Wednesday, July 11, 2012

Hope and Change: Healthcare

"There is a huge tension between the personalize-your-own-world ethos of the iPod/Facebook generation and the command-and-control, mid-20th-century welfare state programs of the Obama Democrats. . . Obama's policies. . . treat individuals as just one cog in a very large machine, designed by supposed experts who don't seem to know what they're doing. . ."

--Michael Barone, “RealClearPolitics”  

"those actually making that history—the people formerly known as the audience in critic Jay Rosen’s apt phrase—are treating their legacy interpreters not with kindness but contempt."

--Matt Welch, Reason

To paraphrase Martin Luther King, Jr., “the arc of history is long but it bends toward popular rule.” People power. Government down, individual rule up.

As we learned earlier, education and healthcare have much in common—they are regulated, public, in a down economy significantly adding jobs, and. . . their productivity growth rates have hit bottom, in fact they have turned negative.

School choice will bring us education hope and change.

In healthcare, the goal is to control costs without undermining quality.

Conservative Yuval Levin, in National Review, sums up very well healthcare’s current failings, all of which Obamacare threatens to compound:
the incentives in our health-care system are all screwed up precisely because of government policies and programs. Medicare, the biggest player in our insurance system by far, is an arcane fee-for-service system that encourages volume over value and inflates (while shifting) costs. Medicaid, meanwhile, has a state-federal structure that makes cost-containment nearly impossible (by having state policymakers make spending decisions while the Feds pay at least half the cost in an open-ended way). And the tax exclusion for employer-provided coverage creates a huge incentive for high-premium insurance while shielding everyone involved from actual prices and costs. All the incentives point to cost inflation and away from outcome-based health economics, so we shouldn’t be surprised to have an inefficient system.
Thankfully, Levin also prescribes a remedy--a people’s “hope and change” path to better healthcare:
Paul Ryan’s alternative to Obamacare. . .proposes an enormous expansion of coverage. . . it would transform today’s tax exclusion for employer-provided coverage into a capped universal health-care tax credit, which people could use to buy coverage or care regardless of their circumstances. . . Over time the effect would likely be even greater than [Obamacare's 21 million gaining coverage] since this system would create an enormous incentive for insurers to offer attractive low-premium plans that could be purchased for the amount made available by the [new tax] credit (simply put, neither consumers nor insurers would leave billions of dollars on the table unclaimed, and the enormous competition among insurers for that money would yield appealing options). So [the healthcare choice plan] would . . . get us closer to universal access to health insurance than Obamacare—and without the kinds of violations of individual liberty, the Constitution, and the laws of economics involved with Obamacare.
Hope and Change in healthcare comes from individual choice.

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