USA Today's print edition places Gov. Schwarzenegger's universal health insurance plan right where it belongs. The lead story in the Money section.
If a health plan was truly about health, or even nominally about providing universal coverage, one might question the placement. Why cover government health policy as a business concern? A casual review of the plan, and its obvious aims, makes the placement in the business section all too clear.
Here are the basics of the plan, according to the article:
Under the proposal:
• Individuals would have to buy insurance, with government subsidies for people earning up to 250% of the federal poverty level, about $24,500 for an individual and $50,000 for a family of four.
• State programs for children would expand to include families earning up to 300% of poverty, about $60,000 for a family of four.
• Employers with 10 or more workers would have to offer coverage or pay a tax equal to 4% of payroll. Under 10 are exempt.
• Insurers could not turn away prospective policyholders because they've got health problems.
• Insurers and hospitals would have to devote 85% of revenue to direct patient care.
• Hospitals would pay a 4% tax on revenue and doctors a 2% tax to help provide coverage subsidies.
• The state would boost by $4 billion the amount it pays to medical providers through the Medicaid program.
This is the Republican answer to a health care crisis that finds roughly 15% of the citizenry without access to health insurance? As a sound bite, it is certainly a compassioate conservative's dream: Say you are providing health care to all and preserving the free market health insurance model. As a policy, however, this plan is nothing more than corporate welfare at the expense of the very citizens government has sworn to serve. Can one read the above proposal and not imagine it being drafted by a pack of insurance and business lobbyists?
Let's look at the plan a bit:
Individuals would have to buy insurance.
As the boys who sell Guiness Beer might say, "Brilliant!" If the individuals don't have health insurance, just require them to purchase it. It is kind of like the auto insurance model. Only you can't easily opt out of owning your body, as you might of owning a car that you can't afford to insure. Advantage, insurance industry. It is like extortion. Just shut up and buy the insurance. On what penalty, exactly? Will it be a misdemeanor to "live while uninsured?" Will I be fined if I choose not to participate? Perhaps they can garnish my wages? Gosh that would be kind of like increasing taxes on the poor who cannot afford health care now, in order to pay for a government health care plan. Fucking Brilliant I say. Surely, the government will offer something for the working poor in this plan, to assist them with this unfunded mandate.
The government will offer subsidies for people earning up to 250% of the federal poverty level, about $24,500 for an individual and $50,000 for a family of four.
There you go. Stop bellyaching you working poor. The government will subsidize your purchase of private health plans (though the amount of the subsidy is not fully described). So you are in the clear.
Of course, if you are unlucky enough to be well-off (defined as making more than $24,500 if you're single, and $50,000 if you're married with two kids) and you are still uninsured, tough shit. Buy some insurance. That's what the law says. Suck it up and stop making America look like it has a broken health care system. We're having universal coverage now, so stop whining.
Fuckin' ay. Arnie is onto something here.
Employers with 10 or more workers would have to offer coverage or pay a tax equal to 4% of payroll. Under 10 are exempt.
No worries, right? We'll just make sure that employers start providing health insurance. So nobobdy who is working will be left behind under steps one and two.
Wrong. I bet. I'm no health care cost analyst. But from my personal experience running a small business, health care costs are way above 4% of payroll at today's prices. So this is a big incentive for any buisness with over 10 workers to dump the insurance program. Heck. Just pay the tax. It is cheaper than the health insurance now provided, and probably a lot easier to pay the taxman than to talk to the freaking health insurance people everytime there is a problem.
And isn't this plan starting to sound just a bit like socialized medicine anyway. I mean, pay a tax, and then let the government worry about providing health care (or in our case, insurance for health care). Of course, as with all things American these days, this level of taxation will in no way support the kind of insurance-bloated health care we all want. But who is to worry? What government in its right mind would worry about massive deficit spending?
Insurers and hospitals would have to devote 85% of revenue to direct patient care.
Score another victory for the insurance and medical lobbies. A 15% profit margin, built into the legislation. Nice.
This provision, in my view, illustrates the two reasons why the American health care system is failing, and will continue to fail, until it is pronounced dead on arrival at some hospital where it cannot afford treatment someday.
First, the present focus of the American health care system is to provide insurance, not health care. Paying for insurance amounts to an absurd tax on the entire system. Strip the system of insurance, and focus on providing health care.
Second, underlying the insurance system, is a for-profit health care industry. Hospitals, drug companies, and yes, even doctors, who are taking a large chunk of the health care dollar as profit.
With a supply curve focused on profit, and a demand curve that will always pay whatever it can afford for frivolities like not dying of treatable illness, free market capitalism is just not serving us well as a nation.
Isn't it time to re-examine our health care system, in its entirety? To sacrifice the sacred-cow principle that free markets are the answer to all policy questions?
Well, here endeth the rant. With Massachusettes already on board, and California soon to follow, I suppose I'll just knuckle down and pay the new mandated premiums. Until I can't afford it anymore. And then I'll pay my "no proof of medical insurance" tickets. I only hope that they will keep the crime of failing to purchase mandated health insurance as a civil infraction, or misdemeanor. I don't want a felony and its accompanying jail time. Unless, of course, maybe they can let me see the doctor there.