After the SOTU, I was all prepared to dump on Bush's new buzz-phrase, 'Affordable Choices'. I thought that it was just another way of spinning 'The Ownership Society
', and when I discovered what it really is, I despaired. What would I write about today? Turns out, there's a lot of vacuous stuff in the SOTU that deserves attention, and I'll focus my efforts on the health insurance proposal that won't end up insuring anybody.
Bush said that he wants to level the playing field between people that are insured by their employers and those who have to purchase insurance on their own. Well that's a laudable goal. Except that Bush's proposal, a tax-break for everyone...that supposedly will help the uninsured buy insurance, keeps the playing field uneven--just in a different way. The only way to level the playing field would be to make the benefit of employer supplied health insurance taxable income. Then everybody would pay (one way or another) and everybody could deduct. That's level. But Bush didn't propose that. He proposed a givaway of $15,000 in non-taxable income. Those who have insurance will reap the windfall, and those who don't have insurance aren't likely to use their new found wealth to purchase it.
Moreover, the issue is less affordability and more the availability of insurance...at any cost. Do you have a pre-existing condition? Yes? Then you're probably done. Without an employer or COBRA, you're not likely to find insurance. Bush can play with deductions and credits all he wants, but it won't insure more people. The more likely result is that, to pay for the whole plan, Bu$hCo will have to remove the corporate deductions for the cost of insurance, and then many companies will simply do away with the benefit altogether.
If my pre-existing condition is that I lothe the current government, will I be denied coverage too?
The health plan doesn't make much sense, does it? But it does further muddy the waters of the health care debate, such that it is, and that may be the real intention.
You notice that there was no mention of Corporations just saying screw the free insurance, and give them what the insurance would be valued at for tax purposes, in their paychecks. Oh no. So the "taxable income" amount is grossly exaggerated to begin with.
Further there USED to be a time, when we tried to bring the poor up to the standards "above" them, not bring all standards down. That's nothing but plain old class warfare.
The playing field can be "leveled" by increasing benefits as well, you know. Don't be sucked in by this have's vs have not's disguised as insurance reform.
If the "have's" are going to be taxed on the "disposable income" portion of their benefits, then are the HMO's, PPO's going to have to pay extra taxes on that portion of your "disposable income" they receive? He kinda forgot that part as well.
He also "forgot" what you cited - preexisting conditions, such as forcing insurance companies to insure you. HMO's and PPO's reap massive profits because they only insure healthy people. That's not insurance, that's just business as usual.
Windspike... My pre-existing condition is that I'm an insufferable crank, but that makes me hard to live with, not hard to insure. You're probably on some 'Federal No-insure' list.
Abi... I had to reread just those 300 stupid words a few times before I was convinced it was nonsensical.
Fred...DOA via TKO.
TFWY... I was actually trying to be sort of facetious in that I was proposing what I thought would be Bush's plan if he hadn't chosen to be completely nonsensical--just didn't come across.
You're absolutely right about the second, and it's where we really need to get to. With more and more people being thrown into the 'independent and can't get insurance' category, insurance companies are very shortly going to be forced to insure, or get out of the business. As you say, not insuring the sick is not being in the biz.
Why do they fight socialized medicine. It works well in other countries...or so I've heard. They fight it because of the pharma companies and the Doctors wanting to keep their cushy salaries. That's why the foreign health care givers come here because there's more money in it for them. Screw the people...we want our money...because it's what makes the world go around in a most important way.
The flaw in the proposal is that the poor who are uninsuired remain uninsured because they don't pay enough in taxes, or any taxes, for the tax break to make any difference to them. The people who will get the tax breaks already have health insurance, for the most part. The problem is with insuring those who don't have insurance. The Bush proposal may, marginally, raise the number of insured, but it won't do that for many and, on top of it, is nothing more than a gift for the insurance companies, not the people. The solution is in lowering the cost of medical services, not in making sure that the insurance companies get more customers. The Bush proposal is a dodge. It avoids the real issue while yet again handing money to the corporations and helping to raise the budget deficit. Want a solution that benefits everyone? Lower the cost of medical services, which should, in turn, lower the cost of medical insurance. Nationalized health coverage does not end private services or private insurance. Those who can afford it and who believe it is worth the expense can still be insured privately or pay for services directly. So the wealthy can still enjoy better coverage than everybody else. However, one of the biggest reasons that medical services are so expensive has to do with hospitals being required to treat any patient. Poor people go to the emergency room when they need help because they can't go to doctors, who aren't required to treat without insurance coverage. The hospitals then have to treat those people and pass the costs on to the other patients. It is not a rational system. A National Health is much more rational.
Woe betide those who are hovering on the brink of the next tax bracket and have medical insurance through their employer.
Woe also betide all those who are just making it from paycheck to paycheck - because FICA is figured on GROSS (Earned) INCOME - so now all those dollars that your employer pays for your benefits will be subject to FICA - which can NOT be alleviated by a deduction (which will probably be nerfed so that it falls under the medical deductions on Schedule A and is subject to a percent of gross)
This is a potentially huge tax increase on the middle-class.
Why am I not surprised?
As much as I dislike the Governator, his insurance proposal for California really is the way to go: available to all people; affordable; single payer. Right now, insurance is THE most signigicant factor in driving health care cost through the roof; insurance companies determine what health care is covered. I have insurance through work, and as I go through all kinds of testing to deal with what I have I am ever grateful that it is in place. But my god, the hoops I have to jump through for a single liver biopsy!
Sumo, DBK... A nationalized system would certainly eliminate many of the problems in the current system. But DBK, isn't what you're proposing very similar to the Clinton plan back in the mid-90s? Nationalized care-multi-payer? Damn if only hadn't botched that.
Sewmouse, I think you're right except for that last part. Most of the post speech analysis indicated that the 2% medical threshold would be done away with.
Diva...and it kills me to say it, but Arhnult (along with our own mayor here in San Fran) are really leading the way on this issue.
What the "plan" does is encourage employers to do what they are in the process of already but at an accelerated, government subsidized rate.
That is drop health care for employees.
There are two problems with health care - cost, and income.
the Bush cut and run plan does nothing to address these problems.