects. In his three short years in the Senate, he has requested nearly a billion dollars in pork projects for his state — a million dollars for every day he’s been in office. Far from fighting earmarks in Congress, Senator Obama has been an eager participant in this corrupt system. In one instance, he sought more than 3 million dollars for a new projector at a planetarium in his hometown. Coincidentally, the chairman of that planetarium pledged to raise more than $200,000 for Senator Obama’s campaign. We don’t know if they ever discussed the money for the planetarium, and no one has asked Senator Obama. But even the appearance of this kind of insider-dealing disgusts Americans. I’m going to put a stop to that, my friends, if I’m President.

I have made every single donor to my campaign publicly available, while Senator Obama has taken in over 200 million dollars from undisclosed sources. We have already seen the potential for fraud because of his refusal to disclose his donors. His campaign had to return $33,000 in illegal foreign funds from Palestinian donors, and this weekend, we found out about another $28,000 in illegal donations. Why has Senator Obama refused to disclose the people who are funding his campaign? Again, the American people deserve answers.

On health care, Senator Obama has been misleading you about my plan to give you more money for health care, and he has been equally misleading about his own plans. He has said his goal is a single payer system where government is in charge of health care and bureaucrats stand between you and your doctor. Under the plan he has proposed, he will fine families that don’t have the kind of health insurance that Senator Obama tells them to purchase. He will fine employers who do not offer the health insurance that he thinks they should offer.

What he doesn’t say, and what nobody has asked, is how big his fines will be. What he doesn’t want you to know is that with a small fine, his plan will encourage companies to just pay the fine, drop existing health care coverage for their employees and leave them with only one real option: government run health care.

Who is the real Senator Obama? Is he the candidate who promises to cut middle class taxes, or the politician who voted to raise middle class taxes? Is he the candidate who talks about regulation or the politician who took money from Fannie Mae and Freddie Mac and turned a blind eye as they ran our economy into a ditch?

Is he the candidate who promises change, or is he the politician who has bought into everything that is wrong with Washington? We can’t change the system with someone who’s never fought the system.

Washington is on the wrong track and I’m going to set it right. The American people know my record. They know I am going to change Washington, because I’ve done it before. They know I’m going to reform our broken institutions in Washington and on Wall Street because I’ve done it before. They know I’m going to deliver relief to the middle class, because that’s what I’ve done.

You don’t have to hope that things will change when you vote for me. You know things will change, because I have been fighting for change in Washington my whole career. I’ve been fighting for you my whole life. That’s what I’m going to do as President of the United States. Fight for you and put the government back on the side of the people.

Thank you.

###

Tags: 2008 Campaign, Corruption, Earmarks, health care, President Bush, recession, taxes

3 comments October 6th, 2008

McCain Health Care Plan Endorsed by Obama Advisor But Not Promoted by McCain?

Apparently this is true.

The esteemed economist, Greg Mankiew, has another of his excellent posts on his blog outlining the Post-partisan Health Policy of John McCain:
“The PEP blog draws our attention to this trenchant analysis of health policy:

The most promising way to move forward in all three dimensions – coverage, cost, and long-run fiscal situation – is to replace the employer exclusion with a tax credit, a step that has been proposed many times before (e.g., Butler 1991 and Pauly and Hoff 2002). Firms would still be allowed to deduct the cost of their contributions to employee premiums, just as they can deduct wages and other expenses today for the purpose of calculating taxable income. But workers would now have to include employer contributions to health insurance in their earnings for the purpose of calculating taxes (precisely which taxes is discussed below). In exchange for, workers who purchased qualifying insurance would get a refundable tax credit. Qualifying insurance would be along the lines proposed by the President in his standard deduction for health insurance, including limits on out-of-pocket payments, coverage of a general range of medical care, and guaranteed renewability by the provider (Treasury 2008).

“The PEP blog then points out,

This is a pretty fair description of the McCain health care plan. The funny thing is, this is not be found in McCain campaign literature or on his senate website, but rather in a paper written by Jason Furman, Obama’s Economic Policy Director.

All true.”

Mankiew goes on provide the similarities to the McCain plan and speculates that “most health economists would endorse the Furman-McCain plan.”

I think McCain may be missing a good opportunity here.

Tags: health care

10 comments September 6th, 2008

Socialised Medicine Myth Exposed

That well-famed claim that the US has a higher infant mortality rate than nations with socialised medicine? Not quite what it seems:

Q: If socialized medicine is so bad, why are infant mortality rates higher in the U.S. than in other developed nations with government or single-payer health care?

A: U.S. infant mortality rates (deaths of infants <1 year of age per 1,000 live births) are sometimes cited as evidence of the failings of the U.S. system of health care delivery. Universal health care, it’s argued, is why babies do better in countries with socialized medicine.

But in fact, the main factors affecting early infant survival are birth weight and prematurity. The way that these factors are reported — and how such babies are treated statistically — tells a different story than what the numbers reveal.

Low birth weight infants are not counted against the “live birth” statistics for many countries reporting low infant mortality rates.

According to the way statistics are calculated in Canada, Germany, and Austria, a premature baby weighing <500g is not considered a living child.

But in the U.S., such very low birth weight babies are considered live births. The mortality rate of such babies — considered “unsalvageable” outside of the U.S. and therefore never alive — is extraordinarily high; up to 869 per 1,000 in the first month of life alone. This skews U.S. infant mortality statistics.

When Canada briefly registered an increased number of low weight babies previously omitted from statistical reporting, the infant mortality rose from 6.1 per 1,000 to 6.4 per thousand in just one year.

According to research done by Canada’s Bureau of Reproductive and Child Health, “Comparisons of infant mortality rates by place and time should be adjusted for the proportion of such live births, especially if the comparisons involve recent years.”

Norway boasts one of the lowest infant mortality rates in the world. But when the main determinant of mortality — weight at birth — is factored in, Norway has no better survival rates than the United States.

This is entirely unsurprising - anyone who is surprised that a government-run health care system would fudge the numbers to make themselves look good is the biggest fool alive. Remember, when a government bureaucrat sits down to work, there are several factors governing the work done:

1. To do as little as possible, because you don’t get paid more for doing more work in government.

2. To have as few mistakes as possible blamed on yourself.

3. To ensure that 100% of the budgeted funds are spent each fiscal year.

4. To ensure that any information coming out from your bureaucracy reflects well upon your efforts.

The perfection of government is an agency which does nothing while spending a lot of money which has as its end product a fabulous report of how great you all did, with a pitch for increased funding because, well, you can see that we spent all the money budgeted. The perfection of government agency is not a lean, mean public service machine boldly telling the unvarnished truth and desperate to do everything it can to serve the public. Given the nature of government, it is no surprise that such things as infant mortality aren’t reported exactly fair and square. What we have here is the problem of how to reduce infant mortality in a government-run program - they could have either worked harder and done more (and where’s the upside in that?), or they could just change what is called an infant to the point where a large percentage of infants who die aren’t counted. Presto! Without any additional work, you’re doing an even better job than before…

This is the sort of incompetance Obama has in store for us if he wins. We’ll get progressively worse services by agencies who continuously tell us that things are getting better all the time. Its not because Obama is a bad man, but because by putting government in charge he’ll only be turning it over to the people who’s incentives are to not work yet spend large sums of money.

Tags: health care

33 comments August 4th, 2008

Stuff White People Like: Free Healthcare

Another hilarious - and exceptionally insightful - post over at Stuff White People Like.

In spite of having access to the best health insurance and fanciest hospitals, white people are passionate about the idea of socialized medicine. So much so that they have memorized statistics and examples of how for-profit medicine has destroyed the United States.

But before you can exploit this information for personal gain, it’s important that you understand why white people are so in love with free health care.

The first and most obvious reason is “they have it Europe.” White people love all things European, this especially true of things that are unavailable in the United States (Rare Beers, Absinthe, legal marijuana, prostitution, soccer). The fact that it’s available in Canada isn’t really that impressive, but it does contribute to their willingness to threaten to move there…

Read the whole thing.

Tags: health care, humor

15 comments April 7th, 2008

What HillBama Wants to do to Our Healthcare

From Britain:

Nearly half of Britain’s National Health Service (NHS) maternity units had to turn away women in labor last year because they were full, figures showed on Thursday.

Furthermore, a shortage of facilities or staff led to almost one in 10 of these units closing more than 10 times.

One closed 28 times, while another was forced to shut its doors 39 times.

The figures, collected by the opposition Conservative Party under the Freedom of Information Act, showed large maternity units were more likely to be forced to close than smaller ones…

…Of the 147 NHS Trusts that provide maternity services, 103 provided figures.

Of these, 42 percent reported having closed or having been forced to divert women to another site at least once last year because of capacity problems.

Question: Why do only 70% of them provide figures? Are there any horrors hidden being non-reporting? One has to assume that if you’re doing a bang up job, you’re going to annouce it to the world…non-reporting is, in my view, a strong indicator of poor performance.

Be that as it may - this is what you get when you have a government run program. Now, don’t get me wrong - I’m sure that everyone in Britain’s health system wants to provide whatever services are necessary to ensure the healthy birth of Britain’s babies; intent is not the issue - just as its not the issue with HillBama’s health care plans. What is at issue is actual results - and the problem with a government-run program is that the norm for such things is that they get caught up in themselves, and thus can’t spare full effort on their actual job.

Its like this - you have a choice in your county health care budget; provide more maternity care, or give a raise to that troublesome union running the hospital kitchens. What do you do? Well, if there’s not enough maternity care, you can send the poor lady down the road and hope the next hospital is open…but if there’s not enough money for a pay raise, you’ll get a strike and the elected official in charge of your department will sack you for the failure. And even if you’re not sacked, the unions can cause you endless headaches if they don’t get their way, while the lady who was shoved off probably won’t even complain, and if she does you just file it away and “forget” to report it in the annual stats. And if she or her child dies, she didn’t die at your facility, so its as if it never happened.

This is just one example of a million which could be brought forth to show how, in action, national health care just won’t deliver the goods. Keep that firmly in mind: its not whether or not providing health care is a good thing or a bad thing. It is a self-evident truth that providing health care is a good thing. But the central question is, how do we do it? Trust a bureaucrat under a vote-mongering elected official to get it right, or trust ourselves?

Tags: health care

61 comments March 25th, 2008

Contrasting McCain and the Democrats on Health Care

Excellent article by Shawn Tully in Fortune. The highlights:

For McCain:

McCain’s main pillar is the elimination of a tax break that employees receive if their employer provides their health care. That may not sound like a shocker, but it is. The exclusion dates from World War II, when the federal government imposed controls on wages, but allowed companies to compete for workers by offering tax-free health benefits in lieu of pay. The law is largely responsible for the nightmarish patchwork of corporate-provided medical plans we enjoy so much today. Employees and their unions demanded richer and richer packages, and employers complied, since they could buy far more benefits for their employees than workers could buy with after-tax dollars on their own. Americans have paid a steep price, however, by sacrificing their raises as corporate insurance bills exploded, never more so than now.

McCain suggests that we junk all that. Say you’re earning $100,000 a year and your company provides about $9,000 toward your $12,000 family premium, which is about average. Today you’re taxed only on the $100,000. Under McCain’s plan, you’d also pay on the $9,000. That could mean an extra $3,000 or so in federal taxes alone. To compensate for the extra levy, McCain would provide a $2,500 federal tax rebate for individuals and $5,000 per family, meaning a family would simply subtract $5,000 from its tax bill, the equivalent of a big cash payment.

Here’s where it gets interesting. Employers would no longer be able to buy more health care with $9,000 of their employees’ money than the workers could buy on their own. The raison d’être for corporate health benefits would vanish. Employers have another compelling reason to pass the ball to the employee: While wages are rising around 3% ayear, their health-care costs are growing at three times that rate. “I predict that most companies would stop paying for health care in three to four years,” says Robert Laszewski, a consultant who works with corporate benefits managers. Hence, an employer that pays $9,000 for your benefits would simply pack an extra $9,000 a year into your paycheck. (Why? Because in a competitive labor market, companies would have to hand over that cash to employees or risk losing them.) So you’d have $6,000 after tax, plus the $5,000 family credit, to buy insurance. That’s $11,000 in new cash that employees can set aside for health care.

For the Democrats:

The core of their plan is a “pay or play” option for employers. Large companies would have the choice of either providing benefits for workers or dropping their coverage. If they chose the latter, they would pay a mandatory payroll tax to support a new government-administered system. That system would have two parts: a Medicare-like public program, and a menu of private options similar to the generous plans available to U.S. government employees today. Workers who are self-employed or lack insurance would go straight into one of these two options. Low-income Americans would receive federal subsidies to purchase the premiums.

In practice, the system would quickly swell the ranks of Americans with government-paid health care. Remember, health-care costs are rising far faster than wages, so companies have a strong incentive to pay the tax and erase that rapidly growing burden from the books. It’s also likely that the government plan will offer better benefits than many, or perhaps most, corporate plans. In fact, the Democrats call for rich standard benefits packages based on the plan offered to federal employees. Those packages would have deductibles of just $300 and offer prescription drugs, mental health benefits, and “spinal manipulations” (i.e., chiropractic services), among a cornucopia of other benefits. As a result, the federal plan, potentially packed with new benefits pushed for by lobbyists for various medical specialties, will quickly cause an exodus from employer plans.

The standard benefits package isn’t just a bad idea because it will substantially raise the cost to taxpayers. It will also make it virtually impossible for Americans to buy insurance tailored to their needs. Suppose you’re one of those 25-year-olds. You probably don’t want to spring for a full-blown plan that covers old-age diseases like Alzheimer’s and would rather save some money and go with a low-premium, high-deductible plan. But the Democrat approach requires that any competing plans be “actuarily equivalent” (Clinton’s term) to the federal employee plan - which translates as a generous minimum standard for health insurance. “With that mandate, you rule out high-deductible plans,” says Gruber. “It would make it very difficult to design one that would qualify.”

McCain’s plan is strongest in that it turns health care power over to the health care consumers. The drawback for McCain is that Democrats and the MSM will simply lie about it - they’ll tell everyone that McCain’s plan is to cut benefits. Democrats plan is strongest in the fact that it seems like a good idea. The drawback is that it will eventually force everyone into government-mandated health care, thus giving us a medical system as dysfunctional as those of Canada and Britain. I believe this is integral to the Democrats’ plan - taking the individual out of the health care equation and setting up a one-size-fits-all HillBama bureaucratic nightmare, ’cause its “fair”, and “health care is a right”.

Men and women will prefer McCain’s plan - cowards and liberal dunderheads will prefer the Democratic plan. Which will win? Time will tell - though the November outcome will go a long ways towards deciding the issue.

Tags: 2008 Campaign, health care

78 comments March 22nd, 2008

Getting the People to Watch the Experts

I don’t know if any of you out there have been watching the health crsis we’re having here in Southern Nevada - the short story is that a endoscopic surgery center seems to have been reusing needles and syringes over the past four year on as many as 40,000 patients, and at least 6 people have come down with hepatitis C - a difficult to treat and possibly fatal disease. Its a really horrible story and even scared the bejabbers out of me and the Mrs as we both had endoscopic procedures during the past four years, fortunately not at one of this particular quack’s offices (though we didn’t immediately know that).

Anyways, much talk is being done over what to do about this, but no one seems to be hitting upon the idea that the problem is that the experts are in charge of watching the experts - and we need to have the people keeping an eye on them. My ideas on this score are over at Battle Born Politics.

Tags: health care, Hepatitis scare, Nevada News

33 comments March 5th, 2008

John McCain on Health Care

We’ve had our little lefties coming in here to tell us that Obama has detailed plans for everything, while McCain has no real plans at all. I’ve been over to Obama’s website plenty of times looking for these details and have never found them. But, then again, even if he had them, they’d just be a bunch of leftist Tom-foolery - so, who cares? Meanwhile, our John McCain has been hit often enough with the bogus charge of “no plans” - and so, we’re going to start highlighting parts of John McCain’s plan for America.

While McCain’s health care plan is rather filled with great ideas, one has really struck me was worthwhile on both its economic and social aspects:

Allow individuals to get insurance through any organization or association that they choose: employers, individual purchases, churches, professional association, and so forth. These policies will be available to small businesses and the self-employed, will be portable across all jobs, and will automatically bridge the time between retirement and Medicare eligibility. These plans would have to meet rigorous standards and certification.

I like that - we can organize our parish to buy health insurance for members…helping out the poorer members, providing the sort of care we need (rather than some DC-run, top-down Hillbama monstrosity) and, most importantly, taking our health care out of the hands of either employers or bureaucrats and putting it in our own hands. You know - acting like adults who take care of all the difficult things on their own. One of the odder things of modern life is the way people want 200 channels to choose from on TV, but seem willing to sign over the really important stuff - health care, education of their children, etc - to bureaucrats of one sort or another. What would really be cool is to do a survey of the parish and find out if we’ve got enough health care providers to take care of us - and we then work out a health care cooperative using our own people to take care of our own.

You see, the fundamental problem with modern life - the basis of all the other problems we have - is the atomization of the family and the local community. In our world, we move around constantly, never get to know our neighbors and ever more neglect the really important things in life (family and locality, eg) until, now, we find ourselves in a disintegrating society where, in a foolhardy (yet understandable) act of self-defense we demand that the government step in to provide the order and support which used to spontaneously grow out of family and community. Anything which tends to strengthen the family as against society and the locality as against the national is something to be encouraged - we must have a national government to protect us from foreign attack and internal subversion, but beyond that the scope of national government should be very limited…and certainly shouldn’t involve itself in such things as health care for the citizens. It is a very long road to get from here to a properly governed society - but any step in the right direction is a step we should take, and McCain has hit upon one such step in his health care plan.

Tags: health care

106 comments February 21st, 2008

2008 Reality Check

William J. Stuntz over at the Weekly Standard has written an article sure to depress people on the right and the left - boiled down, what he points out is a hard-nosed reality:

For the right, those people who want to deport the illegals and those who want to ban abortion will not get what they want in 2008.

For the left, those people who want universal health care and an immediate/swift end to Iraq will not get what they want in 2008.

On health care, its because we simply don’t have the money for it, even if the strong opposition to it can be overcome. On the war, even an Obama would have to recognise the harsh reality - the surge has worked, and the only thing which could derail victory (and 2012 re-election hopes) is a precipitate withdrawl by a date certain. On abortion, there just isn’t the political majority to ban it, while its not possible to round up and deport 12 million or more people. Grumble all you want (and I’m one of the grumblers vis a vis abortion), but as my father would say, the pragmatic facts of life are that you can’t have everything.

Why does this matter? Because, as Stuntz points out, the person most likely to be able to take advantage of these harsh realities is John McCain - a deficit hawk, pro-life (but not deeply involved in efforts to ban abortion), identified-with-surge politician with a reputation for doing what he thinks is right, critics be damned. There is an aura of reality about John McCain entirely lacking in Obama and Hillary, as well as in McCain’s conservative critics, especially in their monomaniac complaints about McCain’s support for immigration reform (even as late as Saturday morning at CPAC, the anti-McCainiacs were out with their “stop McCain’s McShamnesty” signs). We live in a real world, which has real issues to address - and the Democrats have been serving up absurdities…mindless platitudes about how they’ll fix everything, and that will be contrasted in the public mind with McCain’s harsh realities. Now, mindless platitudes - especially if carried forward by a personable man like Obama - still might carry the day, but even a losing McCain bid will at least lay down a strong GOP marker to compare the Democrats to as we go forward to 2010 and 2012.

Tags: abortion, health care, Iraq Campaign

9 comments February 11th, 2008

Vote Her Majesty, Hillary I, ‘08

Can we say “totalitarianism“, boys and girls?

WASHINGTON (AP) — Democrat Hillary Rodham Clinton said Sunday she might be willing to garnish the wages of workers who refuse to buy health insurance to achieve coverage for all Americans.

The New York senator has criticized presidential rival Barack Obama for pushing a health plan that would not require universal coverage. Clinton has not always specified the enforcement measures she would embrace, but when pressed on ABC’s “This Week,” she said: “I think there are a number of mechanisms” that are possible, including “going after people’s wages, automatic enrollment.”

Clinton said such measures would apply only to workers who can afford health coverage but refuse to buy it, which puts undue pressure on hospitals and emergency rooms. With her proposals for subsidies, she said, “it will be affordable for everyone.”

So, Bill Gates will have to buy HillaryCare…’cause it would be an unfair burden on everyone else if he doesn’t have health insurance…and no worries, ’cause Her Majesty will decree that it be affordable for everyone.

You Democrats really want this sort of nonsense?

Tags: health care

30 comments February 3rd, 2008

The Slippery Slope of Assisted Suicide

Leads inevitibly to this:

Winnipeg, Feb. 1, 2008 (LifesiteNews.com/CWN) - The LifeSiteNews service reports that the Manitoba College of Physicians and Surgeons has issued guidelines for doctors that says that doctors– not patients or their families– have the right to decide when life-sustaining treatment can be withdrawn.

The ultimate decision, says Dr. Bill Pope, registrar of the College, lies with the physician, and there is no need to heed the wishes of patients or families. Doctors must “communicate” the decision with patients or their legal proxy “to make that situation more transparent,” Pope said. “Nonetheless, doctors are permitted to make that decision.”

Once upon a time, when this debate was first opened, the “death with dignity” people insisted that it would only be people who were of sound mind making a completely informed decision who would then merely be assisted in their desire to die. When this debate was opened, we on the other side immediately pointed out that there’s no chance it would ever be just that - we were shouted down as being unfeeling religious bigots who just don’t understand the needs of humanity. Well, here it is - we’re now seeing it become official that a doctor can decide when life sustaining treatment can be withdrawn.

Life is a precious gift - and it is not a gift human beings can willy-nilly take away. Only for the gravest of reasons can we ever take a life, and we must never intend to take the life of an innocent person. Retreat an inch from this absolute position, and you’ll eventually get what we’re now seeing - a human life being subjectively judged by third parties. The Culture of Life is the only rational position; only when we treat human life with awesome respect can we be considered to be fully civilized, and fully human.

Tags: assisted suicide, death with dignity, euthanasia, health care

50 comments February 3rd, 2008

Why The OH-05 Special Election Matters

This race isn’t just about keeping the OH-05 seat in GOP hands… it’s about keeping taxes low, our borders secure, and preventing socialize health care that would also cover illegal immigrants. Bob Latta’s opponent will be another vote for raising taxes, open borders, and HillaryCare.

[youtube:http://www.youtube.com/watch?v=taMDZsSemxs]

Let’s help Bob Latta win in Ohio’s 5th Congressional District!

Visit Bob Latta’s campaign website.
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