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| For that person who is old -or
sick- Health Care probably is the number one issue. No
question! If
we can not take care of our old and sick then society -as we know it- has
failed.
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| Why did not I put this issue as first on my list despite
of its critical importance? Because for the society to
survive as such, and be able to properly take care of its members, it needs
to -first of all- be healthy and viable itself.
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| For the sake of clarification, allow me
to use a metaphor. Let's say we are in a galleon, and the pirates are shooting cannon balls at
us. Some of our sailors are down. What do you do first as
Admiral of the ship? Pick up the fallen sailors and take them to the infirmary? Well, you will have to do that pretty soon of course, or
they will be dead on arrival. However, first you need to assess your
situation. |
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Is the ship sound? (technology
and education). Otherwise
all crew may have to jump overboard. Abandoning those fallen
and injured comrades.
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Do you need to make urgent repairs?
(labor). Delaying might bring the ship under and crew might
perish. All injured and all healthy.
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Are the defense positions covered?
(defense). Make sure all cannons are shooting back to your enemy,
and your sailors ready for a possible boarding attack by the corsairs.
-
Having assessed all of that.
Now, and only now, it is time to pick up your injured
soldiers and take them to the infirmary! (health care)
| This -in my opinion- is the proper
sequence of priorities. Hypothetically
speaking,
a nation is nothing less than a big ship surrounded by some pirates,
fortunately for us most of the ships circling us these days are also
friendly allies. But as the World Trade Center event has proven to us,
that is not always the case!
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| UNIVERSAL
HEALTH CARE:
My position on health care is pretty clear, and
has not changed in several decades. Every person should have access
to universal medical care. Every person should have the right to be
properly cared for when sick, or adequately treated when in need of
some kind of medical procedure. This regardless of their monetary means.
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| Some of those who read this might say:
I read enough, this guy is another spend-spend Democrat !.
Well, you are wrong! As a matter of fact I was a Republican during the Reagan years, and I
was thinking exactly the same way about this issue. If we valued our society for
what it is, we can not afford to offer less to our weak, sick, or old fellow
citizens.
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SENSITIVE
COVERAGE, NOT A FREE-FOR-ALL:
As an Economist I understand that
this goal could be very costly to our society. There is a second
part to my position that is not shared by many others. And
that is: "Only standard medicines and procedures should be included
on this universal coverage. No extraordinary efforts should
be made to extend for a few days, or weeks, the life of someone who is already
in a critical irreversible state. Resources should be saved for
those who can better benefit from those services".
There
will be another group of individuals who would say: I read
enough, this guy is another NoTax-NoTax Republican.
Not
really, what I am is a
person -not biased by religion- who believes in honoring
people with their right to die with dignity when
their final days arrive. And it will arrive for all of us! No need
to hide!
| I wish we could have it both ways. But
there is a limit to everything. More so when the resources are limited
in nature. When you use one of those resources somebody else would
have to abstain from having it. There is no magic. Everything has
an implicit cost.
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| In 2001 the average "per-employee
cost for health care" to employers exceeded $5,000,
and it is expected to go up 14% in 2002. It has been going
up year after year. This despite of higher co-payments
and higher deductibles. The trend is likely to continue
going up, because hospitals have been scrambling to meet their
operating costs, now that Medicare will be spending many billions
less ($100 billions less over 5 years) to meet the mandate of the
BBA (Balanced Budget Amendment of 1997). |
| The United States spent $1.3
trillion in health care in 2001, that is 13.4% of the GDP
(gross domestic product).
That is higher per-capita than in any other Western country.
And some of those European countries offer Universal coverage to
all their citizens. Notice that Germany
spends in health care only 10% of their GDP, Canada 9%, and Japan 7%.
Not only that,
it is expected that the health care bill will go up by 14% during
2002, making it 14.1% of the GDP, or even 18% of GDP if the
recession materializes (decreasing the GDP). Can you
believe this!
Almost one fifth or our GDP is spent in Health Care, and
yet more than 40 million Americans are not covered by medical plans
(and -listen to this- 80% of those uninsured have either a job,
or a family member who works), and 70 million Americans
do not have any drug coverage? |
| WE
NEED TO COVER EVERYBODY, YES!,
BUT WE NEED TO CONTROL HEALTH CARE COSTS, AS WELL! |
| Let's work together to control medical
costs and improve technology, so more advanced procedures and more powerful
medicines would be available for all of us.
|
| Unless patients
pay with their own money- nobody should have the right to
undergo those expensive medical treatments/procedures if not affordable to be
offered to the rest of our fellow citizens who might also need them. |
| This may sound a little
bit draconian, however it would be a big step forward over what we have right now. And it will make good savings in our current national medical bill.
Do no feel shortchanged. |
| Given the advanced state of the
medical/pharmaceutical technologies, with these standard medicines and
procedures (that have reasonable costs) we could palliate the misery of most
maladies, and have all people reasonably covered without taking the
nation into bankruptcy. |
President
Bush plan, proposes to give a tax credit of $1,000 for singles, and
$3,000 per family for those uninsured to pay their
medical premiums. This is -at best- a partial solution.
| (a) Those persons who are high-risk
will not be able to get the coverage they need from insurers, for
that kind of money. |
| (b) Those who do not fill out IRS
tax forms (either because they have no-income, or ignorance,
or are illegal or guest workers) would still be left
out on the blue. |
| (c) Individuals could smartly choose
the best coverage for them -in theory. In practice,
their individual leverage would not stand much of a chance
against unscrupulous insurers. Citizens will be milked! |
| (d) Large families will be
again discriminated against, pushing further down the size of
the American family, and putting pressure on keeping the
floodgates opened for young immigrants to move in, so they
replenish our young society. That is needed to keep Social Security in the
black, or it will go red on 2025. I do not like that
dependence on immigration.
It is not good! |
| (e) Employers will have a higher
share of high-risk employees, who have less turn-over than the
rest of employees only because they need the medical coverage for them or their
families. As mentioned above, employers currently pay more
than $5,000 per employee in health benefits. It will
only go up. |
| (f) The Government will continue
losing $120 billion in tax revenues, because employee's
health care benefit's cost it is not considered taxable
anymore. With the right leverage, you could buy a lot of
premiums with that loss of revenue alone. |
I |
I despise big
Government!
I am one of those who believe
that private enterprise works much better than Government
bureaucracies.
An yet, I think that Health Care and
Drug Coverage are the type of things that only the Government can do
effectively. Of course, changes are needed, coverage
has to be sensible and with limits, compassion -and not
religion- should dictate public policy. But the
Government is the only body which has enough leverage and weight
to get reasonable affordable coverage for ALL people in
America.
By
the way, Dr. Kevorkian
(71) should be out of jail, and should have never been put there
to begin with. |
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VOUCHERS TO PAY FOR 'PRIVATE' HEALTH
CARE .-
As per
the first postulate of my
tax doctrine,
again it should be a right of a taxpayers to get back some of
the SS tax, that has been paid. SS Tax is paid to cover the
expenses the Government will incur to provide Medicaid and
Medicare for the elderly. Similarly
to the solutions predicated for education, the best course of
action here would be to provide high-quality universal health
care. But, as I covered above, there might be medical
procedures and treatments that:
- Can not be offered -affordably- to
all whom might need them, or
- They might be perceived as frivolous
by some taxpaying folks who think those services not only
are costly, they are waste of public funds.
(For instance, an expensive procedure to be applied on a
patient who -even with the treatment- is not given more than
a few weeks/months to live).
I am of the opinion, that in these cases, we
either establish some kind of lottery system, or give a
"voucher" (allowance) for that person who feels in need of that
service, so as to request that service from a "private"
provider. This meets the "better service" requirement of the
second postulate of the doctrine.
The question is again: for how much the voucher would be ?
The last postulate of
my doctrine suggest that only a portion of the
"private" cost will be subsidized by the voucher. I am of the
opinion that the allowance should be equal to the cost of
providing the "closest" procedure -that one not included and
being requested- as offered in the public health system.
For instance, let's say the
patient needs a "new and innovative" experimental heart-pump
implant that costs $200,000. And let's assume Medicare only
provides coverage for a heart transplant costing $50,000 to
which the patient could opt. Then the voucher should be for
$50,000.
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