Health Care Now

Blackadder pointed out elsewhere that for all of the insistence that people cannot wait and absolutely need reform right now in order to alleviate the suffering of the uninsured, the health care bills currently under consideration are designed not to begin to go into effect until 2013, conveniently after the next presidential election. It is, I’m sure, a matter of opinion whether this is a cynical political attempt to avoid the consequences of people actually experiencing one’s health care reforms, or if its the necessary time to enact all 1100+ pages of regulations in the current plan. Either way, perhaps there’s a better way if people are really serious about helping people quickly and avoiding partisanship.

By most counts, there are actually around 12-15 million Americans who are uninsured for more than a few months, do not have the financial ability to buy their own insurance (make less than 75k), are legal residents, etc. This 12-15 million includes some people who are simply poor and can’t afford insurance (perhaps it’s not provided by their employers, or perhaps they’re unemployed) and others who are middle class (but without employer coverage) and have medical conditions which make it impossible to get individual health care insurance.

Let’s assume it’s 15 million. If we also assume that they’re fairly expensive to insure ($5000/person/year) the cost of simply paying to buy them all private insurance would be $75 billion per year, or $750B over ten years — actually less than the estimated cost of the current health care reform bill. (Heck, you could pay for the first 4-5 years by canceling all stimulus spending which is not scheduled to happen until after 1-1-2010.)

If some sort of graded payment system was set up where people paid a percentage of the price according to a sliding scale based on their prior month wages (which the feds should have due to social security reporting) it would probably cost less. This could probably be set up within well under a year and would meet the “health care now” demand. It would probably gain far more bipartisan support, in that it would not involve an overhaul of a major industry and increase in the scope of government.

If “health care now” is truly the first priority, is there a reason why a much more extensive restructuring of the health care industry over four years is being proposed, rather than something quick, clear, and effective such as this?

13 Responses to Health Care Now

  • 12-15 million is the conservative estimate put out by the Republican Policy Committee. The real number could be as high as 30 million (the number that Obama is using to come to his $900 billion estimate). BTW, it says something about Republicans when they count ALL non-citizens are ineligible, not just illegal immigrants.

  • But Obama’s 30 million number includes a large number of people who either already qualify for government health care but haven’t applied for it, and also a large number who can clearly afford health care but have not chosne to purchase it.

  • I may have been off in that, in that I hadn’t realized that the bridge down to ~15M involved excluding legal non-citizen residents, which seems a fairly unjust move.

    Still, the point is not so much that I think we should do what’s described above (which is intentionally overly simplistic) but that the claim that we absolutely can’t possibly no matter what we do provide anything to anyone in less than four years is ludicrous on the face of it. (For instance, England’s transition to the fully government run NHS took only two years 46-48.) If one does, as many advocates claim to, really believe that it’s an absolute humanitarian necessity to have “health care now” then Obama’s plan of not even starting to implement his solution until 2013 should seem totally unacceptable. Such an approach may maximize Obama’s time in office, but it cannot possibly be seen as an approach designed to maximize help to those without insurance.

    If advocates are comfortable admitting that “solving” health care is not all that urgent to them, while getting the government camel’s nose into the tent of a major industry (and having the political stick of “they’re going to take your health care away” to wave at their opponents for the next fifty years) is, then at least we could go on to have an honest debate without all this “there is not time for debate” nonsense.

  • paul zummo says:

    I may have been off in that, in that I hadn’t realized that the bridge down to ~15M involved excluding legal non-citizen residents,

    I don’t think there are 15 million uninsured legal non-citizens. I don’t even know that there are 15 million legal non-citizens in the US.

    Whatever the numbers, your point stands. The calls for immediate action NOW OR ELSE don’t square with reality.

  • Matt McDonald says:

    I don’t think there are 15 million uninsured legal non-citizens. I don’t even know that there are 15 million legal non-citizens in the US.

    I think the case of legal non-citizens is difficult because many of them are sponsored. Their sponsor is financially responsible for them, and would (at least in theory) have to pay their medical bills if they do not secure insurance and cannot pay. As one of those non-citizens, I think it’s perfectly reasonable that the nation should expect us to be financially responsible for ourselves.

  • paul zummo says:

    Here’s an article from Hot Air that digs into the numbers.
    http://hotair.com/archives/2009/09/11/who-are-the-uninsured-2009-edition/

    Here’s the key graph as relates to the last few comments:

    Of particular interest is the citizenship/resident category. Foreign-born residents comprise 12.3 million of the uninsured, with only 2.8 million of those naturalized citizens. That leaves 9.5 million non-citizens in the count. The Census Bureau refuses to categorize on their legal residency status, which means that legal and illegal immigrants get counted in this total. Last year, estimates put the number of illegal aliens in this category as 5.6 million out of a total of 9.7 million. Even if we attribute the entire 200K reduction in this category to illegal immigrants leaving the US (as opposed to legal immigrants leaving or illegal immigrants getting insured), it still leaves 5.4 million illegals as part of the overall uninsured number.

  • I think the case of legal non-citizens is difficult because many of them are sponsored. Their sponsor is financially responsible for them, and would (at least in theory) have to pay their medical bills if they do not secure insurance and cannot pay. As one of those non-citizens, I think it’s perfectly reasonable that the nation should expect us to be financially responsible for ourselves.

    And many, if not most, of the legal non-citizens who are sponsored do have insurance. But millions do not. They pay all the taxes that citizens pay and should receive all the benefits. The Constitution requires it. 14th Amendment’s Equal Protection applies to all persons, regardless of alienage (see Graham v. Richardson).

    Obama’s 30 million probably excludes illegal immigrants and I don’t know who else. It’s a mystery.

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