Skip to comments.Slouching Toward Socialized Medicine?
Posted on 03/22/2007 5:03:13 PM PDT by qam1
"Freedom/You've got to give for what you take" - George Michael
Health care is hot. The status quo is not. And universal care is in the air. The three leading Democratic candidates are reaching out for the healing hands of complete coverage. The numbers say there's more to it than pure poll positioning. The problems are real as millions are uninsured and costs are climbing.
Last year Americans spent more than $2 trillion on health care. This year we'll spend more, and in a decade, we're likely to be dropping a whopping $4 trillion-plus a year on health care - nearly 20 percent of America's Gross Domestic Product (GDP).
Little wonder that ninety percent of respondents to a recent New York Times/CBS survey said that the current system needs either fundamental changes or total rebuilding. Two-thirds said the federal government should guarantee health insurance to all Americans. And 47 percent said it would be better to have a government-run system with universal care compared to 38 percent who preferred the current system.
All of this has the makings of a slouch towards socialized medicine.
That would be bad for erstwhile slackers of Generation X and Gen Next. It would be even worse for the rest of the country. That's because the slouch could easily become a straitjacket, for any move toward state-run healthcare will happen in the context of already exploding debt.
Even if they've already paid off their student loans (snicker) and have exactly no credit card debt (giggles giving way to loud gasps of laughter), X-ers and Nexters are already up to their eyeballs in debt for the big three entitlement programs - Social Security, Medicare and Medicaid.
Federal Reserve Board Chairman Ben Bernanke recently testified to Congress, "Expenditures for entitlement programs are projected to rise sharply over the next few decades." They're being driven by a combination of increasing life expectancies and decreasing fertility.
Spending on the big three currently amounts to more than 8 percent of America's GDP. That will rise to more than 10 percent in 2015; and to more than 15 percent in 2030, if projections by the Congressional Budget Office hold true. The percentage of Americans more than 65 years old is also expected to increase pretty dramatically too, from 12 percent of the U.S. population to 19 percent in 2030.
That puts the slouch towards socialized medicine in its proper context.
No one knows what a government-run health care system would cost. (John Edwards put the price of his universal care plan at $90 to $120 billion per year.) But it is almost certain to be far more expensive and far less efficient than advertised.
Moreover, the combo of socialized medicine with already squeezed budgets will not make for a happy meal. And the rest of the probable menu - raised taxes and/or restricted medical choices - will be more appropriate to the style of the Hamburglar than Mayor McCheese.
In 1966, spending on the big three made about a quarter of the federal budget. Today, it makes up more than half. If current trends continue, the sorts of spending that people think of when they imagine the government at work - whether building roads and making bombs or supporting a teapot museum and a cattle congress (the last two courtesy of the 2006 Pig Book) - will constitute just a fraction of the actual budget. All the rest will be mandatory entitlements.
That doesn't leave a whole lot for X'ers to retire on. It doesn't leave a whole lot for them to sustain America's leadership in the world with either.
As Chairman Bernake concluded, "Dealing with the resulting fiscal strains will pose difficult choices for the Congress, the Administration and the American people."
What's the solution? It ain't the slouch.
Forty-four percent of respondents to the Times/CBS poll said that the government would do a worse job at providing coverage than private companies, compared to 30 percent who thought it would do better. They're probably on to something, as the European experience of health care rationing shows. Besides, as Ronald Reagan observed in his Creative Society speech, "For every ounce of federal help we get, we surrender an ounce of personal freedom."
The solution to better care at lower costs is increased freedom, and a number of solid steps are being taken in that direction right now.
States have much more freedom on how to use their Medicaid dollars, thanks to the Deficit Reduction Act. And last August, President Bush signed an Executive Order calling on federal health care programs to become transparent about quality and price, among other things. Since then Health and Human Services Secretary Mike Leavitt established an initiative on transparency (see http://www.hhs.gov/transparency/) and has been asking private health plans and private employers to join in. He's gotten some big commitments, including from the CEOs of the more familiar Big Three.
More information, more choice, more freedom: That's the way forward.
Otherwise, it could come back to George Michael, "Well it looks like the road to heaven/But it feels like the road to hell."
Now that's scary.
-Charles Rousseaux is a cappuccino conservative in the Bush Administration. The slouchy views expressed are his own.
Ping list for the discussion of the politics and social (and sometimes nostalgic) aspects that directly effects Generation Reagan / Generation-X (Those born from 1965-1981) including all the spending previous generations are doing that Gen-X and Y will end up paying for.
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If these numbers truly reflect the opinions of my fellow Americans, I fear for the future of my country.
The Government already provides 65% of all healthcare in the US, measured in total dollars. It is projected to provide up to 75% of all healthcare by 2015.
The opposition is discussing this based upon the false assumption that healthcare in the US is "private", which it is not, for the most part.
Eliminating the remaining portion of private care will create a government monopoly on care which will result in two things: 1. Soaring, out of control Costs, 2. Extreme Rationing, cut-backs and an end to the US creativity and innovation edge in technology and pharmacuticals.
Only MINOR changes are needed in insurance markets and communications in order to greatly reduce the problem of access. The issues of cost and quality are already being addressed by the market.
Larger problems such as regulation and liability would go a long way toward lowering healthcare costs as well.
Of course, it is much harder to advance a government agenda with only minor market changes, even though most of democratic staffers I know admit the money for healthcare will NEVER be there, given the tax dollars needed to really change things.
Well, it's all in the way the poll is worded. I mean, if a pollster asks people, "Would you like free universal health care?" most people are going to say yes.
However, if you ask the question in a different way, you'll get a much different response: "Do you want a health care system where your taxes are doubled to pay for it, everything is rationed so that you have to wait months to get any procedure done, and the government tells you which doctor you have to see? Also, since we're taking the profit motive out of medicine, most research on new drugs and procedures will grind to a halt."
If people really knew what "universal free health care" would entail, you wouldn't see 47% in favor of it.
If that means more insurance companies, forget it. People are paying more and more for less coverage and at the other end doctors are getting less and less for services. The inefficient, bloated insurance companies are sucking up more and more and in the end, the only ones benefiting are the bureaucracies of those companies.
Alas, we are unlikely to see the question posed as you suggest.
The Democrats will promise "free" universal health care, not worrying how much it will cost. Moderate Republicans will also promise universal health care, but they will wring their hands about the cost. Together, they will grow the government.
Isn't democracy wonderful?
That is one reason so many on the Left propose a single-payer system, under which an inefficient, bloated government can suck up more and more, to the benefit of government bureaucracies.
Of course those numbers don't represent the opinions of your fellow Americans. They represent propaganda that encourage folks think their views are a tiny minority. Neat trick if you think about it. (you should still fear for the future of your country, since the result is the same)
That's simply not the case. In the last decade the insurance companies, on every premium dollar, have cut out approximately 10 cents in administration costs through massive increases in efficiencies and decreases in commissions and bureaucracy.
In the end though, all of these increases in efficiencies and productivity will be washed away by federalized health care, and we'll have to reinvent the wheel when it comes to insurance sector IT.
Woo hoo! A government-run healthcare system with all the warmth and efficiency of the US Post Office!
One of the problems, negated by any increases in efficiency, is that our demands for health care are continually increasing. That is, instead of getting a cheap x-ray, we now get costly CT scans or MRIs. New lab procedures, new surgical procedures, new drugs, new machinery--it adds up enormously. We don't accept negative outcomes and are willing to throw any amount of money at sophisticated and/or experimental interventions. This is true of everyone, rich, poor, illegal, insured, uninsured.
I don't honestly see any way to get healthcare costs under control as long as we all want to live forever and medical science keeps making progress in R&D. And, oh yeah, as long as the population continues to increase.
Are you serious? Consider in that same decade how much premiums have risen (what, maybe 250%?) and how much the amount doctors are reimbursed for the same service vs 10 years ago. The premium payers on one end and the doctors on the other end are getting hosed while insurance companies and drug companies soak them. The only thing that keeps insurance companies from showing huge profits is their bloated, inefficient operations.
Unfortunately, the gov't will find a way to waste even more money and do an even worse job. I think some sort of standardization among say a handful of programs and paperwork would help make things truly competitive between insurance providers and go a long way to also increase efficiency and decrease costs. The current model is hopelessly screwed up.
This means one of two things:
1) Most of us are still going to be forced to pay a lot of money (probably as much or more than we pay now) to participate in the new system, which will obviously deliver slow and lousy medical care, and the $120 billion is just the additional handout portion that we'll be forced to pay to cover non-payers, or
2)It's full-blown Hillary-care, with private market medical care effectively outlawed, and we'll all get an average of $120 billion (John-Boy's high estimate) divided by 300 million (population of the US) worth of government-managed health care each year. That's $400 a year per person, folks. Just think about what sort of medical care we'd get for that.
I suppose all clocks will be removed from emergency rooms.
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