Something Better

When it comes to healthcare, my stock answer is “I don’t know the answer”. In this post, I will ponder what I do not know.

A signature campaign pledge of President Trump was to replace our current healthcare system with an undefined “Something Better”. There were no specifics for the plan, just that it would be “Something Better”. Hmmm.

Who doesn’t like a good mystery? What will it be? Let’s just say Obamacare was a riff off of Romneycare. There is a very good argument for that. So the probability is President Trump will just use a modification of something existing. The first try at replacement was Republicancare, and that flopped by a single vote, or so they would have us believe. I think it was by design. So the president will have to go with something different. Hillary Clinton has spent lots of time working on healthcare. She is a popular self-proclaimed expert in the field. I wonder how her system would work. Politicians are not above snatching each other’s ideas.

To figure out what Hillarycare would be like, I turned to look at Haiti. During the campaign Hillary touted the wonderful job her foundation had done in Haiti, a claim that included Haitian healthcare. So I poked around to see what Hillary’s Haitian Healthcare plan was really like. Much to my surprise I found what was pretty much a free market solution. I will explain.

Healthcare workers are independent operators, they wander the land on regular routes. On their heads they carry a basket of pills, and a pair of scissors. I have seen pictures of the baskets. They have all sorts of pills, from antibiotics to Viagra. Customers request pills for their symptoms, the provider then cuts the required pills from the packaging with the scissors. The healthcare providers get their pills from a few wholesalers. The wholesalers have government connections get expired medication, which is typically still good because we have artificially low expiration dates. The wholesalers also have generic and knockoff medications from various sources. A simple and effective system.

Somehow I don’t think that a system that depends on expired medication would work in this country, who would we buy expired medication from?

Bernie Sanders promised a healthcare proposal after the summer break, this should be interesting. Many people believe that Bernie would be president, if Hillary was not so crooked. Myself, I have not seen conclusive polling evidence showing that to be the case, but I will say that Bernie has huge support, and is the most popular senator. So I would be very curious to see it.

By my guessing, we spend over two trillion a year on healthcare. If we took all the money from the Fortune 500 worlds wealthiest people, their money would run out within one presidential election cycle. Bernie was prepared for that, he wants a ten percent payroll tax also. Still not enough. Bernie also wants to equalize payroll taxes and capital gains taxes. As I go into retirement, more of my income would come from capital gains. However I do agree that there should be equal tax rates for capital gains and income. Give Bernie a point.

From what I understand there is massive unfunded union healthcare promises for many municipalities. I have had unionized friends in the hospital, I believed that they had many unnecessary procedures before they died. This runs up unionized costs. Unnecessary procedures probably happen to any people that have good insurance. I have no idea how many procedures are just revenue producing. I am also sure that many people have procedures that are not paid for. Probably how the hospitals balance their books.

Another cost is lawsuits, malpractice insurance is astronomical, that also gets added to the bill. Then of course the insurance companies get a rather large cut of the pie. Do not forget the pharmaceutical industry too. They make a lot of money too.

I listen to NPR tell stories about some poor hard luck person that gets Medicaid, it turns his life around. At the end he or she says that everyone should have Medicaid. That is tough to hear for some poor hardworking person that pays $10,000 a year for substandard health insurance. You wonder where people choose not to have insurance, or even not work.

I, like many others get their insurance through their employers. I would be absolutely panic stricken if I lost my job. There is a certain amount of logic to that. It keeps America working. We would be a bit lazier as a society if some of us did not have to work for our insurance.

Funny, how the government privatised the space program because it would be more efficient. Now they want to nationalize the healthcare industry? Hmmm.

Really, it would take something like a twenty percent national income or sales tax to have free healthcare. Since we have a representative system of government we can not just vote up or down on a proposal. Instead we have elected representatives to make the decision for us. There would be benefits and drawbacks to single payer. As I said before I do not know the answer.

President Trump has promised something better. That being said there are two things that I do believe. First is that he is brutally honest, and people do not like that. I however respect him for it. Second is he became president owing no one. Personally, I think he will make the deal with Bernie.



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