Not Doing Nothing About Health Care
“We have to do something!”
This cry is sounded repeatedly by those who are demanding some type of health care reform from President Obama.
Its hard to argue with their logic. After all, health care costs are soaring and [according to some] there are nearly 50 million Americans lacking health insurance (although they are not without health care itself). Insurance premiums are rising faster than income, and Medicare will run out of money in 2019, potentially leaving millions of retirees without coverage, or causing taxes or government borrowing to rise rapidly.
I agree that something needs to be done. However, I disagree about what exactly should be done. Even the proponents of the Congressional plan agree that it is far from perfect, but they continue to repeat the mantra that “we have to do something.”
Well, we do have to do something, right?
The American people arent so sure. According to a new Rasmussen poll, 54% of American voters–a larger majority than the percentage of Americans who voted for President Obama–believe that passing no health care reform would be a better option than passing the plan currently before Congress. Only 35% say that the current bill would be better than “doing nothing.”
And it is now being reported that the President has dropped his demand for a “public option.” If this is true, it could leave behind an expensive bill that does little to change the current system.
This plan is being pushed through Congress at a rapid pace. President Obama has set artificial deadlines for when he wants legislation on his desk, yet health care reform is a massively complex issue that a new administration shouldnt reasonably expect to tackle in such a short time. How this Nation to decide on a complex long term health care reform plan in only a matter of weeks?
I am one of the 54% of American voters who prefers “doing nothing” over passing the current plan. However, that doesnt mean I favor doing nothing in general. Here are some of my ideas for health care reform:
1) End (or significantly reduce) income taxes for individuals working as medical doctors, nurses, medical practitioners, etc.
Doing this could dramatically lower the costs of medical care. Ending or cutting income taxes for medical workers will essentially allow them to earn the same amount of money for charging less for their services. This would also encourage those considering becoming nurses or medical staff to return to school and become certified in their fields, as well as encourage older medical workers to work for several more years (if they are able to keep more of their earnings, they could be more willing to work longer). While this could add to the National debt if spending is not cut, the Nation would save a considerable amount of money in added health care costs. And of course, I would support this plan only if it included spending cuts to balance out the lost revenues.
2) End (or significantly reduce) immigration restrictions for individuals working as medical doctors, nurses, medical practitioners, etc.
Ultimately, costs in any industry, including health care, are dependent on supply and demand. Any doctor, nurse, x-ray technician, etc. who is able to speak English should be offered instant American citizenship. There are large numbers of such people all over the world who are interested in becoming American citizens, but who are unable to do so because of current immigration laws.
3) Allow insurance companies to sell plans across State lines.
Federal law currently prevents insurance companies from selling plans across State lines. This is just plain illogical. This leads to inefficiencies and increased costs for both the business and the consumer. Imagine if cell phone companies had to comply with similar restrictions–a company like Verizon would be prevented from having a National plan, they would have to have a different plan and pricing scheme for each State and D.C, and the cell phone user’s costs would be higher as a result. The same is true for health insurance. Allowing insurance companies to sell plans across State lines would essentially create a National insurance market where customers could go online to a site like e-healthinsurance.com and select a plan from companies headquartered anywhere in the Nation. Taking this step would also allow insurance companies to cut unnecessary staff–potentially passing savings on to consumers. There is no reason for a company like Blue Cross to have to have 51 different organizations to create and price different insurance plans.
Remember that just because we “have to do something” does not mean that we should have to do “anything.” There are good as well as bad reforms, just as there are good and bad treatments for any disease. A doctor with a seriously ill patient should look at all the options and diagnose the patient carefully and as accurately as possible before treating the patient. Treating the patient before diagnosing him and reviewing all of the options could be catastrophic.
Americanly Yours,
Phred Barnet
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I agree with 99% of what you say here, but I’m not terribly sure about step #2. INSTANT citizenship? They should at least learn a bit about our country before being allowed to call themselves Americans! 😉
1I totally disagree with # 2. There is no way to control the quality of medical education in every country around the world. This would also completely flood the market with medical practitioners and drastically reduce doctors salaries which I am totally against. I don’t think reducing medical practitioners salaries is the right way to go. Why would anyone do 9 years of med school and residency and be on call all hours of the night if they were making less than they are now?? And on that note, would you want a surgeon trained somewhere you’ve never heard of in Tanzania cutting into you.. even if he charges 1/5 the price of an American?
2John,
Thanks for the comment.
There is a very simple way to “control [for] the quality of medical education in every country around the world.” This plan is completely workable if you force foreign doctors to take the same medical licensing exams that American doctors have to take. This way, whether the doctor was from Canada, Tanzania, or somewhere Ive never heard of, he or she would have to be held to the same standards that all American doctors would.
As far as “drastically reduc[ing] doctors salaries,” that wouldnt be the case either. Remember, that part one of my plan would end all income taxes on doctors. Given that the average doctor finds himself in the highest tax bracket, this would actually result in a massive increase in pay. [Furthermore, it would save the doctor time, allowing him or her to relax or work more instead of having to figure out their taxes.] When talking about reducing doctors’ pay, I think you are also forgetting the demand side of this equation. The simple fact is that demand for medical care is rapidly rising. A big part of this is because baby boomers are getting older and are requiring more care. Allowing more doctors into America will result in better care for more Americans at a lower rate. Yet, ending income taxes for doctors allows them to keep more money while charging less for services–a win-win situation.
Additionally, if we could ensure that doctors from foreign countries were held to the same standards as American trained doctors the cost of medical school might actually decrease. Think about it–if you knew for a fact that medical schools in Asia, Europe, South America, or elsewhere were significantly cheaper, and you were able to go online and find the pass rates for student from these schools, you as an American might be more willing to attend one of these less expensive schools.
To sum up: the goal is to increase supply without decreasing pay or quality. That is why allowing foreign doctors into the country must be done while holding them accountable to the same medical standards as American trained doctors. That is also why this must be accompanied by an end to taxes for doctors.
PH
3When I first read your proposals I was thinking about them separately. Together they make more sense. I’m not sure how hard it is for IMGs (foreign medical grads) to gain American citizenship, but I do know a bit about them that could contribute to this discussion.
Right now there are two ways to practice medicine in the U.S. if you are from out of the country – you have to either do a residency in an American hospital (this is what American kids that study in the Caribbean do).. or go through a lot of testing and jump through a lot of elaborate hoops if you are a practicing physician outside of the country. I’ve always been under the impression that the reason foreign docs don’t come to the U.S. is because either they can’t match in an American residency after school (these are extremely competitive for IMGs because of the limited spots) or the practicing docs can’t/don’t want to pass the tests and jump through the hoops. If a doc can do either one of these things they can practice in the U.S. and their citizenship doesn’t matter. Both of these are ways that are already in place to standardize the quality of the education of foreign docs practicing here. There just aren’t enough IMGs that can do it or want to do it to make up for the need for docs we have today.
Another note: Medical school class sizes are increasing and new medical schools are popping up to increase the supply of docs.
4you forgot the option to start making employer health insurance benefits taxable and then reducing the income tax by the same amount – thus giving people the money they spend on health insurance to spend on insurance or on whatever else they want. Insurance costs would go down as this subsidy (no tax on health insurance benefits) goes away.
5