A sensible approach to health care reform
As we enter what may be the final phase of debate on the Democrats’ health care reform package, here are a few observations.
Most people agree that our health system – cost of care as well as availability and cost of insurance – needs reform. Costs keep spiraling upward, many do not have access to insurance and for those who do, premiums keep rising.
Republicans and Democrats are fundamentally divided over how to address these problems. Republicans believe that unless the underlying cost issue is addressed, we will have accomplished little and spent at least $2.4 trillion over 20 years doing it. In the process, we will have raised taxes and health insurance premiums, forced many into dysfunctional government programs, turned insurance companies into wards of the federal government, and deprived individuals of choice. And health care costs will continue to inflate.
To tamp down cost, Republicans want to empower individuals to make their own decisions about their health care. Some of the steps: tax credits for health insurance and care (or equivalent funds to those who don’t pay taxes), subsidized state high-risk pools for people with pre-existing conditions to get insurance at reasonable cost, expansion of health savings accounts, and medical malpractice reform to reduce some unnecessary costs. Individuals – whether in a large corporation or small business, self-employed or unemployed – would have money in their pocket to decide how best to spend their health dollars. Today, consumers of health care are insensitive to cost because someone else pays the bill. Most health care providers and insurers do not compete on the basis of cost.
Democrats believe in a top-down approach. In broad terms, the Democrats’ proposals would force everyone to buy health insurance or pay a penalty (with subsidies for those who cannot afford to buy insurance), the federal government would dictate the terms of the insurance and establish boards to determine what care should be provided, and approximately 15 million more people would be put on the Medicaid rolls, a system that is already failing many people on it.
I urge your readers not to be fooled by the demonization of the insurance industry or the smoke and mirrors of the Congressional budget process in assessing whether the current health care legislation makes any sense for our country – or for the uninsured.
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The state transportation department’s $2.6 million plan to rebuild the roundabout west of Aspen next summer and fall appears to be moving along on schedule based on two votes in the Upper Roaring Fork Valley last week.