Everybody is lying. The need to lie is paramount, because misguided policies have undermined the finance of healthcare. Several groups of rats have been feeding on healthcare for profit and votes for decades. But, like all of these schemes, economic imbalances eventually come home to roost. The healthcare chicken has turned into a vulture.
The biggest lie has been tacitly or directly supported by both parties. What started as a compassionate and civic minded effort to supply healthcare to the poor has morphed into a colossal empire that is a black hole for money and political influence. As the lure of money has increased, political influence has directed hundreds of billions to special interests such as trial lawyers, health insurance companies, drug manufacturers, device manufacturers and medical providers. It has also been a bonanza for ambitious politicians. The overall effect has been to drive up the cost of healthcare way beyond the actual cost of the care provided.
All of this money had to come from somewhere. As politicians ran out of ways to raise medical taxes, cost shifting to private insurance buyers has been a major source of new revenue for the past two decades. But like all things, this scheme has its costs. The cost is rising private health insurance premiums that are continuing to accelerate. Each year, more marginal private insurance buyers drop out and the problem gets progressively worse. The biggest lie is that Medicare, Medicaid, and welfare healthcare are "fully funded."
The healthcare debate is highly partisan, extensively covered, but it sheds very little light on the Problem. The Problem is that we have a healthcare system that is controlled by special interests that cannot be funded in its current form. Our current health system is on the verge of financial collapse without major new funding and aggressive cost reduction.
The Democrat lie is that we "must cover" 47 million uninsured through a greater public effort. In a sense, they mean to retain and ultimately nationalize some form of the current system while "improving coverage" and "reducing cost." As you read the Democrat proposals, the certainty is major new taxes and aggressive cost reduction. The route to new revenues is mandated insurance coverage along with surtaxes and penalties...big new direct or indirect taxes no matter how you spin it. Aggressive cost reduction will be achieved by "medical review boards" that determine allowed care. This could become truly draconian as the financial stress on healthcare becomes more evident.
The Republican lie is that private insurance with some patches on the current system is workable. Except for the ususal hits for tort reform, there is very little substance in Republican proposals. The Republican role is simply to oppose Democrat proposals by pointing obvious shortcomings, and playing on the fears that voters may "lose their health insurance or doctors." In fact, people are going to lose their current healthcare, because it is being priced out of their reach. The Republicans give no voice for this issue...shame on them. As with the Democrats, they are also beholden to the campaign funding provided by special interests.
Both parties are lying (or blind) about the viability of our health care system without cost reform. Enormus public pressure is needed, because neither party wants to shut off the money spigot from special interests. The real debate should be over public vs. private healthcare. But it needs to be an honest debate that gives full weight to the ways to legitimately reduce costs. Mandates and reduction of reimbursements ultimately damage the availability and quality of healthcare. Voters are right to fear this outcome. Health Savings Accounts are of little value if competitive pricing is unavailable.
In my view, the thrust of the debate (such as it is) is completely wrong. Both parties are working to drive people into private or public insurance. We should be doing the reverse. Routine medical care should be paid by individual patients except for the poorest Americans. Catastropic health insurance (say $10,000 deductible) should be available nationally. This scheme would probably reduce the paperwork volume by 80% and reduce overall health insurance premiums by a similar amount. I would think a real reduction in health care costs of 30+% would result from this one change. There are many other changes that make sense.
