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Politics : A US National Health Care System? -- Ignore unavailable to you. Want to Upgrade?

To: Lady Lurksalot who wrote (1094)	4/4/2006 9:38:19 AM
From: Peter Dierks	Read Replies (1) \| Respond to of 42652

The inevitable criticism took until almost half way through the article. (Too Close To Pharma.)

To: Lady Lurksalot who wrote (1094)	4/12/2006 11:39:01 AM
From: Peter Dierks	Respond to of 42652

Bad Medicine What's wrong with RomneyCare. BY BRENDAN MINITER Wednesday, April 12, 2006 12:01 a.m. EDT "We insist that everybody who drives a car has insurance. And cars are a lot less expensive than people." --Gov. Mitt Romney Massachusetts will likely soon become the first state in the nation to force everyone living within its borders to buy health insurance or pay a tax for walking around uninsured. Gov. Romney says by signing such a mass mandate into law, he will achieve the Democrats' goal of universal health coverage on Republican market-oriented principles. Uh-huh. After HillaryCare was defeated a decade ago, the fight for "universal care" moved to the states, where lawmakers are pushing for it piecemeal in two ways: broad new government mandates, and incentives for employers to cover more people. It's now clear which approach Mr. Romney favors as he considers running for the Republican presidential nomination in 2008. If there is one redeeming value to his approach, it is that it starts with the presumption that even the poor should pay something for their health care. That's not a trivial point. Today many uninsured patients skip out on their bills and leave their health-care tabs for everyone else to pay in the form of bigger hospital bills and higher taxes. And it's not a presumption many on the left have been willing to grant. Tennessee was hit hard with the exploding cost of health care after it expanded its Medicaid program in the 1990s to cover anyone in the state who couldn't afford or didn't qualify for health insurance (due to pre-existing conditions or other reasons). Initially the eligibility rules were so loose that some individuals earning $100,000 a year were able to sign up. Not surprisingly, within a few years TennCare was eating up a third of the state's budget and consuming almost all of the new tax revenue the growing economy was sending to the state treasury. Gov. Phil Bredesen, a Democrat, was elected in 2002 in part on a mandate to restrain TennCare and not to create an income tax to pay for it. After taking office, he managed to remove tens of thousands of people from the rolls, but he soon realized that it was impossible to manage costs without also requiring nearly everyone to pay something for the care they received. Otherwise, as he told me, it's like shopping in a grocery store that doesn't have any price tags and where you don't have to pay the bill at the checkout counter. Requiring consumers to pay at least part of the bill is essential to striking a reasonable balance between consumption and total cost. That means copayments for drugs and doctor visits, deductibles, or other fees. For pointing this out, Gov. Bredesen has been blasted by Sen. Ted Kennedy and other Democrats. Gov. Bredesen is now pushing his own new health-care program that's based on incentives. He wants the state to pay for a third of the cost of premiums for those who work for companies with fewer than 25 people. He estimates coverage would cost about $150 a month for insurance with reasonable deductibles, copays and other fees--leaving the state with a bill of $50 a person. He proposed his plan in recent weeks, says he'll consider it a success if it enrolls 100,000 people (the state has about 600,000 uninsured residents), and is making it a centerpiece of his re-election campaign. What Tennessee and Massachusetts now have in common is that as lawmakers look for health insurance plans that are cheap enough for most people to afford, they're going to run headlong into the reality that buying health coverage is very expensive. The reason isn't just that health care across the country is expensive. It's also that health insurers are prohibited from offering coverage that pays for only catastrophic events, such as a serious injury or heart attack. Rules vary by state, but in most places insurers are forced to cover everything from routine checkups to chiropractic care. Remove these mandates, allow deductibles and "copays" to be raised high enough, and in an instant the price for some health plans would fall to about that of dinner out and a movie for two. Tennessee's approach is to create a new government program that will likely claim more taxpayer dollars down the road, starting with new tobacco taxes. True, as one lawmaker put it recently, the governor isn't promising the "Cadillac" of health coverage. Instead lawmakers are starting from the assumption that the program will cost the state $50 a person and are shopping around to see what kind of coverage can be bought at that price. If in the process Tennessee removes the government controls that increase the cost of health coverage and opens the market for insurance aimed at low-income workers, the Volunteer State may yet become a laboratory for market-oriented health care policy. But Massachusetts' Legislature is unlikely to remove the rules that push up the price of health insurance and is looking instead to cover the working poor the old-fashioned way, with government subsidies. In addition to making health insurance mandatory (taking away tax deductions for those who don't buy insurance), the legislation Gov. Romney is about to sign expands the state's Medicaid rolls, levies a $295 per-employee "fee" on businesses that don't offer health insurance, and sets up a government board to approve new health plans. The rhetoric form the Bay State's governor notwithstanding, RomneyCare will turn out to be not only expensive but also a mandate for more government spending and more government intrusion. Mr. Miniter is assistant editor of OpinionJournal.com. His column appears Tuesdays. opinionjournal.com