Health CareMany argue that the number of
Americans without health insurance (46 - 48 million depending on your source) includes 8-11 million illegal aliens. They continue to argue that dealing with illegal aliens is the key because they are driving up the cost of health insurance. My question is: what about the other 35 to 37 million (legal)
Americans without insurance? That's still roughly 10% of the U.S. population. Could it be true that illegal aliens that make up about 3% to 4% of the population are driving the majority of the cost? I doubt it. There's also the issue of the value of the insurance that many of us have. I, personally, have always been blessed to have a job that provides health insurance. However, recently, I've been denied coverage when purchasing a prescription drug. Even though I had a valid prescription, I was told I had to call my doctor. Now, this wasn't for some exotic drug for which the
Pharmacist might be concerned about drug interactions. This was for basic asthma medication (and I don't take other medications). Interestingly, it happened to be a very expensive medication - for which I'm only responsible for a modest co-pay. My guess is that this was obfuscation on the part of the insurance company. If they put enough obstacles and delays in your path, then they just might save some money. Which is exactly what happened, because as it turned out, I walked away that day with my asthma medicine - after I set
aside the insurance obstacles and paid FULL PRICE!!! I've discovered other examples of this after talking with some of my friends. (Perhaps I'll share that on another post).
Our health care industry (and especially the health insurance industry) needs serious reform.
Too much cost and energy is spent on denying you coverage. There are no incentives for the promotion of good health.
Notwithstanding all the above, I'm not an exactly a proponent of government managed plans. I've worked on government contracts in the past. My experience is that the government is slow, bloated, complex, and largely ineffective.
So what's the answer? The "free market" isn't working. And, neither would a government program.
I believe the answer should be government regulation (not necessarily ownership) of health care cost structures combined with tort reform in the area of health care. Some will argue that regluation of cost doesn't work for medicare. I reply that it's because doctors can simply refuse to see medicare patients. Regarding tort reform, I believe the nation needs to make a choice. Should we continue to allow our doctors to be sued for every minor error? Currently, a large portion of the cost of beging a doctor consists of malpractice insurance (yep, insurance again!!!). Some specialties pay seven figures per year! I believe that there needs to be more regulation as to when patients can sue, and how much redress is avialable.
There is much about our system that is good. We currently have the best care available. And it needs to be
accessible and affordable to ALL.
Now, the other lion in the room with me is roaring. She is much more of a proponent of
socialized medicine. She has less faith in the "free market" and she has reason to be concerned. She feels that this sector has become purely profit-driven, corrupted and needs a major cleansing! Of course physicians, insurance companies and the pharmaceutical industry want to make a profit, but at what cost to the health and well-being of roughly 10% of hard-working citizens?I never want to enter a hospital or physician's office again and be asked first and foremost about means to pay. What about the
hippocratic oath?!!! We are the only "rich"nation that puts profit above people. I argue that its possible to make a profit while at the same time procure high-quality care for all of our citizens. The argument is often made that socialized medicine equals buraucratic bloat and patients long-waiting for rationed care but
in actuality, treatment is immediate to those in dire need and preventative care saves countless lives. We can be a capitalist nation with compassion. We have definately gone too far in deregulation. The other extreme, socialism, is wrong as well for a country as broad and diverse as the United States, but we need a safety net for an issue common to all: health. Those who have the means will continue to be able to have a choice, but I believe that its the government's responsibility to lift those who have no choice, lest we become a nation of darwinists. This election is key to deciding if, in the future, we will be a nation of liberty for the priviledged or liberty for all. For how can one have true liberty without having one's health?!
There is no easy answer to this one, but it's time to stop procrastinating on solving the problem. I believe we should hand the entire problem to the doctors. Doctors are probably the only ones that can draft regulations for insurance companies to make insurance affordable for everyone. Insurance is about managing and accomodating risk. Doctors are the only ones that truely understand health-related risks. A government oversight pannel lead by doctors (with subordinate insurance industry participation) would probably be a good start. Let's keep the ambulance chasing attorneys out.
EducationI wish that some
constitutional scholar would read this and provide a comment that explains how the U.S. Department of Education is constitutional. From my reading of our
Constitution, the powers of the federal government are enumerated - the others are delegated to the States. I don't see where they include the power to regulate education!
I believe that education should be a State issue. Let's let our states decide how we should educate our children. What's good for California may not be good for Iowa. Probably not! The cultures are simply different. Now
Americans are free to move about as they like, so let's let them choose how and where their kids are taught.
However, I must mention that if I were in a school district that was teaching purely creationism, I'd move. That district would lose my tax revenue. Those that couldn't move would file a petition to send their kid to a different school.
I also believe that teachers should be paid according to how they perform - like the rest of us. Now, I understand why tenure was created. Teachers should not be able to be fired because of school administration politics. However, they should be able to be fired by their students!!!! If the students aren't learning, then the teacher must not be teaching. A good teacher knows how to deal with uninvolved parents,
discipline in the class room, and the other challenges of teaching. I think a "three strikes and you're out" policy would work pretty well.
However, we must
pay our teachers fairly. If we get rid of the U.S. Department of Education, we can redirect those dollars for that purpose
TaxesThis is an easy one. We need a flat (or
minimally gradated)
tax rate system. Personally, I believe in the concept of "
Noblesse Oblige". Those that make more should pay slightly more; not to the point of punishment for success. I also believe we should remove ALL deductions- including mortgage interest.
Heresy? I think not. In a flat tax system, most middle class wage earners would pay less (even after mortgage interest deductions). Many argue that such a system would remove the incentive for home ownership. Seriously? Property ownership has been desireable since the concept came into existence. I doubt removing a tax dedution would eradicate that desire!
Flat tax rates. No deductions or exemptions. Simple.
I suggest the following as a starting point:
Income Tax Rate$1 - $10,000 3%
$10,000 - $35,000 10%
$35,000 - $150,000 18%
$150,000 - $500,000 22%
$500,000+ 25%
Affordable?
Foreign PolicyThis is a hard one. I'll limit this to a disucssion of Iraq or I'll be blogging on this topic for months. How should one define "success" in Iraq. Can we expect democracy in a place that will NEVER accept the concept of the separation of church and state. If you don't believe this, please read the Koran. I believe the correct answere is: no, we cannot expect it. So, where does that leave us?
I think all we can do is try to contain islamic extremism
in the area. To accomplish this we need to reduce our dependency to be involved
in the area. Oil. Let's start with
T. Boone Pickens' plan. This will allow us to pursue policies of containment (which we know well from the cold war) and it will reduce our enemies source of power - oil money.
DefenseThe old saying is (attributed to President Washington, I believe): "The most assured way of preserving peace is to be prepared to wage war." I think that's right. We simply need to match our military spending to our current and near term threats. We currently enjoy a VAST technological superiority in our weapon systems. That superiority was attained largely in response to the Soviet threat. We now have a very different threat and we need to pursue policies that will
redirect our defense industry to defend against it. Do we really need another "stealth fighter" to address today's threat? Can we win a war against terrorism (or any war) from the air? One could ask if piloted war planes are obelete. Or, would it be better to secure our infrastructure and information networks? Defending against terrorism, in all it's forms, should be our current priority.
