The Polite Liberal

A rant-free discussion of liberal philosophy and policies.

Name:

The Polite Liberal is the pseudonym of a "nontraditional" graduate student in mathematics (for nonacademics, "nontraditional," is a polite way of saying, "older than 25.") The Polite Liberal is an attempt to spur real policy debate, instead of partisan insults and conspiracy theories. Conservatives (and liberals, of course!) are welcome.

Monday, November 29, 2004

The Ownership Society

Coming back from Thanksgiving, we found a nice little missive from our HMO. Apparently, I committed a heinous sin this year: I turned 30. The penalty for this crime? $1260 per year in incerased health care costs. Heaven help me if I have the bad judgement to turn 65; at that point insurance will cost about four times what it does now.

The health care system in the US is, in a word, nightmarish. I'm not talking about the doctors and hospitals, which are generally excellent. I'm speaking instead of the hopeless system that we've contrived to pay for health care. In the economic boom that followed World War II, it made some sense for employers to provide health care--it gave them a competitive advantage, and in an era of lifetime employment it even provided health care for retirees.

In today's world, that system is falling to pieces. First of all, most jobs simply don't last more than a decade at the outside; it's no longer considered even slightly unreasonable to lay off employees at the first sign of economic distress. "Taking care of your people," isn't considered a virtue in the business world just now. Worse, the advent of low-cost businesses like Wal-Mart has put many businesses in a hopeless position--they can either stop providing health care to their employees or lock themselves into a position where they get ground under by companies that simply don't need to spend as much per employee as they do.

The conservative solution to this appears to be (if any conservatives would like to correct me, I'd be more than pleased) to encourage people to pay for their own health care plans through tax incentives. There are a few basic problems here. First,
health care is quite expensive: for my family (two of us around thirty, one two-year-old) it's about $500 per month. For us, that's barely plausible; for lower-income families it's not even remotely possible. Worse, it gets progressively harder to afford health care as we get older; it's only by insuring twentysomethings at inflated rates that businesses could afford to insure their older empolyees.

The liberal solution to this is, of course, to raise taxes and move to either a "single-payer" system (that is, the government becomes the health-insurance provider for most Americans), or a nationalized system (whereby the government runs health care directly). Since the majority of hospitals and doctors are outstanding, most liberals are pragmatic enough to prefer the former.

A few quick responses to obvous questions:

"But won't increasing taxes cripple the economy?"



Not if the higher taxes are replacing a current cost. My taxes would have to increased by $6000 per year before I'd lose money on the deal. Moreover, the government would be in a much better position to bargain for prices than I am by myself! It would also remove a frightful burden from businesses, and remove probably the single most contentious issue from labor negotiations. (Do businesspeople really like being in the position of having to announce to their employees that they have to discontinue health care for their employees? Does that really help morale?)

"Won't this lead to rationed health care?"



Certainly, but that happens now with HMOs! (That's the entire point to HMOs--they ration care to keep their prices down.) The wealthy will still be able to purchase supplemental plans to pay costs beyond what the government is willing to provide.

"Why should I support health care for people too lazy to work?"



There are three basic answers here. First, many people without health care are working; they just don't make enough to pay premiums. Secondly, life is uncertain--anyone may be laid off at any moment, any small business may fail if times abruptly become tough, and anyone may suddenly become seriously ill. A smug assurance that one will never need such a system is foolish pride, not wisdom. Finally, a serious outbreak of an infectious disease will hurt everyone, not just those unfortunate enough not to have health care. An outbreak of whooping cough (for example) will not politely respect social lines, but will endanger everyone (that immunization you had as a child no longer protects you, by the way; we're all protected from whooping cough by the fact that most children are immunized). A drug-resistant TB outbreak would quickly become terrifying for everyone.

Comments are welcome, as always!

40 Comments:

Blogger Key said...

AGGGHHHH!!!

Are you TRYING to give your mother a heart attack? You want me dead, is that it? ; D

See... I'm guessing that under your [admittedly] rationed health care system, there's only a certain number of heart attacks I'll be allowed to seek treatment for over the course of my life.

While you're thinking "how much worse can it get; HMOs already suck..."

I'm thinking "HMOs suck. I WILL NOT use one. Thank God we live in a free country that allows me work -sweat, blood, tears, etc.- until I can cough up enough money to UPGRADE!"

I want to buy it up. I'm willing to work LONG hours in a HIGH stress environment to afford upgraded insurance.

I make the sacrifice. I should reap the reward.

I would highly resent it if this freedom were taken from me, and left me subjected to the clusterfug nightmare that would be government run health care and/or health insurance.

I guarantee you there will be tales that will make the HMO horror stories pale in comparison. Diseases will not get diagnosed. Specialists will not be seen. People WILL die.

(And immunizations are not a present concern, as they are free at any county clinic.)

More government is NEVER the solution. We have to be disciplined and self-sufficient as a people. We do NOT need them. They are the poorest example of efficient money management that there is to offer, and with reason. By the time taxpayer funds trickle down through the ENORMOUS bureaucratic pyramid of payroll and expenses, what's left?

Sure, we need legislation so that companies play fair, and we need it enforced, but we do NOT need government to manage our money for us.

We are big boys and girls. We CAN do it.

Guidelines. That is what you seek. Corporate incentives to offer health care, etc.... There are ways to improve the overall situation WITHOUT having to deal with a stiff negative repercussion.

2:01 PM  
Blogger The Polite Liberal said...

Key, you can afford health care now, but you're 29 (unless you haven't upgraded your site recently). Take a look at what equivalent care will cost when you're in your sixties. Under the plan I use, health care above $65 for my family would cost around $1650 per month. Do you really want to be working that hard, at a high-stress job, when you're in your seventies? Can you set aside enough to do that? If you can't, you aren't allowed any heart attacks.

Nothing would stop you from buying supplemental insurance (as wealthier elderly do now under Medicare).

There must be a bare minimum of health care below which it is not possible to fall (we're not actually willing to let people die of easily-treatable diseases). In fact, there currently is--anyone can use an emergency room, regardless of their ability to pay. That's driving many hospitals out of business. I'm asking for something saner.

Under your system, what are salaried employees meant to do, if their company doesn't provide benefits? Salaried empolyees don't necessarily get more money for "working harder;" when companies are in financial trouble they typically freeze raises. Are they meant to work a second job? Moonlight? If they have families, should they then pay for extra daycare? Isn't this a bit rough on their families? Or should they simply organize so they can bargain with their company collectively? ;)

8:12 PM  
Blogger Pammy said...

"In fact, there currently is--anyone can use an emergency room, regardless of their ability to pay. That's driving many hospitals out of business. I'm asking for something saner."

I wholeheartedly agree.
It's not only driving many hospitals out of business, it's driving UP the cost of healthcare for those that DO have insurance in the form of increased premiums, higher deductibles, etc. Hospitals charge astronomically high rates to the uninsured or 'self-pays'. Much higher than they charge HMO's or group insured. This is because the HMO's or groups negotiate with hospitals for lower rates. They have to try to make up the difference somehow.
I'm...ahem...50 years old and currently have NO insurance. My job does not offer group insurance and I simply cannot afford it on my own. Because YOU'RE being charged higher rates, you're paying for people like me anyway, in the long run.

7:57 PM  
Blogger Key said...

NOOOOOOOOOOOOO, don't tell me you've given up! You're too young to die. You've only just begun.

Come back...

2:43 PM  
Blogger Key said...

You're really gone aren't you?

Come on! It takes months to establish readership...don't give up! Say something. Dammit.

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