Energion Roundtable Week 6 Responses
This week’s Energion Roundtable question it seems that one thing Arthur Sido, Bob Cornwall,, Allan R. Bevere, Joel Watts and myself all agree on is that this is a real problem and that none of the candidates have a completely satisfactory plan. As Bevere put it, “This is truly a complex and serious problem involving a complex and serious answer.” This is not the sort of thing that can be fully worked out in a campaign.
One question I would have for Watts, Bevere and Cornwall, is just what is Obama’s plan? The coming collapse in either 2024, (or without the double counting 2016) is based on Obamacare being in place. Obama may not be proposing to destroy Medicare, but just what is his plan to avoid the coming bankruptcy?
Cornwall writes of the Republican plan that it would turn Medicare, “into a voucher system, that most experts believe won’t keep up with inflation.” Watts also questions this saying that it “will sooner than later destroy the safety net for the elderly.” Setting aside Cornwall’s “most experts” comment, that still leaves a question for them: If you do not believe that the government can be trusted to spend the money needed to pay for the “voucher,” what make you think they will spend the money to pay for the coverage? Medicare already denies coverage at a higher rate than private insurance, and pays far less,such that doctors are ceasing to accept new Medicare patients. If you cannot find a doctor who will take you as a patient, or if you can, they deny your claim, what good is the current system?
If Government is in complete control, the only way to limit costs is some form of rationing, either though reducing payments, or denying claims. I know that supporters claim efficacy of a single payer system, but I just do not believe that is actually possible. After all, if government was so good at running health care, Medicare would not be in the mess it is. And somehow the argument that they made such a mess of things with Medicare, so we should give them all of health care just does not work for me.
Sido rejects both plans, preferring that we block grant Medicare to the states. Romney supports block granting Medicaid, but not Medicare. (“Why” would make a great question for the debates.) While that has some appeal, I prefer the premium support model, as that gives more choice to the individual, and after all this is essentially the same model that Congress has.
Premium support is only a first step. There must be additional steps to ensure that people have a real choice and that there is real competition, such as the ability to purchase insurance across state lines, which Romney and Republicans support. (This was a particular problem for our small company when we had employees in both California and Wisconsin.) If people are given real choice; if there is real competition; and if the health care system is allowed to explore innovative ways of delivering quality health care services at lower costs, the system will move into balance and inefficiency will be driven out, just like in all the other areas where market forces are allowed to operat. With prices under control, the necessary task of dealing with those in need would be far easier.
