Thursday, October 25, 2012

Another Go on the Health Care Merry-Go-Round


I understand your position on health care. I don't understand how you reconcile what I see as the contradictions in the those conclusions.

You regard it as a moral outrage, or morally unacceptable, that millions of Americans lack insurance, or lack access to health care. I do not believe health insurance and health care are the same, but for convenience sake lets equate them.

You also believe, as do I, health care spending by the US government is unsustainable and its trajectory must change or the country will face severe fiscal difficulties.

Providing health insurance to those millions without it will result in higher health care spending by the US government, exacerbating the fiscal challenges the US government faces.

In order to meet the fiscal challenge health care spending is presenting, the government will limit access to health care by reducing payments to doctors and hospitals (the $716 billion Medicare reduction, for instance) will limit goods and services via IPAB, will tax consumers with gold-plated insurance, etc. All of these items limit coverage, or access. In order to accomplish your goal of expanding coverage you will limit coverage. If it is morally outrageous, or morally unacceptable to limit coverage, why do you support limiting coverage?

You agree health care spending by the US government is on an unsustainable trajectory. I would hope you also agree involvement by the US government in the health care market has increased substantially over the same period of time it's spending on health care has increased substantially and this unsustainable trajectory has occurred. Yet you are outraged that anyone suggests there is a causal connection between increased government involvement in the market and increased spending and maybe the way to alter the spending trajectory is to remove or diminish the government's role. You are unalterably opposed to any diminished involvement by the US government in health care spending.

So the way I look at your position: You want to expand coverage by limiting coverage. You want to reduce government spending by increasing government spending.


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