Monday, September 7, 2009

Wall Street Journal Health Care Article Response

The Wall Street Journal just had an opinion piece on health care. It has some good facts:
  1. 400,000 people engaged in medical tourism here
  2. Our five-year survival rate for all cancers beat those for Canada, Europe and England
  3. The HR 3200 is long and has too many new taxes and penalties and mandates.
But some other facts are just plain wrong:
  1. "Anyone can walk into an emergency room and receive care regardless of their ability to pay.
    That is not true. They can be treated for the emergency, but if they have cancer, a gall bladder that needs to come out, it probably is not an emergency.
    As I have argued here, we need to replace this with a plan that says that those who do not have insurance must go before a sortition jury (Unless it is truly something current like a heart attack or a car wreck) and they will decide whether the person could reasonably be expected to have health insurance or be putting money away into a health savings plan. The person making $20,000 with a family probably will be excused for not having helath insurance. Ditto for the person who was layed off. Ditto for the person who went to the health insurance companies but was turned down. The yuppie making $70,000 who went bare would not. And we would like at the amount in the health care savings care plan as compared to one's income. The proverbial washer-women who saved a few thousand dollars over her life in her health care plan would be given much more credit than the young urban professional.
    We would all serve on these committes. I know I would probably push people to go to the premier medical facilities such as John Hopkins, Hospital for Special Surgery and Memorial Sloan Kettering, just as I do for my students and family. They would all use Pubmed the wonderful free resource provided by the United States Government that indexes the medical journal literature, to research diseases, treatments and outcomes.
  2. They blame "runaway lawsuits," "malpractice"premiums for the problem. Malpractice costs are only two cents of every health care dollar. They blame defensive medicine. But the CBO found many studies that show this is not a problem.
Doctors and hospitals that do provide charity care should be rewarded at tax time by sortition juries. The Wall Street Journal advocates vouchers! But I would argue that those who receive public funds for their health care should have to answer to the public for what is done with it. As mentioned above, this would be done on a one-on-one basic through sortion juries. Of course, I am not including here programs that represent earned dollars like Medicare.

I also have advocated that businesses that do provide health insurance for their workers be rewarded at tax time. This is better than mandates.

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