Healthcare Politics - Some final thoughts
I do hope everyone does make it to the poles tomorrow. It has been an odd campaign in my opinion. I felt after the first debate (which was excellent and professional), that I'd be comfortable with either man winning, now I'm not so sure either is really up to the job - this is because I'm not satisfied either can handle the problems of the economy and how both campaigns have denigrated in the final weeks I guess. (And no, I'm not looking for any opinions on who to vote for in the replies - try to stay on topic please).
Anyway, to stay on topic myself, I wanted to offer some thoughts on what I think is wrong with US healthcare and how to take the first steps toward fixing it. We need to start with a psychological shift in our appreciation of the costs of healthcare. The current system goes out of its way to mask the costs of healthcare from the consumer -- mostly via employer based tax-free programs. How many of you can tell me what your employer pays for your program? You probably know how much you contribute, but what is the full cost? How about how your plan compares to others? We rely on employers to make these decisions for us.
So step 1 in my opinion is to break away from the employer sponsored heathcare program. It is delusional to think this is not cost born on the consumer, but it is masked as such. I'd prefer to see employer 'reimbursed' healthcare. You buy your own policy and up to a certain amount, you are reimbursed by your employer (pre-tax).
There are a few advantages, the main one being that your heathcare doesn't end with your employment. COBRA helps here, but for a serious condition that inhibits your ability to work, it runs out awfully fast and then you are screwed i.e. no ability to regain employment to continue your heathcare (and you now have a potentially uncoverable 'preexisting condition' if you want to buy the care on your own). The single leading cause of bankruptcy is health related loss of job and care.
I don't look forward to having to buy my own care. The paradox of choice will certainly play a large role here. Heck, I put off buying a cell phone for a few years because I didn't want to be burdened with the decision of 'which plan', that would be even more extreme with healthcare. Another problem would be potential inequity in reimbursement i.e. the CEO and the mailclerk shouldn't get different reimbursement rates from the company, though the CEO should absolutely be able to purchase a pricier plan if he cares to do so out of his own pocket (as he can now).
It is also my opinion that any move toward universal coverage is not-compatible with the current employer based system -- mandates would only tend to punish those at the time they can least bear the burden. Also business mandates of providing care are much easier handled when the mandate is simply providing a base level of reimbursement.
So with all that said, I do lean toward McCain's proposed healthcare program. It is the first step in the right direction, but only the first. I thought that during one of (the final I believe) debates, there was a huge missed opportunity on McCain's part. Obama accused McCain of trying to end 'employer based healthcare as we know it' and McCain sheepishly failed to state 'Yeah, that's exactly the point!' and explain why. In any case, as long as we insist on trying to sell the consumer healthcare as a pretend 'no cost to them' program -- we won't be reforming it in any appreciable way.