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Charles Krauthammer Proposes a Reasonable Way to Start Healthcare Reform

He’s already written a superb couple of columns about why Obamacare is sinking and why Obama is retreating from it.

Now, he’s got a couple of novel ideas on how we can begin the reform of our healthcare system. He gives us these in his latest piece at the Washington Post.

First, he sums up why Obamacare will fail:

In overhauling any segment of our economy, the 1986 tax reform should be the model. Yet today’s ruling Democrats propose to fix our extremely high-quality (but inefficient and therefore expensive) health-care system with 1,000 pages of additional curlicued complexity — employer mandates, individual mandates, insurance company mandates, allocation formulas, political payoffs and myriad other conjured regulations and interventions — with the promise that this massive concoction will lower costs.
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This is all quite mad. It creates a Rube Goldberg system that simply multiplies the current inefficiencies and arbitrariness, thus producing staggering deficits with less choice and lower-quality care. That’s why the administration can’t sell Obamacare.

For some reason, likely Obama’s arrogance and obsession with popularity, he can’t for the life of him understand that the people might actually like the status quo better than the proposed cure itself. The Democrats are surprised that the people might actually disagree with their healthcare plan.

And no, Dick Durbin, we’re not there about the Youtube. We’re there to make sure you hear how opposed we are to your healthcare plan. Of course, you’re so courageous in standing up to “the mob” that you just backed down and said you’d be open to having no public option, didn’t you?

The No. 2 Senate Democrat said Sunday that he’s “open” to health care reform that doesn’t include a government-run “public option,” the latest indication that the Democrats’ package could be scaled back as Senate negotiators try to hammer out a bipartisan compromise and constituents flood town halls to express discontent with the current legislation.

But I digress…

Anyways, Krauthammer has proposed two great ideas on where to start.

The first, is tort reform. Gee, haven’t we heard about that before?

(1) Tort reform: As I wrote recently, our crazy system of casino malpractice suits results in massive and random settlements that raise everyone’s insurance premiums and creates an epidemic of defensive medicine that does no medical good, yet costs a fortune.

An authoritative Massachusetts Medical Society study found that five out of six doctors admitted they order tests, procedures and referrals — amounting to about 25 percent of the total — solely as protection from lawsuits. Defensive medicine, estimates the libertarian/conservative Pacific Research Institute, wastes more than $200 billion a year. Just half that sum could provide a $5,000 health insurance grant — $20,000 for a family of four — to the uninsured poor (U.S. citizens ineligible for other government health assistance).

What to do? Abolish the entire medical-malpractice system. Create a new social pool from which people injured in medical errors or accidents can draw. The adjudication would be done by medical experts, not lay juries giving away lottery prizes at the behest of the liquid-tongued John Edwardses who pocket a third of the proceeds.

The pool would be funded by a relatively small tax on all health-insurance premiums. Socialize the risk; cut out the trial lawyers. Would that immunize doctors from carelessness or negligence? No. The penalty would be losing your medical license. There is no more serious deterrent than forfeiting a decade of intensive medical training and the livelihood that comes with it.

Good idea right? Unfortunately, it won’t have a chance in Hell. Why? BecauseJohn McCain wanted it.

And there’s also the little fact of the Democrats’ love affair with the trial lawyers (John Edwards, anyone?).

The second idea Krauthammer proposes is delinking health insurance and the workplace.

(2) Real health-insurance reform: Tax employer-provided health-care benefits and return the money to the employee with a government check to buy his own medical insurance, just as he buys his own car or home insurance.

There is no logical reason to get health insurance through your employer. This entire system is an accident of World War II wage and price controls. It’s economically senseless. It makes people stay in jobs they hate, decreasing labor mobility and therefore overall productivity. And it needlessly increases the anxiety of losing your job by raising the additional specter of going bankrupt through illness.

The health-care benefit exemption is the largest tax break in the entire U.S. budget, costing the government a quarter-trillion dollars annually. It hinders health-insurance security and portability as well as personal independence. If we additionally eliminated the prohibition on buying personal health insurance across state lines, that would inject new and powerful competition that would lower costs for everyone.

Sounds like a good idea, right? But the Democrats are frightened by the thought that the people might actually be able to make choices for themselves. Scary, no? If you’re a Democrat, it is because, generally, those are the sort of people that vote them out of office.

Also, there is one other thing that will prevent this from happening. Yep, that’s right, John McCain supported it.

Repealing the exemption has one fatal flaw, however. It was advocated by candidate John McCain. Obama so demagogued it last year that he cannot bring it up now without being accused of the most extreme hypocrisy and without being mercilessly attacked with his own 2008 ads.

So, that’s a no go, right, Mr. Obama?

Mr. Krauthammer is a brilliant man. Unfortunately, his brilliance is lost on those of the political class. Well, chiefly those of the Democratic persuasion.

COMMENTS

  • EasternEstablishmentJoeSixpack

    The Post Office HAS to deliver on vastly unprofitable routes anywhere in the boondocks. They HAVE to charge the same everywhere. FedEx and UPS started with places like downtown Manhattan, and surprise, they could make money there. They have branched out from there taking all the profitable locations.

    The Post Office is left with the money losers. Government is the last resort for services we have to have, like letters to/from small towns. Stop for a moment and think what would happen if all the small towns with too much distance or too little volume were cutoff from the rest of the world. That is not what should happen in a nation like America. It is not that we need more government or less government, we need government doing the right things well.

    • George Claghorn

      … that you just proved the point conservatives have been making for ages: government cannot compete with businesses.

      Begone, troll. Take your KnownFacts™ elsewhere.

    • The_Gadfly

      the problem the post office has isn’t delivering to the boonies for a flat rate. The problem they have is charging prices a magnitude of order smaller for sending bulk mail as opposed to first class mail. The first class and package prices have to subsidize that bulk mail and it kills them.

      I’m actually bemused by the “flat rate” commercials the post office is running to encourage businesses to use their boxes instead of other services with “variable” rates. I’ve used UPS, Fed Ex, and USPS for shipping services. UPS and Fed Ex usually work out to cost no more for equivalent levels of service, and if the proximity is closer, offer significant savings — precisely because their price for shipping directly reflects their cost for shipping each package. And you know, I think I’d be happier if there were less bulk mail in my snail mail box when I check it.

  • derhoosier

    Tort reform? Of course. His second point is also dead on, however, there is a “but …” The price of insurance is totally out of whack because of all the various government mandates, all of which doodle the price around such that there really isn’t a free market to fall back on if we pull the plug on insurance-through-your-employer. I believe I heard a few weeks ago that there are more than 300 that originate at the state level. The example that comes to mind– and I could have this completely wrong– is that there is I believe at least one state that requires that health insurance plans include drug and alcohol abuse counseling. There are probably one or more that require bundling neo-natal care or some such. Being forced to pay for that isn’t that attractive to my post-menopausal wife. And at this point in life, if either one of us were liable to start abusing the bottle or drugs we’d know it. And we aren’t. :-)

    • The_Gadfly

      I recently searched health care prices and found personal plans ranging from $60 to $1200 a month. These were non-group plans. The plans in the $120/month range were indemnity plans with a $2500 deductible and 20% co-pay.

      For a family of 4 the same search had price ranges of $260-$700 month on the recommended page, but if you look at all listings the range changes to $150 to $1725 for the gold plated plans (e.g. a no deductible, no co-insurance, $10/visit HMO plan for $1600/month, major us carrier). Picking the same well known carrier there is a plan for about $300/month for the hypothetical family, with a $1700/year deductible.

      Remember, all the numbers I’m quoting are direct purchase, non-group plans. They are comparable to rates that employers currently pay to insure you. So there is a free market to fall back on, and it isn’t nearly as moribund as reform advocates claim. I expect that if the primary model for buying health insurance changed, the rates would probably come down. Right now the focus is on selling to employers, who don’t have exactly the same desires you do. Oh, and they are already pretty responsive. On a different search where I needed to provide email and phone contact information, I received two phone calls from company representatives within 5 minutes of hitting the send button; again, nationally recognized companies like Blue Cross and Blue Shied or Kaiser Permanente.

    • http://beaglescout.wordpress.com LJ “Beaglescout” Miller

      However Krauthammer’s solutions involve adding more freaking government control! He needs to go back and rethink. I know it’s hard to get rid of your own old big-government instincts when you finally realize that the Democrats are wrong and Republicans are right, but geez. At least try!

  • The_Gadfly

    is that I don’t think it was an accident of WWII. I am inclined to believe that the Progressives of that era, who idolized Hitler and Mussolini before they changed their minds and recast them as right-wing devils incarnate, planned it that way because the were trying to move to the socialist model. They thought Mussolini’s concept of the state controlling the markets by controlling The Big Players in the market was the most efficient way of getting there, at least in the US. Jonah Goldberg does a very good job of describing all of this in his book Liberal Fascism, which I think is a must read if you want to understand the Democrat-MSM-Union coalition.

  • 6eorge Jetson

    Goldberg’s large body of work also included the following timeless cartoon

  • http://www.criterionchemical.com Chemical Sam

    I have always been puzzled why it is that buying health insurance through your employer is considered better, or cheaper…why groups plans are cheaper. John Belushi down the hall is jamming is no curve-buster.

    Don’t tie policy to jobs.

    Cut out lawyers.

    Absolutely keep insurance a free market, competitive industry.

    In on board with that. Gee, I guess we should have elected John McCain.

    I could even go one further. But don’t jump me for the idea. Do not punish people for health issues they can’t control. Reward people for improving the aspects of their health they can control. There are risks with pirvacy issues, and monitoring issues, which might kill these ideas, but I’d be willing to float it.

  • larueladue

    Do you really think the lawyers that dominate Congress, and the government in general, will let common sense run rampant? They won’t kill the goose that laid their golden egg…

  • vettepilot

    As long as it’s done in a free market way… My old employer used to do health screenings every 2 or 3 years, including a blood draw that measured LDL, HDL, and a few other things. Insurance rates weren’t tied to the results but the screening was a requirement for coverage.

    In a completely free market system, something like this would be completely acceptable; heck they could even go the next step and tie the results of screening to your rates. If you don’t like that, as a consumer you would be free to vote with your dollars (assuming alternatives are available) and utilize another provider.

    I suspect that another reason that the left doesn’t want these sorts of alternatives being made available is because of the shared risk nature of “insurance” (and lets be honest, what the left is offering isn’t insurance, it’s essentially mandatory welfare). If the plans you propose (and I mention) are available, the healthy and health-conscious will tend to favor those arrangements in lieu of other more generic plans, due to their presumably lower rates. This means that the number of people who contribute to the pool but rarely receive disbursements goes down, making providing insurance to the rest unsustainable. The left knows that by opening the market up to competition these kinds of plans will pop-up, and they need those customers’ money to fund their plans…

  • EasternEstablishmentJoeSixpack

    You are spot on about Tort Reform and why it isn’t a bedrock of Health Reform. Unfortunately, left alone the bandits make a killing and everyone’s cost go sky high.

    But lawyers aren’t the only bandits in Health Care. What do you expect in a system where the person selling gets to tell you how much you are buying?

    In 2002 the insurance industry had 2.4 billion in profits. In 2008 they had 12.1 billion. What miracle of capitalism did they accomplish to be so richly rewarded? Well, largely they raised rates and dropped people who had medical problems. In other words, they got a handle on their costs. They can do this because they have worked hard to individually get into a quasi-monopoly position by eliminating regulation.

    Anyone who has read Adam Smith knows that the desire of business is not to succeed in competition, but to secure the maximum profits that comes from monopoly. Basic Capitalist theory and practice.

  • Jake W

    That was the point behind all the snark in my post.

    A little depressing, isn’t it?

  • PoliPundita

    …is to make the public aware of the benefits of tort reform and the dirty little not-so-secret behind the Dems unwillingness to even consider it.

    According to Rasmussen, 53% of the people are unhappy with the current proposal. Contrary to Demspeak, we do have alternatives, and we need to get this information out there as people finally begin to wake up and pay attention.

  • OccamsRazor

    It IS time to present a Conservative plan. The democrats will never expect that, while on their heels, it’s NOW that WE _FRAME_ the healthcare discussion as needed. I for one think this is a brilliant outline first pass for a plan. Off the top of my head, I’d like to also find a way to release the pressures of illegal immigration without costing the Republicans too much misunderstood political capital with regards to _illegal_ immigration-it’s a healthcare burden. I’ve witnessed it, from personal experience, here in VA. Albiet, this a fight we most likely do NOT want now.

    The Hippocratic Oath is what makes our doctors the best. They believe it when they take it. It’s galvanized in rationalized thought over ~8 years of study. I know plenty of personal doctors as family members and friends. However, this oath is used as leverage against them by the left as if it were an atheist playing the ‘Rules for Radicals’ against a Christian and their 10 commandments. It’s ridiculous. It’s preposterous…and it must be stopped.

    A doctor, by their good hearted nature, will accept anyone who is hurt-their politics, creed, color aside. In paralell they are in fact also a generally brilliant bunch-often times, naturally, demanding more from their lives. That dichotamchy of the human condition is misunderstood by the left, and will be to their own perils in ’10.

    Mr. President:

    FedEx and UPS came AFTER an already established government run crappy orginization (while the post office is expected to post a 7 billion dollar tax payer LOSS and is cutting back 100/1000s of quarters). FedEx and UPS shredded them to smitherins in a few short decades, and posts _profits_ to even exist.

    And with this model in comparison,

    You propose to run _OUR_ _VERY_ _HEALTH_ _AS_ COMPETITION_ _AGAINST_ _THE_ _WORLD’S_ _BEST_?!?!

  • Caleb Howe

    Not only is capitalism evil, but this concept is so bedrock to Redstate that you can expect a hugely successful run here.

    Also, Adam Smith is the devil. And Bill Gates. And Wal-Mart. Wouldn’t you agree?

  • Robert A. Hahn
      In 2002 the insurance industry had 2.4 billion in profits. In 2008 they had 12.1 billion.

    That does not have the ring of truth. It has the clank of something made up. Perhaps you could tell us where you got numbers like that.