ObamaCare: Putting the cart before the horse

“ObamaCare”—the Obama administration’s hotly-debated push for Universal Health Care coverage—includes providing health care for illegal immigrants and resident aliens who cannot afford health insurance. The increased cost of such coverage, provided by Social Security’s Medicaid and Obama’s proposed new “Public Option” (government-run health care program), would be born in great part by the states, many of which are already strapped for cash due to the recession, escalating costs of health care for the uninsured, and over spending in other areas.

The debate is rooted in the out-dated, woefully inadequate, government-muddled and widely criticized immigration policy and Social Security.

To tackle Universal Health Care Reform before reforming Social Security and immigration is to put the cart before the horse. Social Security and Immigration Reform are prerequisite to reforming many aspects of overall health care.

The President and Congress should abandon their partisan quest for Universal Health Care Reform and shift to a bipartisan, incremental strategy whereby some areas of health care could be taken up immediately and others would necessarily be deferred pending enactment of Social Security and Immigration Reform.

Some health care issues that could be addressed by the President and Congress, concurrent with working through Social Security and Immigration Reform, include, but are not limited to, tort reform to lower malpractice cost; a free market environment for health insurance companies to sell policies in any of the states; portability for keeping an insurance policy when changing jobs; individual tax breaks for health insurance costs similar to those available to businesses; elimination of benefit caps and policy cancellation because of large claims; and banning the denial of coverage because of pre-existing conditions (which is already law in Colorado and some other states).

Under ObamaCare, Medicare and Medicaid are slated to be modified to accommodate the over all restructuring our our health care system. But rather than repair Medicare and Medicaid, they should be replaced—phased out of existence in favor of transitioning to insurance coverage in the private sector. The Medicare Advantage program—administered by insurance companies—is a good first step in that direction.

A major criticism of Medicaid is that not all people without insurance are eligible for Medicaid and that the program’s escalating costs are increasing the financial burden on taxpayers at both the federal and state levels. Dealing with the issue is best left to the states, insurance industry and medical profession.

The main problem plaguing Medicare is that most people at age 65 drop their private insurance and enroll in lower-cost Medicare. Insurance companies profit greatly when a person pays into one of their programs for years and years and files only a few small claims, then drops out before claims increase in frequency and cost due to deteriorating health in advancing age. Medicare, on the other hand, “inherits” those same ageing people who will require considerably more health care in the closing years of life. The result for Medicare: more money is going out to pay health care benefits than is coming in through payroll withholding (“premiums”). Consequently, Medicare, as presently structured, faces inevitable bankruptcy. On the other hand, insurance companies that provide the best coverage and cost to policy holders are thriving!

Today’s health care system must be modernized to better provide for long-term care for the elderly, the disabled, the temporarily unemployed, and the uninsured.

Both Medicare and Medicaid fall short of meeting the nation’s medical needs, and are neither self-funding nor sustainable through continuation of present-level government subsidies. There is a foundational argument as well: the very existence of such Federal health programs is not enumerated to the Federal Government by the Constitution. All powers not enumerated are reserved for the states. And the predominant preference of the states over decades and decades is for health care insurance provided by non-government companies and not government.

As history has glaringly demonstrated, the future of today’s government-run health care and retirement programs is doomed to failure because they are inadequate and unsustainable. Private sector insurance companies, operating in a competitive, lower-cost free market without undue government intervention, would best be positioned to meet our nation’s retirement and health care needs.

But the cart cannot go before the horse: the problems with many major aspects of health care cannot be adequately addressed without first dealing with retirement and immigration. If I may mix metaphors, it is foolish to build a house upon the sand. Today’s Social Security and immigration programs form an unstable foundation that cannot sustain the weight of the building of the kind of health care system our country needs.