Republican presidential frontrunner Rudy Giuliani unveiled his own health care reform plan yesterday, while taking potshots at the "socialists" over in the Democratic party proposing universal insurance. Rudy got his sound bites in, but I don't believe his tax-credit-based program will win him many votes, and could in fact cost him the general election, if he makes it that far.
According to coverage by the Associated Press, the foundation of Rudy's plan is to provide a $15,000 tax deduction so families can buy private health insurance. While this might offer some relief to those currently uninsured, it also will certainly encourage more employers to dump their health benefit plans and leave workers to fend for themselves.
Rudy's half-baked scheme is similar to those in the private sector trying a defined contribution approach for the purchase of health insurance--the same path that stripped millions of their pension security. Instead of guaranteeing health coverage, the employer gives you a tax-protected stipend and lets you buy your own policy.
Good luck finding affordable coverage as an individual in that framework, especially if someone in your family has a serious "pre-existing condition."
Mr. G made a point of pushing the central idea that he wants to give people more "control" over their health care, and more "choices." There certainly aren't many choices in today's health insurance system--you are stuck with the plan and benefits offered by your employer, which often dictates which doctors you can see, which facilities you can use and even which drugs you can take. There will be even fewer "choices" and millions more uninsured if Rudy succeeds in making our system completely "free"--in other words, every man and woman for themselves.
Rudy did not offer many specifics, such as the cost of coverage under such a system, or how many uninsured people would be able to afford such coverage. And AP reported he "also acknowledged that it could take years for insurers to drop their prices and make insurance affordable to those who don't have it." Thanks a lot.
Rather than present a serious alternative to our current patchwork system, Rudy seized the moment to hammer his Democratic counterparts, which really was the point all along.
"We've got to solve our health care problem with American principles, not the principles of socialism," he said. "I know Democrats will say this is unfair, I know they'll squeal... But I'm a realist. I face reality, which is: if you take more people and have government cover it, it's called socialized medicine."
While Rudy expressed hope that one day tens of millions of individuals would shop for health insurance the same way they buy auto coverage today, the reality is that the two systems are vastly different. Health insurance is a lot dicier to underwrite--especially on an individual basis. One little health problem and insurers run for the hills.
As broken as the current, employer-based system is, I would rather stay put and try to patch the gaping holes than toss everyone into the "free" market on health insurance and hope for the best. In insurance, there is indeed power in numbers.
Rudy won't lose any Republican primary votes with his plan, but he won't win many in the general election if this is the best he can do on health care reform. In fact, in a close race, the uninsured vote could cost him the White House against a Democrat with a more comprehensive plan to provide health care security.
That is, if he manages to get that far despite his more "liberal" leanings on abortion, gun control and gay rights.
I still cannot imagine today's national Republican party nominating someone with Rudy's progressive views on such hot button issues. (For the record, I voted for Rudy twice to be New York's mayor, as well as twice for Mike Bloomberg--who is a far better mayor, by the way. I wonder how Mike would handle health care reform?)
What do you folks think of Rudy's idea?
Comments (2)
I contend that the problem is that the health insurance industry is expected to operate in a completely different manner than how insurance traditionally works. I cannot file a claim with my auto insurer for oil changes, new tires and tune ups. However, health insurers are expected to foot the bill for every doctor's visit, including the annual check-up.
I thought the HDHP/HSA was going to have an impact, but it appears that no one wants to pay any upfront costs for thier health care save for the $10 or $20 copay, despite the fact that the HDHP/HSA saves significant premium dollars.
Simply put, if our expectations are for full health care coverage at minimal out-of-pocket costs, then universal health care is inevitable.
Posted by Steve Michaels | August 2, 2007 12:11 PM
Posted on August 2, 2007 12:11
Steve Michaels is correct. Health insurance is not viewed as insurance. It is viewed as a service contract.
The problem with that view is, unlike a TV or copier, there is no finite cost to human well-being. Nor can we go out a buy a replacement body.
As a point to start a discussion of solutions, Mr. Guliani's idea has merit. Perhaps if we make the cost of health insurance premiums totally deductible, not unlike an IRA, more people will be able to afford coverage. Under current tax laws, only the employer gets any sort of relief in the manner of tax deduction.
The Democrat Party only has one song that it sings: Socialized Medicine. No matter how they try to spin it, that is what is is. That leads to more government control over our lives.
Do we really want the government in charge of health care? Think FEMA. Think of our Congress that spends our money before it even knows how much of it is there.
I can support government-provided health insurance as a backstop for those who cannot afford anything. I can even support government-provided health insurance as a base that the private sector can supplement.
I cannot and will not support absolute government control of health care.
Posted by Jack J Maniscalco | August 3, 2007 9:02 AM
Posted on August 3, 2007 09:02