When Chemists Attack

As some of y’all know, the Shrimp and Grits family grew in October. Now, the bills are starting to roll in. Health care bills, that is – bills from the hospital, where my wife gave birth. Bills from the doctors at the hospital. Bills from the anesthesiologist. Bills from the pediatrician. More bills from the hospital.

In short, never-ending medical bills – and none of them cheap.

So, when I heard that President Bush was going to address health care in his State of the Union address, I was interested. Health care costs in this country are ballooning.

Over the past few years, I’ve seen

• my premiums go up (and up, and up)
• my deductible go up along with my premiums
• my out-of-pocket maximums go up
• my copays go up, especially for prescription drugs. (To add insult to injury, almost every time I’ve gotten a medicine prescribed that wasn’t an antibiotic, I’ve had to go through trying to fill the prescription, having it denied by insurance, then having to get the doctor to call the insurance company and essentially beg them to cover the medicine.)

Any kind of meaningful health care reform is going to have to address a lot of things. We need to find ways to control costs, ways to reduce the "red tape" people go through to get care, ways to make sure that all Americans can get the care they need, ways to ensure that families won’t lose everything if a member gets a long-term illness, et cetera. That’s a tall order.

Here’s what Bush said:

A future of hope and opportunity requires that all our citizens have affordable and available health care. When it comes to health care, government has an obligation to care for the elderly, the disabled, and poor children. We will meet those responsibilities. For all other Americans, private health insurance is the best way to meet their needs. But many Americans cannot afford a health insurance policy.

On what basis does Bush assume that private health insurance is the best way to meet the needs of most Americans? I have private health insurance. It seems to be more a part of the problem than part of the solution. The private insurer takes my money, provides me with little or no care without me paying even more for it through deductibles and other out-of-pocket expenses, and hassles me when my doctor prescribes medicines that they think cost too much. Plus, they don’t pay one cent towards any preventative care.

Bush continues:

Tonight, I propose two new initiatives to help more Americans afford their own insurance. First, I propose a standard tax deduction for health insurance that will be like the standard tax deduction for dependents. Families with health insurance will pay no income or payroll taxes on $15,000 of their income. Single Americans with health insurance will pay no income or payroll taxes on $7,500 of their income. With this reform, more than 100 million men, women, and children who are now covered by employer-provided insurance will benefit from lower tax bills.

Say what? Bush’s proposal to fix the health care system in this country is … a tax cut???

(I’ve since seen that it’d be a tax increase or at best a wash for some – those who have decent employer-provided insurance.)

I need some help here. I’d like someone to explain to me how jiggling the tax code this way is going to stop the upward spiral of health care costs and get Americans hassle-free access to quality care. How does this proposal address the rising prices of prescription drugs? How does it cut through the massive piles of paperwork and bills that those who are lucky enough to have insurance deal with?

Assuming it gives a few people a temporary financial boost (which will probably correct itself within a few years), how is this not the equivalent to putting a Band-Aid over a severed arm?

Bush again:

At the same time, this reform will level the playing field for those who do not get health insurance through their job. For Americans who now purchase health insurance on their own, my proposal would mean a substantial tax savings – $4,500 for a family of four making $60,000 a year. And for the millions of other Americans who have no health insurance at all, this deduction would help put a basic private health insurance plan within their reach. Changing the tax code is a vital and necessary step to making health care affordable for more Americans.

So what’s "basic" health insurance? Extremely high deductibles and exremely limited coverage? ("Safe Auto" for health?) Wouldn’t this proposal simply lead to people buying this "basic" insurance to get the tax break, driving the prices of halfway decent insurance plans even higher?

My second proposal is to help the States that are coming up with innovative ways to cover the uninsured. States that make basic private health insurance available to all their citizens should receive Federal funds to help them provide this coverage to the poor and the sick. I have asked the Secretary of Health and Human Services to work with Congress to take existing Federal funds and use them to create "Affordable Choice" grants. These grants would give our Nation’s Governors more money and more flexibility to get private health insurance to those most in need.

Thinking back on this part of Bush’s speech, this thought struck me: Those most in need do not need private health insurance. What those most in need do need is health care.

There are many other ways that Congress can help. We need to expand Health Savings Accounts … help small businesses through Association Health Plans … reduce costs and medical errors with better information technology … encourage price transparency … and protect good doctors from junk lawsuits by passing medical liability reform. And in all we do, we must remember that the best health care decisions are made not by government and insurance companies, but by patients and their doctors.

I’m all for upgrading the archaic information technology systems in use in the medical field. On the patient side, the reams of paperwork are a major hassle. Every time I’ve seen a new doctor, I’ve had to fill out a brand new set of papers. I don’t imagine it’s any better for the doctors, who must be positively buried in paperwork. And these mountains of paper do lead to error. Not too long ago, my records at one doctor’s office got mixed together with someone else’s. Luckily, the doctor caught on – it wsa pretty obvious that I wasn’t being treated for a stroke. (I was being treated for hay fever.)

And I’m all for price transparency. Getting an itemized bill out of the local hospital is almost impossible (but it’s needed to get reimbursed by pre-tax plans like MoneyPlus). It’s pretty obvious, though, that the hospital simply doesn’t want to you know what you’re being charged for. (We’ve been double-billed several times.) Sigh. Only in America do you go into the hospital for one service, then get a two dozen bills for it afterwards.

Medical liability reform? I might be able to get behind that with some evidence that "junk" malpractice suits really are a major reason health care costs are so high today.

In summary, I’m pretty underwhelmed by Bush’s new health care tax jiggle. Maybe some of y’all can enlighten me on what good is supposed to come of this?

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Edited to add:
Stephen Colbert weighs in on the Bush health care plan. It’s all so clear to me now.

This entry was posted on Thursday, January 25th, 2007 at 9:43 pm and is filed under Politics. You can follow any responses to this entry through the RSS 2.0 feed. Both comments and pings are currently closed.