It has been a busy couple of weeks here in the Capitol, what with the budget, health care reform, the bond proposals, and everything, it has been hard to keep up. I thought I would let things settle down a little, and then comment.
First its time to give credit where credit is due. October, November and December were unusually warm throughout the country, and we were starting to read about how global warming was kicking in. Then, AB 32, California’s global warming solution came into effect on January 1, and within a week, California experiences a record cold snap. Good job, California government. I am sure that the country would not have experienced that cold snap without the hard work of our legislature. What is next? To paraphrase an old musical–"I know we made a law a year ago here. July and August mustn’t be too hot. And next, a legal limit to the snow here?" You finish the song. You’ll get the idea.
But what about health care? The Governor’s proposal is basically the old SB 2 on steroids. Remember SB 2. The Governor opposed SB 2, which was referended and defeated by the voters in 2004, saying that it was a job killer. He has now proposed SB 2, with kickers. SB 2 was a pay or play system which would require employers with 50 or more employees to buy a state mandated health plan or pay a tax. The Governor’s plan requires employers with 10 or more employees to pay the tax, or play with the insurance, and adds a tax on doctors and hospitals, adds illegal aliens into the mix, and creates a massive government bureaucracy to run it all. It was a bad idea when Senator Burton, the chief liberal opponent to Gray Davis, proposed it. It is a bad idea today.
So what is solution? Real simple. The problem in health care is not access, everyone who wants health care can find a place to get it. It is not quality. Our state and country have a health care system that is high quality and highly innovative, with high quality doctors and new therapies showing up every day. The problem is how is it paid for. Through a series of problematic decisions over the last 40-50 years, we have created a "third party payer" system, that is, someone other than the patient, either the government or the employer, pays for the health care. This has interfered with the doctor/patient relationship in a number of ways, and was created by the government, through tax laws and government financed health care for the poor. In addition, it doesn’t matter whether there are multiple third party payers or a single payer, a third party payer system will continue to fail, and ultimately kill one of the best medical systems in the world.
So how do you fix it? Three basic principles: (1) Restore the doctor/patient relationship by removing the tax incentives for third party payer (today, if I pay for my own health care it is with after-tax dollars, if my employer pays, it is with pre-tax dollars, and if I am self-employed, I’m just out of luck); (2) Remove mandates on insurance so that they can tailor health policies to meet the needs of the individual purchaser, and not the desires of the politicians in Sacramento (an eighteen year man has different needs that his elderly grandparents, and won’t buy a policy that is focused on his grandparents and not on him); and (3) Grant flexibility to Medi-Cal and Medicare recipients, so that they can tailor the government grants they get to fit their needs.
Government created the problem in health care. More government is not going to solve it, as the more liberal thinkers in Sacramento think it will. These simple principles would shrink government control over your health care and mine, restore the doctor/patient relationship, and expand the market choices, now available only to the rich, to the poor and middle class. However, since these proposals don’t make Sacramento politicians more important in your health care decisions, they are currently not being considered. Perhaps they should.
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