Tuesday, January 23, 2007

What Bush Won’t Talk about Regarding Healthcare in His State of the Union Address

President Bush has a long history of proposing ghosts to address the legions of uninsured in America. His signature high deductible health plans paired with health savings accounts did little to cover the then 42 million people without health insurance. As the President touted his solution the number without coverage rose by 4.1 million. It would have been an ever greater 4.6 million people but the Census Bureau came through with a “formula change”. He won’t give any projections as to how rapid adoption of HDHP’s and HSA’s will stem the rising tide of uninsureds, now 46.3 million. Here’s what else he won’t mention as he touts the magic of supply and demand to solve the ills of the health care marketplace:

1) No word will come on how many OB/GYN’s who “practice their love with their patients” came out of retirement to fill spots in those 1,500 counties without an obstetrician.

2) Conspicuously absent will be the President’s lauded Patient Navigator program launched in 2005 to help patients get through the notoriously complex medical maze. This and America’s low health literacy rates work against the individual capacity needed for the average citizen to negotiate prices with insurance companies and health care providers.

3) As the President delivers his remarks about supply and demand, never mind that his crackerjack health care team is completely unaware of the medical market’s price inelasticity. That means providers can increase prices with virtually no reduction in demand. Triad Hospitals told the folks at Goldman Sachs about this in 2004 (see page 15 of their Investor Presentation). As many Goldman Sachs people serve in the Bush administration, it's surprising no one told the President’s health care advisors.

4) He’ll fail to mention that “modernization” of Medicare and Medicaid mean contracting out coverage to private health insurers with roughly double each program’s traditional administrative costs. The addition of premium sharing, higher deductibles and co-pays are projected to knock tens of thousands of poor people off the rolls. He will fail to mention how his home state of Texas knocked 200,000 kids off the CHIP rolls with such “updating”.

5) President Bush will not discuss the tens of thousands of U.S. citizens no longer on Medicare or Medicaid as they chose not to fight “to prove” their citizenship in order to continue receiving benefits after being dropped this past summer.

6) He might mention that businesses are bailing on their traditional health care commitments to their employees. What he won’t say is Bush "the cheerleader" stands on the sidelines egging them on.

7) The President will fail to mention his greasing the skids for Uncle Bucky’s WellPoint to raise premiums to match those new tax deductions of $7,500 for an individual and $15,000 for a family.

8) Mr. Bush may compare health insurance to home ownership but certainly won’t explain why the government can insure multi-million dollar vacation homes built on the coast while ignoring 46.3 million people. Are buildings more important than people?

With all this unsaid, the public might believe President Bush proposed something meaningful with his new tax deduction. However, I can assure you that it’s just another ruse. Both businesses and this administration are intent on dumping both health care and retirement costs on the individual. You might want to look behind you because something’s coming and I sure wouldn’t bend over…

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