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Thursday, September 20, 2007

Karl Rove -- Not All Wrong on Health Care

An occasional reader sends a Wall Street Journal column from newly unemployed Karl Rove. ["Republicans Can Win on Health Care," Wall Street Journal, 2007.09.18, page A15]. I'm surprised to find the GOP strategist and I can identify some common thinking (beyond our agreement that Hillary Clinton's health care plan is junk).

Obviously, I have some differences of opinion with Mr. Rove. For instance, he trots out the usual free-market-theology boilerplate that "Socialized medicine inevitably leads to poor quality, inefficiency, rising taxes and rationing. The waiting lines and poor care that cause people from other countries to come here for treatment are not the answer." He follows that boilerplate with the standard absence of evidence for such boilerplate. The only people coming here for care are rich people (Saudi princes and such) who don't like waiting their turn behind poor people. And Rove also makes no mention of the growing trend of medical tourism -- 500,000 Americans seeking care overseas in 2006.

Also, Rove's emphasis on tax credits as panacea shows the thinking of a rich guy who has an accountant and the extra wealth to make those credits pay off. For folks making under $40,000 a year, additional tax credits don't amount to a hill of beans, at least not enough beans to cover the increases in health insurance premia.

However, I can roll with Mr. Rove on portability -- what a waste of human potential to lock people into less-than-optimal jobs just because they can't afford health insurance! I also agree with his point that, under the current system, we need more interstate competition. Says Rove, "Lack of interstate competition helps to explain why the same health policy costs $8,334 in North Dakota but $10,312 in South Dakota. If consumers in South Dakota could buy that North Dakota policy, prices for health insurance would go down." Talk about medical tourism -- we need medical insurance tourism! When's the next bus to Fargo?

Rove makes a similar point in talking about the need to pool risk. He's right: the bigger the risk pool, the better we can spread out the costs. Of course, the logical conclusion is that the best pool would the biggest pool: all Americans under a truly universal, single-payer plan.

1 comment:

  1. How about this evidence?

    Colorado had a Zaniya-like task force and they were considering 4 different health care reform options. A consulting group hired by the force determined that only one of those would have saved Coloradans money: the single-payer plan... and it only saves 4.7 percent.

    But... this savings comes only by "dramatic compromises in the breadth and quality of care."

    ...

    There are better ways to handle health care, Cory. You still haven't given consideration to any of my three ideas:

    1) Government regulates price, but private insurance still does the paying. (Regulating the procedure costs is all that is needed to bring health care back to the affordable realm.)

    2) Government makes a voluntary health plan and competes with private insurance companies. (If a government-run program truly is more efficient, then it can win covered lives by competition, not coercion.)

    or

    3) A universal health care plan funded solely by a sales tax that exempts basics, and over-taxes unhealthy choices. (Buying cigarettes, whiskey, and French fries leads directly to health problems, so part of the sale of those items should put money away to pay for the resulting care.)

    ReplyDelete

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