schip

http://www.nytimes.com/2007/08/03/washington/03health.html?ei=5090&en=2c6c76f39501d11d&ex=1343793600&adxnnl=1&partner=rssuserland&emc=rss&adxnnlx=1186776018-B9FHEkEu76D5Z/RW8u8Pzg

Missed this one last week. Feel compelled to come back to it. I'm not sure what the hubbub has been about regarding universal health care coverage. But since they seem resigned to force it upon us, or die trying here's the nuts and bolts of a program they have running. SCHIP is sort of a Medicare off shoot designed to insure children. As with Medicare, it maintains a relatively efficient process, but rapidly escalating costs. Hatch (R) maintained that insuring these children was worth every penny. That may be, but it's a lot more than pennies we're paying for it. Something always disregarded in these efforts to pass UHC is that there is cost associated with it. Someone is paying for it, even if no bill is sent to your home or private insurance company. That someone is the American taxpayers.

We are told the error of reason that we tax the rich for this. But I work every day with people who want to be rich, in one form or another. I can tell that people in America will want to be rich, if they know how and are willing to work for it. The reward for this conquest of economics is not adulation, but penalty. So part of my work, as any decent financial planner work involves, is finding ways that money can be made and later spent and enjoyed without earning taxes. As a result, anyone with a decent accountant or a sound financial plan (not just a place to put money into, cohesive planning is far more intense than that) can pay less in taxes (percentage wise over a lifetime) than a working class stiff does. It's not wrong, because everything is perfectly legal. But it's probably annoying and possibly even strangely unfair. Because people who are working class tend to do what they're told, and what we're told as a general public doesn't quite work in reality. In fact it often fails miserably. People with money or education learn this and act accordingly. Most people have neither.

Back to UHC then. If its taxed and we pay for it. Then we should know the bill. If we take a percentage of our income taxes as the percentage of the overall budget, then we could if we choose conclude that we are paying a certain amount of some hundreds or thousands per year in medical expenses. What people have failed to note is that regardless of whether the government or the private insurance company foots the bill, the costs are rising steadily. And while those costs are rising, Americans are becoming rapidly less healthy. I've yet to see any manner in which UHC addresses this paradox. In fact, I suspect it might even do the opposite of its intentions, though we would see some spikes in costs up and down over the next few years if it's adopted en mass. What I'd like to see is something less drastic and draconian than government insurance programs, replaced instead with a tidbit laced into the story. "federal excise tax on cigarettes would rise to $1 a pack under the Senate bill and to 84 cents a pack under the House measure, from 39 cents a pack.". I'm not a connoisseur of cigarettes, but $.39 doesn't sound like a harsh percentage. Even $1 is what? 50% of cheap cigarettes? Talk to me again when you reach 100%, and throw in a beer (booze in general, but beer is the dark master of health problems in the poor) tax, a pot tax (after they somehow become legally regulated), and a junk food tax (which is paradoxically cheaper than real food). Then you'd either see a drastic increase in available funds (which is probably bad given the spend! spend! spend! environment) or a drastic decrease in waistlines and health costs. Either way, we as a society win something, nothing is banned or forbidden, but the choices become harsher realities.

Right now, I'm not convinced this insure everyone magic (hello snake oil) is going to make us a stronger healthier nation. Which is really the point of practicing medicinal arts anyway. Make people healthier and generally happier with their state of being. I'm certainly not going to be happier paying to subsidize someone else's lung cancer or angioplasty. In fact I'm going to be pretty pissed off about it because it's generally their screwy choices that landed them in that predicament.

I'm also rather annoyed that a veto on it becomes a political issue, not because of the overall issue, but because it's painted as not caring about the children. Who cares about the children? It is the entire country we are meant to govern. And if they're all acting like spoiled brats who want everything handed to them, then they haven't learned anything important at all from their own childhoods. That's not my problem yet, but it's getting to be pretty annoying. To reverse the argument slightly, I'm rather perturbed this 'genius' in the White House is only now figuring out that spending our money on ineffective programs isn't the way to govern. NCLB, various war or military grants, arts, etc. And now it comes back to the children. A hard truth is that Americans are suckers for their kids. And we when we hear that our government isn't willing to take care of them, somehow this is bad news. Except that we as parents or even as a society are supposed to take care of the kids first. Skipped a step there didn't we. Must be that wonderful education government's been giving away for free.