Monday, July 27, 2009

Who pays for health care costs?

Let’s end this foolish bickering.

Robert Reich, former Secretary of Labor and professor of public policy at the University of California, Berkley said, in his Blog on 7/26, that President Obama needs to insist that any act on Health Care Reform contain:


(1) A public plan option,

(2) A mandate on all but the smallest employers to provide their employees with health insurance or else pay a tax or fee (so-called "pay or play"),

(3) A requirement that every individual and family buy health insurance, coupled with subsidies for families [earning] up to 300 or 400 [percent over times] the poverty level in order to make sure it's affordable to them; and

(4) A small surtax on the top 1 percent of earners or families to help pay for this subsidy . . ..”

This is one of the most succinct listing of necessary basic operational elements seen to date. These will substantiate the three absolutely essential philosophical tenets:

(1) Insurance for all the people,

(2) The elimination of pre-existing exclusion practices, and

(3) A reduction of overall health care costs as soon as possible.

This citizen has been a resident of the “representation-less” District of Columbia for more than twenty years. Believe me the workings of Congress as a whole provide an unlimited amount of entertainment and a great deal of frustration over its actions and non-actions. One of the most palpably pathetic arenas of nabob nattering is “Who will pay the cost of reformed health care services?”

The minority leaders in both houses blather incessantly about not only “socialized medicine” but also the “spend, spend, spend” of the administration’s plan. Employers – mostly the so-called small ones – yammer about them being forced to drop the benefit because of the increased costs. Those citizens blessed with incomes in the top one percent of our nation, who can most easily pay an additional amount into the social insurance system, also decry how they will need to reduce the number of their employees to cover the additional costs.

Let’s get one thing clearly understood – crystal clear to recall a former president – the only “ones” who will pay the cost of reformed health care are the same man and woman who pay it now: John Q. and Jane Z. working tax paying citizen. Increased expenses have to be covered by increased incomes. The wealthiest among us won’t stand for any reduction in profit levels for their corporate stocks; they demand an increase in service and/or goods prices. The health care service system simply executes the now classic cost shifting to cover the “uncompensated care” costs. The health insurers increase premium amounts or restrict services or both to keep their shareholders happy. And the social insurance system (read the government) eventually is required to raise the level of its income. Who pays the higher taxes? Who has insurance premiums hoisted to the stratosphere? Who pays the higher prices for goods and services? John and Jane do.

John and Jane cover all of the “uncovered” costs now. They will do so at an increasing level whether or not the health care system changes. This should be the end of the debate about costs. Let’s get on with the reformation so that our health care system can begin to nearly rival those of other first world nations.

Everyone insured - No one excluded - An extra mite from the wealthiest - A true social insurance sharing of the costs for the benefit of all Americans

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