12-25-2013, 09:10 AM
This health care issue is a mess. But in my mind some things should be clear to all of us.
The cost of what we use as nation of individuals for healthcare is just that; the cost. How and who pays for it and who gets what and what's the best way to organize it is really what we are dealing with.
Does one pay after tax or through taxes before salary or after. For the employer portion is really part of our total compensation. The same is true for corporate taxation. The bottom line is that the total cost is now being paid by all of us in unequal amounts and for varying service levels that may or may not be related to our individual share of costs.
Pay as you go or insurance polices. Individual or group insurance. Single or multiple payers.
Should the wealthy pay more than the poorer. Should the old, students, children, handicapped, unemployed be subsidized. Do we get what we pay for. What should be covered. Do costs go down if we leave some people out of the system and do these costs really disappear or only reappear in higher taxes or premiums.
"Can you think of ONE entity that screws with the economy only to make it worse?" This statement is a common idealogy today but most would agree that we would be worse off without : parks, police, roads, airports, libraries, bridges, courts, etc.
This deals with opinions on techniques of organization and management and probably shouldn't be confused with healthcare. I think both government and corporate organization can use and need improvement and neither is a panacea. Who can't remember bad experience with dealing with either. Confusing the arguments doesn't help us deal with the healthcare issue facing us.
Can the cost be lowered? Maybe a more honest look at our healthcare fears, needs and wants. I do think that the more middlemen the worse it is for efficency and cost for either social or business organizations.
My bias is towards a single payer for efficiency and scale. And I do believe in social equity but also that all members of the nation need to contribute and that genuis and hard work should also be rewarded. This complexity requires a careful and informed discussion of the real issues to find the best solution without falling into the trap of our preconceived ideas and settled opinions.
Our society is fracturing under many confused idealogies and we need to cut through these to find real solutions for carefully defined issues. We also seem as a nation incapable of studying other models and learning from those who have been working through the same issue. We don't have to follow but we should at least build off the work.