Before attending to this week’s business I should like to defend
myself from the machotypes who fell on me for saying in last week’s
column that a .30 caliber Weatherby magnum was capable of reaching
a bird at 1200 yards. Allow me to quote from a memo to
AmSpec’s expert on the subject, my friend Chuck
Fowler.
Quoth: “A 165-grain bullet from a 30-378 Weatherby drops
nineteen and a half inches at 500 yards. It screams out of the
barrel at a blistering 3500 feet per second. I’m sure at 1200 yards
it may drop twice again as much as at 500 yards and maybe even
more. But once a scoped gun is zeroed for 1200 yards, a person of
modest ability can easily hit a human-sized target. A person with
some skill could hit a bird, and no one with good sense would bet
his life on it not being possible to hit him.”
I stand by my statement but remain a bird lover, particularly
Wild Turkey.
******
Washington — I write as a confirmed hypochondriac. I have more
medicines in my medicine cabinet than Arianna Huffington. In fact,
I have more medicine cabinets than Arianna Huffington, and I did
not even have to divorce a multimillionaire to afford my multitudes
of medicine cabinets. I have a half dozen personal physicians. The
only docs I avoid are plastic surgeons, and that is because they
would have me looking like Senator John Pierre Kerry.
Thus you might think I am exultant over the advance of the new
prescription drug bills through Congress that our solons plan to
append to Medicare. Actually, I am not. As these bills approach the
conference committee where they will be reconciled, I reach for the
Prozac. They are unfunded. They are likely to lack market-based
reforms. They will force all of us into a healthcare straitjacket.
We hypochondriacs need to be able to make choices. What strikes me
as an unendurable affliction might strike you as a hangnail. Yet I
might want to take my hangnail to a doctor and I ought to be able
to, assuming I pay for it. With a proper array of healthcare
programs available to me I just might be able to get insurance for
my hangnails.
The basic thing that all of us, hypochondriacs and the
physically fit alike, need to remember about health policy is a
condition that the great economist Milton Friedman recognized a
generation or more ago, to wit: healthcare demand is elastic. The
cheaper and more available it is the more it will be in demand. If
it were free, we hypochondriacs would be in the doctor’s office all
the time. At least we would be in the doctor’s office if the doc’s
fees were paid by government — and if government did not regulate
care, thus restricting procedures.
The restriction of procedures is just one of the problems with
Medicare. The other is that it is underfunded and will go bust
someday. Scholars at the American Enterprise Institute calculate
that Medicare’s long-term shortfall is more than $30 trillion. If
the contemplated prescription drug coverage is thrown in, add
another $6 trillion to $12 trillion. And still I cannot get my
hangnails treated. As the shortfall mounts ordinary Americans will
not be able to get some genuinely urgent procedures covered. In
fact, services are being cut back even now. In the years to come
there will be more cutbacks in Medicare and a huge tax
increase.
The government cannot run unfunded programs forever. Yet with
the present prescription drug bills now headed for conference that
is about what the politicians are contemplating. To repeat, the
unspoken truth of these prescription-care bills is that they are
not even funded.
The Bush Administration until recently included market-based
reforms in its plans for prescription-drug legislation. Now it has
apparently thrown in the towel. Senator Edward Kennedy is opposed
to such measures. Of course, any market-based reforms can be
expected to rouse Kennedy’s ire. He wants to move towards a
single-payer health system whose proper name is socialism. Any
policy that further damages Medicare he believes will put further
pressure on the government for his quaint 1930s goal.
Actually the government already has a solution to the healthcare
muddle, but it is only available to members of Congress and
government employees, namely, Federal Employees Health Benefits
Program (FEHBP). In its 28 years, FEHBP’s costs have been no
greater than Medicare’s and its benefits are more extensive. Even a
hypochondriac can admire it.
Under FEHBP the government’s Office of Personnel Management
annually sends out a memo to health insurance providers, outlining
goals and soliciting each company to put together plans consistent
with those goals. The plans that meet the government’s minimum
standards are offered to government employees who can then select
the policy of their choice. Furthermore, employees can negotiate
with the companies as to which options are included in their
personal policy. I would want the hangnail option. Thus my policy
might cost a bit more than Senator Kennedy’s though he ought to
take the weight-watcher’s option. The government then agrees to pay
between 72% and 75% of the policy premium.
FEHBP has wide acceptance among health specialists and
healthcare providers. Frankly I cannot understand why Republicans
and Democrats cannot agree on extending it beyond government
employees to the rest of us. The only reasons I can ascertain are
that A) Republicans are not up to the political fight, and B)
Democrats are holding out so as to move national healthcare towards
socialism and away from market reforms. By now it is pretty clear
that today’s reactionaries are with Senator Kennedy.
