Prescription for Confusion

Posted Sept. 22, 2009, at 6:04 p.m.

The much-anticipated health care reform bill from Senate Finance Committee Chairman Max Baucus shows what you get when you try to solve a major problem not by addressing the problem head-on but by contriving complex ways to get around it. Millions of Americans can’t afford health care? Fine them for not buying it. Businesses are being crushed by the rising cost of health insurance? Penalize them for not offering coverage to their employees.

Here’s the problem in a nutshell: More than 47 million people in America don’t have health insurance. When they get medical treatment — usually at a hospital emergency room, which is more expensive than a visit to a doctor’s office — each of us pays for it, to the tune of about $1,000 a year.

Health insurance costs are rising rapidly. Premiums are expected to nearly double over the next decade, and health care spending is projected to rise to more than one-third of the country’s GDP by 2040. Half of all personal bankruptcies are attributed to medical costs, and private insurance administrative costs eat up 20 cents of every dollar spent on health care.

The cost of insurance eats up precious dollars that companies could better use to develop new products, hire new employees or offer raises. People stay in jobs they don’t want or like simply to keep their health insurance, stifling innovation and keeping young people out of the work force.

Every other advanced country in the world has figured out that a single-payer system solves all these problems. Everyone is guaranteed health care and the government pays the bills, which by the way are much smaller than the bills in the U.S. Private insurance is also available in most of these systems.

This is not government-run health care, it is government-paid-for health care. We already have this system in the United States, but not everyone gets to use it. Including Medicare, Medicaid, the Department of Veterans Affairs, federally subsidized children’s health care and the coverage of federal employees (including members of Congress), more than half of Americans already have health care that is paid for and managed by the federal government. They go to the doctors of their choice, the same doctors those with private health insurance pay much more to see. Their bills are paid without having to wade through a blizzard of paperwork.

If it works for other industrialized countries and half of Americans, it should work for the other half.

The problem is that a switch to a single-payer system is politically difficult, largely because insurance companies and other entrenched interests make it difficult. So, we end up with a mishmash like Sen. Baucus’ bill, which extends insurance to about half those currently without it by forcing them to buy it through new insurance exchanges. Government subsidies will help cover the cost, but the penalties on those who don’t buy insurance and the companies that don’t offer it — figured to be about $50 billion — are expected to lower the cost of the bill. So are savings from Medicare.

These are complex and convoluted ways to get to a fairly simple problem. It is the solution, however, that Congress has to work with. So, lawmakers should focus on improving and simplifying the legislation because doing nothing would be worse.

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