Tuesday, October 20, 2009


According to ROSS DOUTHAT published in the Tines on 10/18/09, there are three major problems plague American health care. The cost of premiums is eating up an ever larger share of take-home pay. The cost of our public health care programs is eating up an ever larger share of the federal budget. And millions of people who need insurance are priced out of the market.

If a Baucus type bill passes into law, we should expect a significant decline in the number of Americans without health insurance. But for Americans who have employer-based insurance — still the lion’s share of the working-age population — premiums could climb more swiftly than ever. That’s exactly what’s happened under Massachusetts’s recent reform, the best state-level parallel to what Congress is attempting.

If you’re a wavering moderate who’s concerned about the uninsured, then, whatever bill emerges from this month’s negotiations might seem like an opportunity that won’t come round again.

But any lawmakers voting “yes” should have no illusions about what they’re voting for. This version of reform probably won’t make health care more affordable for most Americans, or place the system on firmer footing for the long run. Indeed the rising costs will call for more radical changes.

One such approach is the eventual endgame that liberals pushing a “public option” are aiming for: a federal takeover of the health-insurance sector, paid for by rising tax rates, in which the government guarantees universal access while using its monopoly power to hold down costs.

Douthat notes that there’s another path, equally radical, but more in keeping with the traditional American approach to government, taxation and free enterprise. This approach would give up on the costly goal of insuring everyone for everything, forever. Instead, it would seek to insure Americans only against costs that exceed a certain percentage of their income, while expecting them to pay for everyday medical expenditures out of their own pockets.

Such a system would provide federal funded universal catastrophic health insurance, in other words, while creating a free market for non-catastrophic care. This option may be this country’s best resolution of the health care crisis. It may be well worth trying before going down the road of failure.


  1. Doc, I just don't think Health Care should be profit motivated. No one should make money from a person sickness. Look how much is being made from our illnesses. There is no motive to really find the cure. Look how much money is being made just from cancer. Do you really think the industry would kill the golden goose? It also puts us at a big disadvantage with other countries who subsidizes health care, thus can easily outbid us in job costs.

  2. 10:53 I appreciate your comment and the opportunity 'No one should make money from a person sickness' affords me for a philosophical
    blog. That will be forthcoming if there is no other urgent health care news.