That's the big question. What is this all going to cost? Ultimately this is going to effect the entire country, in more than one way. Will it improve our lives or become detrimental? Which party is going to benefit from all this? Will it help to create jobs or will it continue to add to unemployment and reduced hours? Will it be available to people who need it the most? Will seniors carry the biggest financial burden? What about those who are unemployed? What about those who need to switch jobs? Will we be able to keep our doctors?
All good questions, and the answers aren't necessarily clear or easy. But the philosophical question is pretty simple - what part of the cost of health care should be borne by each of us as individuals, and what part should be borne by the general community? How do you answer that question, LB, especially in the context of the reality that we all consume different amounts of health care, and those of who've been unlucky in life's lottery consume disproportionate amounts?
If you're an advocate of single payer, the reality of disparate health care consumption, cutting across class lines, requires that the burden be shared by all by means of general taxation.
If you're an advocate of the status quo, you place the burden mostly on employers, who'd rather use those dollars to expand production of whatever it is they make or do.
If you're INVAR, everything's a commie redistributionist plot and the only option for the unfortunate is to pray to God.
The approach taken by the House bill is to stabilize insurance markets by carving our the sickest and taking them out of the general risk pool, thereby allowing insurers to lower rates and offer more choices to the rest of us. Then address the sickest by means of general taxation, spreading the burden among us all - as I believe it should be.
To me, that's an acceptable compromise. We should as a community address the sickest among us, and share the burden of their care. It is morally wrong to require certain folks to bear the burden (in ObamaCare's case, by forcing young folks unlucky enough to be stuck in the individual insurance market to subsidize care for the sickest.)
As an analogy, think of the Philadelphia tax on soda and sugary drinks. It was passed with the justification that revenues from the tax would fund universal pre-K. But if universal pre-K is such a laudable goal, shouldn't we all be paying for it, not just those who drink soda? By what moral calculus are soda drinkers, and soda drinkers alone, handed that burden? Same thing with health care - if 5% of the population drives 50% of the spend, then shouldn't that burden be apportioned fairly and broadly, rather than imposed on young kids who still don't have good jobs with benefits?
The House bill's risk-pools idea is sound as a pound - so long as it is adequately funded. My expectation is that the Senate will buy into the concept, but fund the pools to the extent needed to truly succeed - and by succeed I mean not only providing care for the sickest, but freeing insurance markets to offer real and fairly-priced choices for the rest of us.
