Obamas Healthcare Reform: Is It Needed?
The profile of those individuals that the Obama Administration wants to turn the system upside-down for is vastly misrepresented. The need for a grand scheme for reforming the US health care system to provide medical coverage for all is vastly exaggerated. A careful examination of the data leads inevitably to the conclusion that baby steps are indeed all that is necessary.
Sixty percent of the Americans get their insurance through their employers. Nine percent buy insurance directly. Of the latter group about 38% buy the insurance to supplement their Medicare coverage. The government provides medical insurance to 14% of the US population through Medicare. This percentage is rising fast as the baby boom generation begins to retire. The next largest program covering 13% of the US population is Medicaid. This program targets children (SCHIP), pregnant women, elderly and disabled people. The third government program is for Veterans who account for 4% of the US population. Those uninsured are about 45 million and represent 16% of the US population. Contrary to public opinion they are not all poor or helpless. In fact a disproportionate percentage of them are perfectly able to buy private insurance, but do not, preferring instead to free ride a system that is currently set up for abuse.
Only 25% of the uninsured have income below the Federal Poverty Line (FPL). The next 25% are 100 to 199% above the poverty line. Fully 28% are above 300% of the FPL. Almost 80% of the uninsured are under the age of 44. Only 21% are below the age of 18. In the 18-44 age-category, about 40% are below 200% of FPL. A substantial majority (57%) of the uninsured are childless adults. Almost half of the uninsured are white and about 30% are Latinos. The foreign born (a polite designation for illegals) account for 21% of the uninsured population or about 10 million persons. Almost 74% of the uninsured have full (46%) or part time jobs (28%). The membership in these groups is dynamic. Almost half the uninsured have no insurance for six months or less. Almost 51% are uninsured for at least one year. But as some leave the uninsured ranks, others enter.
The fact of uninsurance is transitory to a considerable extent. But, everyone is receiving medical treatment, often using the most expensive venues: emergency rooms, often arriving in ambulances paid for by the US taxpayers. We all pay for this abuse.
If the illegal population is not considered (there is a logical argument that the cost of illegal immigration should be a part of the Homeland Security budget because of the failure to control our borders), and if those who are over the 200% FPL threshold (40% of the uninsured- adjusted to prevent double counting), therefore able to buy basic insurance coverage (partially or totally unsubsidized), are also subtracted from the total, we are left with only 40% of the uninsured population. This data may be very conservative as some government statistics indicate that only one third of the uninsured are below 200% of FPL.
All of this translates into a population of about 18 million individual (maximum)that is at risk in terms of health coverage. Assuming the government pays fully for a basic coverage from private insurance at $5,500 per person, the total additional costs will be almost $100 billion per year. This cost will have to be reduced by the considerable saving resulting from removing those individuals from the free riders rolls. The government has another option. Place the 18 million in the Medicaid program. At a cost of 3,600 per adult, the Medicaid option will cost about $65 billion per year.
But, many who can buy insurance may still opt not to. The challenge to the government in this case is to restrict, hopefully eliminate, all free riders on the health care system. The size of the co-payments, taxation, payment for ambulance service if the doctor determines that there is not a serious emergency are some of the mechanisms to force the uninsured who can afford insurance to buy one. Thus,for the system to work, it must be controlled and incentivizezed on both ends of the spectrum: the purchase of a subsidized private insurance and receiving free medical services.
Conclusion
The proposed transformation in the health care system of the US is not necessary and may well be very harmful.
There is a large set of options to use effectively short of gutting the system. We believe that the push for “reform” is primarily ideological. Copying the European health care system is a terrible idea: everyone gets squeezed in terms of access. The rising costs of health care are incorporated indirectly in a punishing tax structure. This is not the American way that has fundamental choices as its anchor.We need not follow the European path despite OBama’s deep admiration for it.
Simple steps will go a long way to correct the problems:
- Allow for interstate sale of insurance
- Tort reform
- Stronger enforcement of the anti fraud laws and vigilant oversight over the insurance companies and the HMO
- Deal decisively with preexisting conditions.
This entry was posted on Tuesday, March 30th, 2010 at 1:39 pm and is filed under Healthcare Reform Bill. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.
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