But yes, people, hear you me, I said "privilege." When Hancock and the Revolutionary Brethren signed the Declaration, they resoundingly stated the basic human rights of each citizen of this great country, which were later sought to be protected by the Constitution. And when the Civil Rights Act and subsequent rights acts were made law, they sought to reiterate that sentiment and clearly state that no citizen should be treated differently in the eyes of the government or law due to race, gender, disability, etc. Nowhere, however, does it state that people have to get drugs to heal their ailments. Why? Because that costs money, and the use of that service/product is for the use of the individual for his or his individual benefit. But defense costs money, right? And so do parks, and funding for the EPA and SEC, right? Yes, they do, but those expenditures are for the public good. Defense keeps our citizens safe, parks are for the enjoyment and use of all citizens, the EPA protects our environment and its organisms to protect the livelihood and well-being of all citizens, and the SEC monitors the capital markets so that all citizens have the security to invest in a (supposedly) even playing field for the protection of and creation of wealth. Whereas no one benefits if I am able to get antibiotics for my ear infection. Except me. And people can make do in their lives without pharmaceuticals. Today's Americans may deny it, but there was life before Pfizer. Viagra is not essential to anyone's survival or the survival of our species. Thus, privilege.
Yet I feel that our society is in a state in its life cycle that national healthcare should be a recognizable goal. We are a mature economy, with a national defense and education system and the resources to provide healthcare. We should find a way, and I feel there are viable means to providing healthcare to the masses.
However, I truly fear our sense of entitlement as a society. Frivolous lawsuits, welfare abuse, unemployment fraud, tax evasion, egregious civil damages from the courts...it seems that Americans across all demographic strata feel that their personal needs are greater than all those around them. If you don't get your "fair share" (whatever that is), you will go to any length to make sure you get it. Your doctor messes up in the operating room? Used to be called "human error" and was a risk associated with getting an operation, is now called a "lawsuit." Your kid disrupts class and the teachers reprimand him or try to remove his influence? Used to be called a "generally dislikable and unteachable student" but now the teachers are blamed for "discrimination" and they are no longer allowed to discipline. You crash your car into someone? Used to be called "your fault," now you're supposed to keep your mouth shut and let the insurance company's legal team try to prove it was the other driver's fault to have them pay for your repairs. Whatever happened to "mea culpa" and taking responsibility? What happened to everyone has an opportunity to excel, to pursue happiness, and thus we should lift each other up because helping one benefits all? I have seen no evidence of our nation's desire to better itself. People just expect higher wages, whether their skills have improved or not, more government handouts, and the means to have what their neighbors have, whether they have earned it or not.
Basically, I don't see this whole healthcare situation going well. Remember when Florida had hurricane problems and insurance companies were suffering losses? They fled Florida in droves and no one could get homeowners' insurance. The State had to step in and build an (expensive) insurance segment to backstop the policies and urge insurance companies to stay. Want to see what happens when insurance companies suffer massive losses from having to cover people with pre-existing conditions or poor personal health habits? China's not such a bad place for an executive to live. I'd move my whole operations over there and start insuring the billion people over there that my actuaries tell me are intelligent targets for insurance. To be honest, their GDP more closely resembles capitalism than ours at this point. Go there; come back and tell me it doesn't. And say I don't want to leave and go open up shop in China? I'll just threaten to do so until the U.S. government steps up and says it will guarantee my losses. That should work, since we know that massive corporations can pay monumental salaries to executives but still suffer losses so large that the government has to step in, and they receive barely a slap on the wrist. So why go into meltdown; just have the government guarantee you from the outset.
So you say "Well, insurance companies, bah, we live in a capitalist economy, someone will step up and figure out how to securitize/hedge the risks and profit." Great. But what about malpractice insurance? How long until an overworked doctor (because we aren't going to have enough practitioners to handle the influx of patients) or an undertrained doctor (same story here) slips with the knife or doesn't diagnose properly and gets sued for some ungodly amount? Thanks to bus stop and late night television advertising, anyone can dial an 800 number and get a lawyer to sue the bejesus out of a doctor. They make a lot of money, right? They can afford to pay me when they mess up. Nevermind that they slaved away in high school, college, medical school, and a residency and amassed massive debts in order to get where they are. But I work eight hours a day, why don't I get paid that much money!? You didn't go to medical school and suffer through a residency, that's why. That sacrificed years of their lives to earn that salary and that position. So anyway, either we're going to have to pass legislation (more of it, you see, that's why our politicians have jobs, because we can't restrain ourselves or admit responsibility so someone else has to) putting caps on damages or backstop malpractice insurance. Or else eradicate lawyers more stringently based on frivolous lawsuits, which may provide a nice solution. If only the Bar would take a more aggressive stance on the issue.
Which leads me to another issue: student loans. Like I mentioned, a lot of doctors amass huge debt loads to get through school. So do lawyers, MBAs, and...well...just about everyone who does not have wealthy parents or are wildly successful teen entrepreneurs. Remember (back when I was in school) when you filled out an application, a bank reviewed it, and if it met its lending standards, the bank would loan you the money at really low interest rates? Well, those low rates were possible because the government was subsidizing (or guaranteeing, thus reducing the risk and therefore the necessary interest rate charges) your student loans. Guess what? The government screwed it up a few years ago; changed the whole system. Then, a couple months later admitted that they had screwed up. But instead of reverting back to the old, working model, they decided to put another new system in place. Not as good as the original, but workable, for now. A number of lenders fled the student loan market, but there were enough remaining to keep equilibrium. But now, this administration is proposing we shift all student loans to the federal government. Great, more risk, more cash outflows on the US balance sheet. Remember when the private lending sector overloaded on risky loans and put them on their balance sheets instead of allowing outside investors to purchase them to spread risk across the system and lessen its impact? I remember, because Lehman and Bear Stearns (who employed people far more intelligent and financially savvy than the US government) eventually collapsed under the stress on their balance sheets. Stress that could have been avoided had they not decided to keep everything to themselves. So now, instead of highly specialized institutions issuing loans to students and assuming some risk, we're going to have the government issuing all loans and taking on alllllll the risk. Sounds like genius. Remember over the past year how many times you've heard that "too big fail is *" (*insert expletive here)? Well, does that apply to our government as well? Who's going to bail it...I mean, US, out? Did you notice my double entendre there...us meaning the possessive we or the acronym for our nation?
Now, back to my original thought...I don't see this healthcare thing going well. So let's look past the issues I've raised thus far, ignore the hurdles to the actual realization of an efficient, workable system of nationalized healthcare. Let's instead focus on another sobering issue: the fiscal reality of it all.
This is where it gets interesting. So I keep hearing that the plan is going to cost $948B and reduce the deficit by $138B. And I understand that a lot of time and effort and calculation went into determining those figures. Good for the number crunchers in the Congressional Budget Office. I'm sure they're very talented and do a great job. One caveat...they only do what they're told. Here's the situation: you're supposed to look at a static situation, apply the inputs/assumptions and the specifics of the policy and discern the composite impact. Guess what? Don't know if you've noticed, but the economy is not static. Go ask one of the hundreds of quantitative hedge funds or regional commercial and mortgage banks that blew up over the past three years if the economy is static and they'll give you a very swift answer. So ask the CBO if they included the number of small businesses that would cut their employee health benefits plans, forcing their employees onto the government plans. With 9-10% unemployment and plenty of employable talent, I wouldn't care about providing health insurance to my employees. If you're replaceable, no insurance for you! Build that into your model, CBO, I dare you. Small businesses employ the majority of Americans. If they start shedding plans to save costs and offload them onto the government, guess how that changes the budget.
So, as you can see, all of my apprehension stems around cost. Unforeseen, unmitigable, unrealized risks associated with increased costs of the program. A good program? Maybe...time will tell. But a program that costs what they say it will and will - get this - decrease the deficit? Good luck.
Which brings me to the crux of my fears: our out of control government spending. Is government necessary? Absolutely. Should our country nationalize most major programs? Worthwhile debate. But should our government be digging holes that may lead to the country's firesale to Chinese, Japanese, and Middle Eastern debt holders in ten years' time? No. Like any good Chief Executive, his management team, and his trusty Board of Directors, our President, his Administration, and our Congress should be doing some serious cost-benefit analysis on ALL segments of the government and making the tough decisions. "Change" is not always for the good. We should not change simply for the sake of change, as we did with student loans and healthcare. We should be assessing the current state of our nation, and understand that we have a lot of issues to resolve and a lot of inefficiency to eliminate.
We need to fix our infrastructure. We need to reform our tax code and minimize the IRS but maximize tax revenues. We need to set up a solid carbon credit or other environmentally conscious method of capping emissions and pushing for cleaner production. We need to seek alternatives to foreign energy dependence. We need to aid our most vulnerable states in their financial crises. We need to stabilize the real estate markets by getting people jobs and encouraging rational spending and economic stimulation. We need to enact more precise regulatory measures on our financial markets to avoid corporate collapse and fraud. We need to do some soul-searching on education and determine why our system is lagging the other rising world powers. We need to revisit our political stance in foreign affairs and devise a strategy for dealing with international conflict more effectively.
What do all of these issues have in common? They are all issues facing our nation, but they are all issues that can save massive amounts of taxpayers' dollars and shrink our deficit....if solved correctly with implementable strategies. And then - THEN - we could put a comprehensive health care bill in front of our leaders, and they would evaluate it, revise it, and pass it with flying colors. I didn't see a lot of bitter feuding surrounding the validity of providing health care to our citizens. I saw a lot of feuding surrounding how we are going to pay for it. And that, in my estimation, is the key aspect here.
