"Public Option Now" Blog Weighs Congress' Progress on Health Care

The Public Option Health Care Now blog, recently founded by yours truly to follow and enhance Congress' efforts toward health care for everyone in the US, has written a brief and cogent commentary of what's right and what's wrong with the US Congress' efforts over the last week:

Those Who Earn the Most Should Contribute the Most to Health Care for All

There's something uniquely American and wrong about the approach that the nation is taking to the reform of health care: The United States already spends fifty to one hundred percent more per capita on health care than other countries that have health care for all. And now, the US plan to cover everyone will cost five hundred billion to a trillion more dollars, which will make it perhaps 150% more expensive than our nearest rival.

There are a lot of reasons for this, but the primary one is deference to medical entrepreneurs and corporate players. Some physicians order twice or three times as many expensive tests simply because they own the testing machines and have to find a way to pay for them.  And that's something I haven't heard directly addressed. Some hospitals charge two or three times more for the same operations as others do, without providing better and sometimes providing worse medical outcomes. That reality, too, is one I haven't heard directly addressed.

While the Brazilian Government provides medicines for free, by focusing on bulk purchases or manufacture of brandless drugs, the US's health care plan will extend from six years to twelve the number of years that a drug remains under patent and cannot be purchased as generic, which will make the price as much as ten times more.  Public Option Health Care Now

As we learned in 1993, when Bill and Hillary Clinton endeavored to cover all Americans with health insurance, giving each of the stakeholders (people somehow served by the status quo or by potential changes) something to feel happy about is more effective than alienating them and hoping to make do without their support, when trying to get a bill through Congress.

However attempts to please everyone, e.g. by giving bloated and venal insurance companies a role in covering the uninsured, are promising to make the new system more complex and expensive than it needs to be.

The massive bureaucracy associated with individual mandates to purchase insurance, and mandates for employers to purchase insurance will effectively double the bureaucracy that now exists at the IRS, as well as the paperwork for employers, for the purpose of collecting tax receipts that pay for national programs.

And so I'm concerned that the health care "reform" that's on the table will accept and perhaps exacerbate the most wasteful aspects that make US health care so expensive and spend more money on them. Instead, the US Congress should raise taxes on the wealthiest one percent of Americans to a level sufficient to pay for the whole program, which would be fair because those who are making the most money and who have the most ability to support health care would also pay the most.

I rarely agree with arguments made by members of business groups, but I do agree that there are some large and small businesses that are barely viable financially now, and adding a new tax to them, regardless of their ability to pay, could hurt jobs and the recovery. Instead, as Congressman Charles Rangel has proposed, those individuals who demonstrably ARE making the most money should shoulder the burden for this reform, by taxing net income in excess of $350,000 per year in a graduated way, with the highest earners paying a higher percentage of income.

In that way, those who make the most money out of the health care system would also be those who pay the most to keep its inefficiencies as they are.

Certainly the Republicans will argue in the next election cycle that Democrats implemented new taxes for Americans, but this argument will be more easily countered now, as during the Clinton Administration, if Democrats can say that only the rich are paying more while the working class and middle class (the vast majority of taxpayers) are reaping the benefits.  Public Option Health Care Now

If over the next two months any bill gets through Congress that covers those who are not insured, then that will be an historic and monumental accomplishment, whose inefficiencies can be resolved later, one by one, as they are identified. On the other hand, if critics convince the US Congress to do nothing, then "nothing" is what many in this country will continue receiving when they most need health care.  And many of those who have good health coverage now will find it increasingly and eventually untenably costly to keep it.