Bush health care "reform" another disaster waiting to happen.

On Thursday, the third annual World Health Care Congress was held in D.C. With a name like "World Health Care Congress," one would expect to find knowledgeable medical care industry types, like doctors, sharing their opinions on how to provide better health care in general and basic health care for the some 46 million Americans who are currently uninsured. However since this was an event sponsored by Astra-Zeneca, AllScripts and the Wall Street Journal, what you got instead was John Snow and Allan Hubbard pushing the Bush administration's idea of health care "reform" also known as Health Savings Accounts or HSA's.

In case you haven't heard about HSA's, (which is entirely possible since the Bush administration has been such a disaster that there is always a sexy scandal to overshadow Bush's feeble attempts to highlight his policy change wishlist), they (HSA's) are a "low-cost, high-deductible" savings account, sort of a "souped-up IRA" according to Treaury Secretary John Snow. The fund contribution are not taxed going in nor, according to Snow, are they taxed when they are withdrawn to be used for medical procedures. This, like Social Security "reform," allows you to "keep your money" and exercise the much balyhooed "personal responsibility" that so moves the Republican faithful.

Before I get to the second part of this plan, let's take a moment to understand just what "low-cost, high-deductible" really means and why the Republicans find it so desirable. The Republicans motivation for "reform" has absolutely nothing to do with the fact that 46 million Americans have no health care coverage and has everything to do with the fact that the rising cost of health care is cutting into profits of American business. Right and left, employers are running away from health care benefits either by finding ways not to have provide coverage to their employees, (WalMart), or dumping their pension obligations on the government's Pension Benefit Guaranty Corporation, (United Airlines).

For More Info see WakeUpWalmart.com and "judge lets United dump pensions", Washington Times 12 May 2005

"Low-cost, high-deductible" means one thing and one thing only; the burden of paying for your health care has shifted from being shared by you, your co-workers and your employer to being borne by you and you alone. The "low-cost" part of this equation is the low cost of the contribution to your plan. While it will be less than the paycheck deduction currently taken from your salary, your employer will be under no obligation to augment that contribution, much less match it. In this way it is similar to your 401(k) or the aforementioned "souped -up IRA."

Let's assume for a moment that this is a good thing, because after all, "you control your money," but what about that "high-deductible"? If you've ever been able to afford collision insurance on your car, (a luxury well beyond my current means), you seen a high deductible before. In auto insurance, a high deductible usually means $500 to $1000. According to Allan Hubbard, the "high-deductible" would be in the neighborhood of $10,000. What this means, for those of you unfamiliar with insurance, is that even after you have socked away all this money, you won't be able to touch it to pay for your medical care until you shell out another $10,000. Sounds great, doesn't it?

Let's forget the fact that the median American income hovers around $46,000 and let's ignore the unpleasant question of where that average worker is supposed to get one quarter of his/her yearly salary to pay the deductible. Let's instead concentrate on the second part of the Bush "reform" plan. (Just in case you're wondering why "reform" always appears in quotes, it's because that's what you do with gentle euphemisims. When a Bushie says the word "reform" what they are really saying is dismantle, destroy or eliminate altogether. See the Bushspeak Glossary definition for more info.) According to the Bush administration, the reason health care costs are skyrocketing out of control is not because insurance companies, in an attempt to mitigate the damage to their bottom line when they are forced by their pesky policy holders to pay out claims, continually raise the cost of premiums while cutting customer pay outs or reimbursements. Rising costs are instead the result of the third payer system allowing us to become lazy consumers. Because we don't have a choice in what health care program we enroll in and because when we have the temerity to become ill, we pay our co-pay and allow the insurance company to pay the remainder of what the service costs, we have fostered a system of inefficiency and waste.

If any of this is starting to sound familiar, that's because it is. This is the same argument the righties use every time one of those social programs they hate comes up for discussion. Welfare is bad because it pays more than some jobs and gives lazy people a reason to not get a job. (Let's conveniently ignore the fact that the majority of people on welfare are single mothers trying to raise their kids on a minimum wage job that doesn't pay nearly enough for her to provide proper nutrition and/or a stable home life.) We need more choice in schools because our public education system is failing our kids and they should be able to take their school funding and give it to private schools. (Never mind the fact that we have cut education funding for public schools nearly every year for the past decade and the current system of using property taxes is inherently unequal and insures that kids that live in good neighborhoods will continue to get better educational opportunities than kids in areas abandoned by business and government.) I think you get the idea.

What is the Bush answer to this lazy consumerism? Why, giving you the information to make smart health care decisions with the money that you have so neatly socked away in your "souped-up IRA." After all, when you have your roof repaired, you shop around, have estimates done and compare the companies total prices for the getting the job done.

So why can't your medical care be the same way?

Very simple. When you choose the wrong roofer, only your carpet and furniture get destroyed, if however you get conned by the guy offering the low cost angioplasty, you come out with a toe tag and grieving family members. Despite the Bush administration's assurances, we are not good consumers. Every year thousands of people are ripped off by unscrupulous business people pushing roof and auto repair following storm seasons. The elderly, the people most in need of medical services are routinely defrauded by anyone lacking any sort of conscience. The Federal Trade Commission, the Consumer Products Safety Commission, Angie's List, Consumer Reports and many other like them were created to stop consumer fraud and educate the public. The primetime news shows, purveyors of fear and sensationalism that they are, are rife with stories of plastic surgery and lasik eye procedures gone awry and doctors with multiple incidences of malpractice contintuing to practice medicine. There is no evidence that left to our own devices, anything more than increased death rates and lower standards of care will be the result.

The simple fact is that this plan of "reform" amounts to deregulation of a medical industry that despite the amazing technological advancment is increasingly looking like the era of the robber barons. In an industry that is already raking the American populace over the coals, increasing their ability to fleece the people who most need their help doesn't look anything like a good idea. Tomorrow we'll take a little time to look at a few scenarios that would arise if these "reforms" were ever to be enacted as national policy and why that would be a truly horrible idea.