Sunday, January 28, 2007

Universal health care

1 month since my last post and I choose to write about universal health care? How boring is that! But I've spent a lot of time this week trying to make sense of the health care plan proposed at the State Of The Union address earlier this week. I agree that health care is one of the major problems facing this country, and also agree that it is a very difficult one to solve, so when politicians actually take action on it instead of just mention it, I tend to pay attention. So let's try to make sense of the proposed health care system.

Let me start by saying that I could be misinterpreting this plan, so if I've gotten some of the facts wrong, well, chalk it up to the confusion of the plan.

First off, there's a tax break for people that buy into health care plans. A $15,000 tax break, no matter what your actual plan costs. Ok, that sounds good to me. Health care should be tax deductible to help people afford it. But isn't it kind of odd that I get a $15,000 tax deduction, even if my plan only costs $5,000 and my employer is the one paying for it? Hmmmm. A little strange, but let's continue.

Oh wait, it turns out that for plans that cost more than $15,000, the amount over $15,000 will not be tax deductible, whereas currently if I contribute more to my plan at work (i.e. to add my wife or to increase our coverage), it is tax deductible. So now I'm a little confused - will this plan raise or lower my taxes? Wow. Hooray for the crystal clear American tax system.

So the incentive here is that people will no longer opt for more expensive plans, thus dropping the earnings the health care system makes, which in turn encourages them to offer cheaper plans. I guess that makes sense, but it's a lot of wishful thinking I think.

So anyway, the whole point of this is to bring health care to people who currently don't have it, and pretty much everything we've talked about so far is really only relevant to people who already get health care through their work. So how do the people who can't afford health care currently get health care under this plan? Oh that's right, with the tax deduction, they can now afford health care... but wait... most of the people who can't afford health care are already tax exempt because they have so little income they don't pay taxes anyway, so essentially this plan gives them a great deduction on the $0 they already pay.

But then the plan also aknowledges a further need for universal health care that this plan doesn't provide. How is this handled? By giving federal aid to states that implement a universal health care system. "We can't figure out the solution to this problem, but if you figure it out, we'll chip in a few bucks and take the credit. But if you live 5 miles in the other direction you're out of luck. So sorry."

This plan is so confusing, I'm not even sure who it helps and who it hurts.

It brings to mind an article my wife likes to quote so much. Essentially the point of the article was that the U.S.A. pays more per person on health care than any other (or most other) countries, but still has a higher percentage of "sick" people (people with diabetes, heart problems, etc.). The article argued that we need to increase spending to drop the percentage of sick people. My wife's reaction: "uh.... duh... when you have sick people, you need to spend money to treat them, which is why we spend so much money on health care. Maybe if we figured out why these people in other countries weren't getting sick, we wouldn't have to pay so much money to treat them?" In other words, maybe we need to shift our focus from treatment to preventative care - not as lucrative to pharmacuetical companies, but certainly a lot cheaper on our country as a whole.