You are wandering lost in the desert for several days without water, parched, your lips cracking, tongue swollen, eyes rattling around in your skull, desparate for an oasis. A man appears, and you think you are saved; he tells you he’s got just what you need, water. But instead of life-sustaining liquid he gives you empty water bottles and a coupon for free water, usable at a well that has yet to be drilled.
Your hopes dashed, you expire.
Pres. Bush’s health reform plan provides individuals with tax breaks to help them buy insurance that for many does not exist. Sort of like water in a desert.
The Bush “plan” is comprised of a tax deduction of $15,000 for a family and $7500 for an individual, available to anyone buying health insurance. That would be great, if there was any individual health insurance to buy.
That rather significant problem seems to have escaped the President, who has been out in public (well, a very narrow, carefully selected and screened “public”) (registration required) promoting his solution to the health care crisis. Here’s a quote from a NYTimes article reporting on Bush’s recent appearance – “Marty Ginn, an office manager from nearby McMinnville, told Mr. Bush, “I have a pre-existing condition, I have trouble with my left knee, and the quotes were just outrageous and I’m just kind of stuck.”
“That’s patently unfair,” the president replied after telling Ms. Ginn that under his plan, she would get a tax deduction of $7,500 to help defray the cost of coverage.”
In his prepared comments, Bush noted:
“Right now there’s a limited market for the individual. It makes it hard to find a product that either suits your needs or you can afford. The more policies written to meet the individual – in other words, the larger the risk pool – the more likely it is that costs will come down for the individualized policy. That’s just the way it works. Yet the tax code discourages the individual from being in the market.”
I think what Bush is saying is that if more people try to buy health insurance, there will be more health insurance to buy. That’s true, for those individuals who can pass medical underwriting or will accept exclusions for pre-existing conditions.
It is patently untue for individuals with health issues.
Health insurance companies do not make money insuring people who need health care; they make money by getting people who don’t need health care to buy their insurance.
And the Bush plan does nothing to change this. For those people, Bush’s plan is a coupon for water from a well that doesn’t exist.
I am convinced that the vast majority of people at any one time are well and not seeking expensive medical treatment. If you look only at Medicare pools or Medicaid pools, you are looking at demographically distorted pools, and thus any data is also distorted.
I do not believe this country has ever tried putting everyone in a large pool with a defined minimum benefit, community rating and guaranteed acceptance and renewability. If we did this with a tax suported paying system, or at least supplemental financial aid for the poorer folks in a competitive (sort of) private pay system with mandatory coverage instituted by law, I think we would see interesting results.
The President could be on his way to a real system beneficial change if he proposed such changes along with this tax scheme! But alas, it isn’t in his genes!
“I think we would see interesting results.”
I agree.
I don’t know how much you would like it – but definitely, interesting.
Interestingly, right after I posted my above suggestions, I got this White House Fact sheet about what Bush proposed ? yesterday. Here is the URL:
http://www.whitehouse.gov/news/releases/2007/02/20070221-3.html
Look at this paragragh:
“Helping The Poor And Hard-To-Insure Afford Coverage Through The Affordable Choices Initiative
The President’s Proposed Affordable Choices Initiative Will Help Governors Reduce The Number Of People In Their States Without Private Health Insurance. States that make basic private health insurance available to all their citizens should receive Federal funds to help them provide this coverage to the poor and the sick. Under the Affordable Choices Initiative, existing Federal funds would be used to create Affordable Choices grants to give eligible governors more money and more flexibility to get private health insurance to those most in need.”
I am a single payer advocate, but I do try occasionally to live in the real world and accept compromise as needed to get much good done. If such subsidies were then coupled with more fair rules and regulations on the individual private insurance market, well then a form of workable universal coverage might actually be insight. Kind of exciting for once!
Such joy people like you get for bashing Bush. So what if his plan isn’t perfect – what plan is? The individual market needs fixing and perhaps this is the impetus it needs – putting health care premiums on the backs of employers cannot be sustained. Instead of the usual Bush bashing, give the White House credit for being realistic about what changes can be pushed through, both in terms of his political capital and in terms of the political pushback that will inevitably happen no matter what he proposed (and you thought Harry and Louise were bad!).