The American Spectator

Carner York| 1.12.09 @ 2:08PM

I would guess that the vast majority of Mass. citizens would say that the health care system doesn't work well because the feds have not put enough money into it. The same lie is believed without question about our public school system.

John| 1.12.09 @ 2:14PM

This is a prime example as to why Romney wasn't even close to being a Conservative. He was just another of the North Eastern Establishment who put on the conservative jacket. It didn't fit, looked bad, and was the wrong color.

The truth is that health care payment and delivery is not "fixable" the impulses to fix it just make it worse.

The truth is that to "fix health insurance" we need to do away with the entire concept of employment based group health policies and move to a system with the following features:
1. Doctors publish the costs of all of their procedures and treatment courses. (Transparency)

2. Insurance companies can sell nation wide to anyone. The stipulation being no one can be denied coverage for any reason; but plans can be tailored by the needs of the insured (If I don't want to pay for abortion coverage I don't have that component in my insurance...)

3. 100% of all health care costs including the cost of purchasing insurance is tax deductible.

4. Companies are given tax breaks to provide vouchers to employees. But there is no group limitation or any other constriction except that the employee must spend the money on a qualified plan.

5. If the government wants to pony up vouchers for people who are incabable of paying for coverage themselves, then that can be negotiated and voted upon (but it must be strictly means tested since any availability of Government vouchers will tend to militate against people purchasing their own insurance.)

Once pricing transparency, availability, and portability become standard... the market will tend to sort out the rest.

That is true health care insurance reform. What Taxachusettes did was do the 'S'squared-'D' Squared... and it failed and it will always fail... without fail.

r/John

james23| 1.12.09 @ 2:45PM

And yet, to this day, many Republicans and some self-described conservatives regard Romney as 'strong on the economy.'

Carner York| 1.12.09 @ 2:59PM

John - That is so logical that it has no chance of enactment or even consideration by our elected representatives. Perhaps if it included some provisions for reducing the carbon foot print of X-ray machines or reducing the amount of toilet paper used in hospitals, it might get some attention. Beyond the sarcasm, that was a really great post and something that should become part of the conversation.

ruth| 1.12.09 @ 4:35PM

Unfortunately, John, the fatal flaw of your proposal is that it makes sense. James, there was no one for conservatives in 2008.

Interested Conservative| 1.12.09 @ 5:40PM

John - I have some experience in the business, and while your list makes sense, it's only the beginning. Of course there are objections to each of your points, most of which are from the left, but also a few from the free-market right.

If nothing else, consider the distinction between "insurance" and "pre-paid benefits". The business problem involves modelling - i.e. easier to underwrite the relatively few houses which burn down vs. the virtually universal use of health coverage.

PS - Good luck getting the states to concede authority to a "national" insurance system.

John| 1.12.09 @ 10:32PM

My point is that the states AND the feds should have minimal involvement at all. Merely the baseline regulatory standards posted for any insurance.

I have absolutely zero problem with a "prepaid" scheme... remember the operative is... the customer should be able to come up with an insurance package that suits his needs.

If that means a health savings account with a reasonable catastrophic plan for Hospitalization and expenses over a certain threashold then I am all for it... BUT (always a but there...) There ABSOLUTELY MUST BE PRICING and INSURANCE TRANSPARENCY. Nothing works without knowing the costs and how they are calculated for both care and insurance up front. You can't shop blind. You cannot responsibly consume in the dark.

By National I mean National... no groups based on very limited associations like work... just groups based on the type of insurance plan offered.

I am really big on allowing religious organizations to form nationwide groups. It would be wonderful to be able to buy into a tax free plan offered by an insurance company co-sponsored by the Roman Catholic Church. I am sure that there are lots of folks who would take advantage of such nationwide groups.

My point is that the market, once freed from being pinned to employers... would provide a wide range of options for the consumer.

The government need only set the basic rules that I outlined and step aside.

There never will be a completely "satisfactory" level of coverage for the mushy - hearts and flowers crowd who are always looking for something at zero cost. Their fantasy world is a disaster in any current reality. The Left never understands the scale and complexity of anything, so it only manages to do a hopelessly incomplete job of everything.

(Lest people think that I am not aware of health issues... a family member just passed away this summer after a two and a half year losing battle with the final stages of ALS. The costs were horrendous... They were mind boggling... but anyone who thinks the state is going to foot the entire bill for $500,000 of medical expenses and in home care for a 70 something little old lady, is not playing with a full deck.)

We either learn to fund our own medical care, or the entire system collapses of its own weight and unsolvable complexity.

R/John

Paul Hsieh, MD| 1.13.09 @ 4:53PM

I'd like to thank Philip Klein for writing about this important issue. If anyone wants more information about the facts and figures cited in the DC Examiner piece, please see my article from the Fall 2008 issue of The Objective Standard:

"Mandatory Insurance: Wrong For Massachusetts, Wrong For America":

http://www.theobjectivestandard.com/issues/2008-fall/mandatory-health-insurance.asp

or http://tinyurl.com/6zkcap

Paul Hsieh, MD
Freedom and Individual Rights in Medicine (FIRM)
http://www.WeStandFIRM.org

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JAYDEE| 7.1.09 @ 10:53AM

John's price transparency argument is dead on. I've argued the same thing for years. There should be a mandatory format for providers to post their prices on the internet. Then consumers can shop and create a true market. Additional measures: Train more doctors; Allow lower level nurses and techs do limited procedures independently; tort reform; dismantle "Certificates of Need" (highly anti-competitive requirements where permission from the state is needed to open or expand a medical facility). The entire public debate is devoted to government tinkering with payment mechanisms- an approach that will always fail. Only true market competition will reduce the underlying cost of heath care.

JAYDEE| 7.1.09 @ 11:18AM

John's price transparency argument is dead on. I've argued the same thing for years. There should be a mandatory format for providers to post their prices on the internet. Then consumers can shop and create a true market. Additional measures: Train more doctors; Allow lower level nurses and techs do limited procedures independently; tort reform; dismantle "Certificates of Need" (highly anti-competitive requirements where permission from the state is needed to open or expand a medical facility). The entire public debate is devoted to government tinkering with payment mechanisms- an approach that will always fail. Only true market competition will reduce the underlying cost of heath care.