Thursday, June 28, 2007

Bush Goes Health Care Rough Riding

I can always count on President Bush to deliver a good bed time story. His talk from the Roosevelt Room almost inspired an afternoon nap but my adrenaline soared while belly laughing at his assertions.

First, President Bush called S-CHIP government run health care. If other states are like Texas then private health insurers are the government, because they're the ones providing the health insurance. Texas CHIP contracts with AmeriGroup amongst other private insurance companies for coverage. This is the same company concerned about Michael Moore's new movie, Sicko.

Second, for a party that wants to "leave no child behind", Republicans made remarkably little progress in reducing the total number of uninsured kids since Bush I left office. In 1992 8.4 million children had no health insurance. Thirteen years later the number stood at 8.3 million. You do the math.

Third, the number of uninsured grew to 47 million on Bush Junior's shift. It would've been higher but for several Census Bureau "calculation adjustments". The President expects the less than 2% of Americans with a health savings account to change market behavior. Past studies showed managed care had to reach a significant portion of a doctor's practice to change medical care patterns. One and a half percent isn't anywhere close to the 40-50% benchmark.

Fourth, Bush plans to press the levers of supply and demand while our nation experiences a doctor shortage. While priming the pump to increase supply in oil and gas, Bush healthcare does nothing to increase physician supply. How amenable will those busy physicians be to negotiating price with patients by phone?

Fifth, the tax deduction/credit is a slick way of allowing employers to dump that pesky health insurance benefit to the employee. That's you! Watch out as CEO's look for the post outsourcing profit boost needed to drive up their incentive compensation. As for its impact on the legions of uninsureds, the President said it would only drop the number by 5 or 10%. This gets the number down to around 42 million, hit in Bush's second year in office.

Sixth, Republicans used a number of administrative procedures and requirements to toss people from government sponsored health insurance. These include citizen requirements, making the application process more burdensome, implementing premium sharing and raising co-payments. The state of Texas did such a thing years ago causing a drop of over 200,000 kids from the CHIP rolls.

Seventh, President Bush likes to hammer other countries' health care systems. Rationing occurs under every system, including the U.S. Republicans prefer it be done on the basis of monetary resources. However, they're adding outcomes to the mix. The predictable result is doctors will take care of rich, unsick patients first. Any excess capacity will go to the poor, unhealthy patients. Does that sound like the aim of a good healthcare system?

The Bush Health Care Plan is another stealth method to reduce the number of people on S-CHIP, Medicaid, and Medicare or at least reduce the rate of growth. It turns out both employers and the government hate paying for your health care. If they back out, who's left to foot the bill? Ask the 200,000 kids no longer on Texas CHIP...

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