Issues 2004 – Health Care

With this post, I think I am caught up with Jeff’s Issues 2004 posts.

This one’s in response to his first post of the series, on healthcare.

We had dinner last night with some good friends who are American but have lived in Toronto for almost 20 years and have raised a family there. We asked them about the Candian system. They told us that its not that bad. The quality of care is fine, but you have to wait for treatment. They ration healthcare in Canada to keep the costs down. They told us that compared to the US, if you are poor or lower middle class, their system is much better. If you are middle class, or upper middle class, our system is better for you. For the rich, it sort of doesn’t matter. It’s true that you can’t “buy” healthcare in Canada, but if you “know a doctor” and its more likely that the rich people will know the right doctor, you can go to the front of the line. Worst case, if you are rich, you can go to the US. Buffalo, Detroit, and Seattle all have wealthy Canadian patients.

It sounds a lot like our public school system. The poor mostly benefit because they couldn’t get an affordable education elsewhere. The middle class might suffer because if they could pay for education, they might be better off. And the rich mostly do pay for education, so it doesn’t matter.

So, with that all said, let me tell you what I’d like to see in a healthcare system for the US:

1) Everyone must be insured. If you live in the US, if you vote, or go to a public school, or drive a car, or get social security, or are employed, or anything that requires that you deal with our government, you must have health insurance.

2) Kids must be insured. All children who reside in the US regardless of who their parents are must be able to get healthcare, and not in a hospital emergency room, but in a clinic or a doctors office.

3) Employers must stop footing the bill for healthcare. This is crazy that our employers are at the front line of the healthcare food chain. They aren’t equipped to make those choices and they shouldn’t be burdened with them.

4) Insurance must be collected in the same way as social security. It should be a payroll tax deduction. If you work and are paid, then you pay for your insurance.

5) For those who are unemployed or unable to work, healthcare must be an entitelment. The indigent end up in our hospital emergency rooms anyway, so we ought to do it right upfront.

6) We must have a preventive, wellness oriented healthcare system. We should vaccinate everyone. We should require annual physicals. We should eductate the children on how to eat properly. Etc, etc.

I don’t get too excited about who runs this system. It’s going to be run by a combination of government and industry. The whole idea of a government “take over” of our healthcare system was in my opinion more of a scare campaign by the healthcare industry than reality.

I believe that doctors, and hospitals, and the other companies that have the expertise to make the required investments in our healthcare system should be incented to do that. The goverment should be in the business of collecting the payments and moving the money around. They already do that for social security and other taxes. They are good at that.

One more point and then I am done. I went to Bush’s healthcare page and was turned off by the emphasis on Healthcare Savings Accounts. This is all part of his “ownership society” nonsense. It works great for those of us who are in a position to save, but won’t work for the majority of this country that lives paycheck to paycheck.

Then I went to Kerry’s healthcare page and was embarassed. He has no plan for healthcare that he’s willing to share with the american public right now. I’ll gladly give him mine if he wants one.