Healthcare Reform Fit for Donkeys and Elephants
Whether you are a donkey (Democrat), an elephant (Republican), or something in-between, we all stand to lose in this election year if we blindly follow the lead of U.S. presidential candidates who would convince us that universal health insurance for all is affordable, easily accomplished, and without risk of paralysis of an already fragile healthcare infrastructure, as well as embark on something far more sinister, the financial collapse of a government stretched to limits untested in the past. We go to the polls on November 4, 2008, and, exercising the trite for the sake of the message, never have the stakes of our nation’s health been so high. Both presidential candidates, Sen. John McCain and Sen. Barack Obama, would have us believe that their respective health insurance “fix-its” would extend coverage to our 46 million uninsured and guarantee continued “smooth-sailing” for the three-fifths of us who rely on employer-sponsored health insurance to stem tides ranging from the common cold to brain tumors. Unfortunately, reading between the lines and a closer look at their proposals leave us with either a bad taste in our mouths or holes in our pockets. So, with the limited space available here, let’s dissect the McCain and Obama plans, and leave a clearer field than does the college biology student who disembowels his or her first fetal pig.
Barack Obama’s vision for health insurance would cover the legions of uninsured, maintain a certain status quo of employer-sponsored health insurance, reduce waste by increasing the efficiency of healthcare delivery, and put a health insurance savings of $2,500 in the pockets of beleaguered U.S. families. Sounds good, right? What could possibly be wrong with a plan that calls for a “play-or-pay” policy that rewards employers who contribute substantially to the cost of their employees’ health plans and penalizes, via taxation, those who do not? Is their any argument to a voice that calls for a national health plan, with benefits comparable to those enjoyed by members of Congress, with premium rates equitable for all, and without prejudice for preexisting health conditions? The popularity of such a plan among America’s financially hard-pressed is obvious, until the price tag is examined closely. Sen. Obama’s adherence to a policy that slows spending growth and provides affordable healthcare to America’s masses, including the poor and the dwindling middle class, bridges the healthcare divide. Yet, in an atmosphere of projected increasing healthcare costs and diminished employment-based health insurance, the biggest losers stand to be those who have the most to gain, as they will most assuredly be the parties targeted to finance the pipedream of the “donkey.”
If that were not bad enough, John McCain presents an altogether diametrically opposed vision and solution to America’s health insurance crisis, that has us begging for more (as we are tempted by the specter of lower taxes), as we are violently thrown over the table. Sen. McCain’s plan would decapitate employer-sponsored health insurance, increase reckless and unrestrained competition in the individual health insurance market, and do nothing to lower the numbers of our nation’s uninsured and lessen the toll they take on the national safety net system. The McCain plan is no less a pipedream than that of Sen. Obama, with the former resurrecting obsolete ideas of tax credits for individuals and families that don’t keep pace with the raising costs of premiums, association health plans (AHPs) that operate on behalf of their membership, only to “cherry-pick” and exclude the unhealthy, free-market insurance that would undermine care for the chronically ill, which is notoriously expensive, and, finally, greater reliance on state high-risk pools, which vary enormously from state to state in the amount of funding they make available to the sickest of all Americans. So, as the old proverb goes, while the “elephant never forgets,” it certainly does not dote on creatures smaller (or considered lesser) than itself.
Whether we choose the “blank check” of the donkey or the egotistical capitalism of the “larger-than-life” elephant, we must recognize that symbols do not do justice to the “animals” they represent. When men behave as animals, and work ceaselessly for the benefit of a chosen few or of small-interest groups instead of the greater good, then all of us and all of society suffers, and public health per se takes two giant steps back.
Barack Obama’s vision for health insurance would cover the legions of uninsured, maintain a certain status quo of employer-sponsored health insurance, reduce waste by increasing the efficiency of healthcare delivery, and put a health insurance savings of $2,500 in the pockets of beleaguered U.S. families. Sounds good, right? What could possibly be wrong with a plan that calls for a “play-or-pay” policy that rewards employers who contribute substantially to the cost of their employees’ health plans and penalizes, via taxation, those who do not? Is their any argument to a voice that calls for a national health plan, with benefits comparable to those enjoyed by members of Congress, with premium rates equitable for all, and without prejudice for preexisting health conditions? The popularity of such a plan among America’s financially hard-pressed is obvious, until the price tag is examined closely. Sen. Obama’s adherence to a policy that slows spending growth and provides affordable healthcare to America’s masses, including the poor and the dwindling middle class, bridges the healthcare divide. Yet, in an atmosphere of projected increasing healthcare costs and diminished employment-based health insurance, the biggest losers stand to be those who have the most to gain, as they will most assuredly be the parties targeted to finance the pipedream of the “donkey.”
If that were not bad enough, John McCain presents an altogether diametrically opposed vision and solution to America’s health insurance crisis, that has us begging for more (as we are tempted by the specter of lower taxes), as we are violently thrown over the table. Sen. McCain’s plan would decapitate employer-sponsored health insurance, increase reckless and unrestrained competition in the individual health insurance market, and do nothing to lower the numbers of our nation’s uninsured and lessen the toll they take on the national safety net system. The McCain plan is no less a pipedream than that of Sen. Obama, with the former resurrecting obsolete ideas of tax credits for individuals and families that don’t keep pace with the raising costs of premiums, association health plans (AHPs) that operate on behalf of their membership, only to “cherry-pick” and exclude the unhealthy, free-market insurance that would undermine care for the chronically ill, which is notoriously expensive, and, finally, greater reliance on state high-risk pools, which vary enormously from state to state in the amount of funding they make available to the sickest of all Americans. So, as the old proverb goes, while the “elephant never forgets,” it certainly does not dote on creatures smaller (or considered lesser) than itself.
Whether we choose the “blank check” of the donkey or the egotistical capitalism of the “larger-than-life” elephant, we must recognize that symbols do not do justice to the “animals” they represent. When men behave as animals, and work ceaselessly for the benefit of a chosen few or of small-interest groups instead of the greater good, then all of us and all of society suffers, and public health per se takes two giant steps back.
© 2008, Albert M. Balesh, M.D. All rights reserved.
posted by Dr. Al at
11/09/2008 03:21:00 PM
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