This is Charles Krauthammer's column from today's Washington Post. I believe it is a very realistic projection of where healthcare reform will wind up.


http://www.washingtonpost.com/wp-dyn...073002819.html

If the "individual mandate" that Krauthammer describes would do the trick, that would be wonderful. (Easy for me to say--I'm not one of the 18 million Americans who would have to pay premiums to support me!) Maybe if we add in some tort reform, some taxes on the wealthiest among us, and some sort of government-mandated record-keeping and insurance claim simplification, we could get there from here.

I was a little disappointed in Krauthammer's use of the phrase "transfer of wealth" again. He's right, of course. To substantially reduce the cost of healthcare in the U.S. in order to avoid the system from breaking our economy worse than it is now, of course there will have to be a transfer of wealth. It might be means testing for benefits, increased taxes on some, mandated insurance on those who don't want it or need it, forced reductions in payments for service--lots of things from among a list of things that would either increase out-of-pocket costs for some, or substantial elimination of benefits while keeping the premium payments at a high level. Either way, wealth will be transferred. But I see little to be gained by continually trying to inflame citizens by continually using the phrase.

Originally Posted by Villages Kahuna

If the "individual mandate" that Krauthammer describes would do the trick, that would be wonderful. (Easy for me to say--I'm not one of the 18 million Americans who would have to pay premiums to support me!) Maybe if we add in some tort reform, some taxes on the wealthiest among us, and some sort of government-mandated record-keeping and insurance claim simplification, we could get there from here.

I was a little disappointed in Krauthammer's use of the phrase "transfer of wealth" again. He's right, of course. To substantially reduce the cost of healthcare in the U.S. in order to avoid the system from breaking our economy worse than it is now, of course there will have to be a transfer of wealth. It might be means testing for benefits, increased taxes on some, mandated insurance on those who don't want it or need it, forced reductions in payments for service--lots of things from among a list of things that would either increase out-of-pocket costs for some, or substantial elimination of benefits while keeping the premium payments at a high level. Either way, wealth will be transferred. But I see little to be gained by continually trying to inflame citizens by continually using the phrase.

Tort reform isn't reform at all. If the goal is to reduce medical costs by eliminating the reason for "defensive medicine" practices, that will require blanket immunity from suit. Where limitations on medical malpractice claims are in force (CA is the best example), defensive medicine practices are still unchecked and overall medical costs still follow the same cost curves (if not higher) as elsewhere. So, are we willing to give blanket immunity to suit for the medical profession?

This "transfer of wealth" concept frightens me. Where is the line drawn? This is the "camel's nose under the tent flap" story with a dollar sign application. If done with health care, what's next - the type of car you can drive, or how much energy you can use at your house?

And when we increase taxes on the 'some," who are they? Of course, it's not us!

So we tax the "wealthiest among us," which always seems to be a bigger and bigger pool as more and more money is needed due to politically-inspired cost estimating that's always woefully short. Since the CBO says again that the cost curves are totally wrong as forecasted by the proponents of this health care scheme, we can expect "trickle down" taxation to bite us all.

We have the CBO so that we can have the most accurate and objective cost estimation before the gavel comes down. If we want to ignore the CBO forecasts as "inconvenient" to "Change, We can believe in," and continue merrily towards fiscal ruin, then we indeed have drunk the kool-aid and delegated full control of our lives to the party - and that is socialism at its worst.

When a health care plan can be shown by the CBO as meeting the fiscal goals of the plan's sponsors, and those goals are such that we actually have a better posture than present, then it will be endorsed by all of us. But this "to heck with the CBO forecasts, we need this passed by ____" is folly.

As much as we might like it to be otherwise, the reform of the U.S. healthcare system is going to result in a transfer of wealth. It doesn't have to be called that, but a transfer it will be. Call it what you want, increased premiums, means testing for benefits, higher copays, reduced coverages, reductions in payments to providers, higher taxes, negotiated prescription prices or hospital fees, limitations on medical research, lower payments to doctors, even a "government option"...they are all transfers of wealth from one group of citizens to another.

If costs are to be reduced, it simply can't be any other way, "nose under the tent flap" or not. The cost of healthcare as either a percentage of GDP or on a cost per capita basis must be reduced, and reduced substantially. Call it whatever you'd like, but the result will be a transfer of wealth.

Transfer of wealth is socialism. No if, ands or buts.The American dream is on a slippery slope. I think it is preposterous that people of our age who have enjoyed the benefits of capitalism their whole life, would want our grandchildren to be straddled with the limitations of socialism. The audacity of hopelessness.

Originally Posted by Keedy

Transfer of wealth is socialism. No if, ands or buts.The American dream is on a slippery slope. I think it is preposterous that people of our age who have enjoyed the benefits of capitalism their whole life, would want our grandchildren to be straddled with the limitations of socialism. The audacity of hopelessness.

Health Care is an extremely emotional issue for some. My husband and I have wonderful health care. But, my best friend in Chicago is 55 and works for a law firm. They do not provide health insurance any longer and she cannot afford it. She just found a lump in her breast and cannot afford to go to a doctor. People say hospitals and doctors will work with you. She tried that. They don't. Would any of you anti-public healthcare proponents care to tell her what to do???

Health Care in America should be just as much of a "Fundamental Right" as carrying your precious guns. In fact, more.

As long as there is one homeless person in this country, one starving child, one American without Health Care... "The American Dream" will remain a myth.

Originally Posted by chelsea24

Health Care is an extremely emotional issue for some. My husband and I have wonderful health care. But, my best friend in Chicago is 55 and works for a law firm. They do not provide health insurance any longer and she cannot afford it. She just found a lump in her breast and cannot afford to go to a doctor. People say hospitals and doctors will work with you. She tried that. They don't. Would any of you anti-public healthcare proponents care to tell her what to do???

Health Care in America should be just as much of a "Fundamental Right" as carrying your precious guns. In fact, more.

As long as there is one homeless person in this country, one starving child, one American without Health Care... "The American Dream" will remain a myth.

"Health Care" wasn't in the constitution last time I looked. Second amendment to the constitution gives Americans the right to bear arms. The American Dream is alive and has been for over 200 years, where as the socialist utopia that you describe has been tried many times and failed. Please remember that the USA feeds many people throughout the world including some of your utopia failures.

We already have a transfer of wealth going on in america.

Those of us who pay taxes and health insurance premiums
are paying for the healthcare of those who pay little or no taxes and have no health insurance.

You have to remember that all residents of america get healthcare free if they have no insurance and no money.

Chesea24 tell your friend to go to emergency or to a regional medical center or to buy insurance if she can afford it.

Originally Posted by Villages Kahuna

As much as we might like it to be otherwise, the reform of the U.S. healthcare system is going to result in a transfer of wealth. It doesn't have to be called that, but a transfer it will be. Call it what you want, increased premiums, means testing for benefits, higher copays, reduced coverages, reductions in payments to providers, higher taxes, negotiated prescription prices or hospital fees, limitations on medical research, lower payments to doctors, even a "government option"...they are all transfers of wealth from one group of citizens to another.

If costs are to be reduced, it simply can't be any other way, "nose under the tent flap" or not. The cost of healthcare as either a percentage of GDP or on a cost per capita basis must be reduced, and reduced substantially. Call it whatever you'd like, but the result will be a transfer of wealth.

The issue is that health care costs (as an industry) have indeed risen, while the rest of the industries in America have been relatively stagnant or depressed. With a vibrant economy where all industries are on the upswing, health care costs become invisible.

Nationalizing industries don't work, as the industry eventually becomes "average" (remember the "C" grade that schools aren't supposed to give anymore?). No nationalized industry has ever excelled, and most barely stay afloat. Why should we think health care will be any different? If indeed costs are lowered, so will the standard and quality of care, as every industry has inherent costs for product development and delivery. While some economies of scale may be found and exploited, they will be quickly offset by declining research and development - nationalized industries shun R&D on the "we have enough problems of today, let tomorrow be taken care of by the next watch."

By the time all of the costs for HR 3200 for the next 20 years (under the best estimate!) are tallied, it will be proven cheaper to have the taxpayer pay for a private Blue Cross policy for every citizen and lawful permanent resident in the US who is uninsured today. As far as the rest of us, health care costs will indeed NOT stabilize, as there will be just a bigger market in "supplemental" policies to cover what government won't. And again, watch the boom in medical tourism, especially to Central/South America and the Caribbean.

we each understand what it is that is being called health care reform. Does the reform fix the abuse of the system?

Cashman, thank you for your thoughts. I am actually going to plead with her to go to emergency. I hope that works. She did go to the Social Services office of the hospital and they were unwilling to work with her. She simply cannot afford health care as she lives from paycheck to paycheck, as so many Americans do nowadays. (Makes me count my blessings for sure.)

As far as Regional Medical Centers... that's a no go. They want your credit card up front. I know this because I took her into one one day (for something else) when I was still living in Chicago and I gave them mine for her. They weren't going to see her.

You said to remember that all Americans get free health care if they have no money and no insurance. I'm curious as to how you think that works? I'm not being sarcastic, I am genuinely curious. I think that we, the more fortunate, sometimes believe we know how it works. But that the reality of it is quite different. As previously stated, she does have a job. But, paycheck to paycheck means choosing between -- do I start with the doctor's visit, mammogram, biopsy $$$ -- or risk not paying my rent???

Yes, I think the reality is very different than perceived by some.

I just keep thinking.... "There, but for the grace of God, go I...

Originally Posted by SteveZ

The issue is that health care costs (as an industry) have indeed risen, while the rest of the industries in America have been relatively stagnant or depressed. With a vibrant economy where all industries are on the upswing, health care costs become invisible.

Nationalizing industries don't work, as the industry eventually becomes "average" (remember the "C" grade that schools aren't supposed to give anymore?). No nationalized industry has ever excelled, and most barely stay afloat. Why should we think health care will be any different? If indeed costs are lowered, so will the standard and quality of care, as every industry has inherent costs for product development and delivery. While some economies of scale may be found and exploited, they will be quickly offset by declining research and development - nationalized industries shun R&D on the "we have enough problems of today, let tomorrow be taken care of by the next watch."

By the time all of the costs for HR 3200 for the next 20 years (under the best estimate!) are tallied, it will be proven cheaper to have the taxpayer pay for a private Blue Cross policy for every citizen and lawful permanent resident in the US who is uninsured today. As far as the rest of us, health care costs will indeed NOT stabilize, as there will be just a bigger market in "supplemental" policies to cover what government won't. And again, watch the boom in medical tourism, especially to Central/South America and the Caribbean.

If you think health care is expensive now, wait until it is free.

What I have a problem with is the parts of today's "system" that work does not need to be reformed.

The average senior on Medicare, with reasonable health or stated other wise reasonable non health, has probably not had to spend much out of pocket for their care.
My wife went through breast cancer and all the pre op specialists and all the post op procedures and Medicare + OUR SUPPLEMENTAL covered EVERYTHING. She is a survivor hence the treatment expenses have subsided.
Her older sister was not so lucky, she was not a survivor, very costly treatments for 2 years of care....all covered by Medicare + supplements.

One would/could say health care is working well. There is of course abuse within these processes....what will be done about that in the new reform?

If in the proposed reform, idiotic aspects, like death counseling, would be stripped away in a heart beat. 37,000 administrators, not counting bricks and mortar or management or supervision...and the price....who knows....but here again another major chunk of $$$$$. Who is going to eliminate such stupidity from the reform?

The biggest issue seems to be how to add those who are not covered for what ever reason/race/belief/etc......and how to pay for it.

In the reform where are the words that say those currently over 65 are grand fathered. How does it help reform the system if we have to get less coverage? Pay more for what we have? How does that translate into helping the economy? It does NOTHING if we pay more from a fixed income for what we already have.

In the reform where is the language that states what changes will be made to the pharmacy/medicinal aspect of health care? How about the government taking over these industries (just kidding).

How about eliminating tort, not just reform it. But like the pharmaceutical aspect, there is too much special interest influence for that to happen.

I am for improved health care coverage or reform if it in fact solves the real issues at hand. As long as it remains a political, scratch my back and I'll do yours as usual....there will be no reform.....only more covered....more cost and less wealth.

The devil is in fact in the details and as usual the details will not have an effect on the outcome....just politics as usual.

Thus far I have yet to see any REAL improvements proposed....not as long as the current ills remain.

btk

Originally Posted by billethkid

What I have a problem with is the parts of today's "system" that work does not need to be reformed....

My own health insurance is much the same as your own. I had major surgery in late April and my hotel bill for my wife staying in downtown Chicago while I was in the hospital was more than my deductible and co-pays for the procedure. It works well for me. I would be perfectly justified in saying, "don't change a thing in my behalf--I'm just fine, thank you very much".

But what about the people who don't qualify for Medicare (the "single payer government system" that many say will be the death knell for American healthcare)? I've read statistics that 14,000 people per day are losing their health insurance because their employers are discontinuing medical insurance as a fringe benefit. The premiums have escalated beyond the point where the employer can afford to pay them.

And the illegal immigrants, of course. The lobbyists have been quite effective in gutting any proposed immigration reforms because employers want and like the cheap labor provided by those crossing our borders illegally. We all know that even the illegals can get emergency care for nothing. It's not really "nothing". of course. The costs get shifted eventually to those that are paying insurance premiums, like the employers who can no longer afford to do so. By the way, would anyone disagree that this is really a "transfer of wealth"?

What a Catch 22. The critical problem is fast becoming grave. Fewer and fewer people have reasonable healthcare coverage. And the lobbyists are hard at work making sure that it stays that way--or gets worse.