Charles Krauthammer is not against coming up with health insurance for those who do not have it, but he points out that the current bills are utterly incoherent, making a system that is already inefficient even more so:
The United States has the best health care in the world — but because of its inefficiencies, also the most expensive. The fundamental problem with the 2,074-page Senate health-care bill (as with its 2,014-page House counterpart) is that it wildly compounds the complexity by adding hundreds of new provisions, regulations, mandates, committees and other arbitrary bureaucratic inventions.
Worse, they are packed into a monstrous package without any regard to each other. The only thing linking these changes — such as the 118 new boards, commissions and programs — is political expediency. Each must be able to garner just enough votes to pass. There is not even a pretense of a unifying vision or conceptual harmony.
The result is an overregulated, overbureaucratized system of surpassing arbitrariness and inefficiency. Throw a dart at the Senate tome:
– You'll find mandates with financial penalties — the amounts picked out of a hat.
– You'll find insurance companies (which live and die by their actuarial skills) told exactly what weight to give risk factors, such as age. Currently insurance premiums for 20-somethings are about one-sixth the premiums for 60-somethings. The House bill dictates the young shall now pay at minimum one-half; the Senate bill, one-third — numbers picked out of a hat.
– You'll find sliding scales for health-insurance subsidies — percentages picked out of a hat — that will radically raise marginal income tax rates for middle-class recipients, among other crazy unintended consequences.
The bill is irredeemable. It should not only be defeated. It should be immolated, its ashes scattered over the Senate swimming pool.
Then do health care the right way — one reform at a time, each simple and simplifying, aimed at reducing complexity, arbitrariness and inefficiency.
He goes on to recommend malpractice reform (which the current bills do not address, out of respect for trial lawyers, one of the Democrats’ biggest sources of donations, even though fear of malpractice suits causes doctors to run countless unnecessary and expensive extra tests); then allowing insurance companies to compete across state lines (which the current bills do not address, even though this would cut insurance premiums); then taxing benefits to raise money to help the uninsured (which I’m not sold on).
But still. . .His point is that this bill is a bloated monster that won’t accomplish what it claims to. A better solution would be to take one reform at a time with the goal of making health care less expensive and less complicated.
{ 2 comments… read them below or add one }
“..out of respect for trial lawyers…”??
Trial lawyers have Washington bought and paid for. There is zero chance tort reform will happen with the current makeup of Congress.
Yet Krauthammer is right: without it, we aren’t going to be able to get a handle on medical costs. And further, without it, we are going to continue to see a decline in proactive medical care, and a continued move to defensive medicine.
My wife works with older doctors who bemoan the fact that the younger docs haven’t even been trained in doing neurological tests without instruments–tests that are more reliable but cost only the time of the physician in doing them. Why? Because there is no paper trail with such a test, and all fingers point back to the physician. If the doc can point to a machine for “who’s to blame”, then s/he’s off the hook. Otherwise, someone is going to sue them.
I had a conversation recently with a married couple; both are docs, surgeons. She’s given up and is going to just raise her kids. He’s given up and is going to work for a drug company. They both have been sued repeatedly, the latest by someone for whom they did pro bono work. All scurrilous suits, they claim. All requiring expensive lawyers to defend them.
Now, if these lawyers and their clients knew going in that if the suit was decided against them they’d be the ones having to pay, perhaps they’d be less tempted to go on fishing trips.
As an outsider, I think this sounds like a more reasonable approach. But as Bruce points out, changing the sue-happy culture seems to be an impossibility….