and the
Citizens Economic Research Foundation

Barbara's Column

Stop all the arguing and embrace 'Oh!BarbaraCare'
by Barbara Anderson

The Salem News
Wednesday, September 16, 2009

Now that I have watched the latest televised presentation by the president on ObamaCare (the one in which he lied), and studied research and suggestions from various organizations and columnists, I am ready to present my "Oh!BarbaraCare" plan.

I realize that I'm no more qualified to have my own health care plan than most citizens. But all citizens of a representative democracy should acquire enough solid information so they can guide their representatives on vital issues. So if you don't like my plan, feel free and competent enough to do your own.

We must first use our rational faculties to challenge assumptions before we begin offering solutions.

Assumption One: All of us are entitled to health care.

Question: At whose expense? We can't be entitled to something that someone else must be forced to provide. Aside from the payments, what if no one wants to be a doctor or a nurse?

Yet: We as a society have decided that we want all Americans (and legal immigrants) to have at least basic and emergency health care. To ensure this, we must be careful not to discourage providers and hospitals by paying them less than the service is worth to them.

Assumption Two: The U.S. health care system is broken.

Reality: The U.S. health care system is the best and the most effective in the world.

However: There are some problems, and it does need to be reformed.

Assumption Three: The U.S. health care system is too expensive.

Consumers, define "too expensive." How much is it worth it to you to be healthy?

However: It's reasonable to assume that health care could cost less if waste, fraud and inefficiency were addressed.

Anyway, President Obama says that HisCare will be funded by addressing these things, so that the cost doesn't add to the deficit.

Oh!BarbaraCare says, address those things now with existing government programs, before adding even more people to a wasteful system. Let's get those legitimate savings, then proceed to address the real problems, which are:

1.) Cost. Some low-income people, not eligible for Medicaid, and many small businesses, really can't afford expensive health insurance.

Oh!BarbaraCare would continue and expand the programs that subsidize basic insurance for the poor. For all of us, the focus should be on insurance for catastrophic health events, requiring almost everyone to pay reasonable deductibles and co-pays (see "not entitled," above).

One big change here: Oh!BarbaraCare would not use business to provide insurance. Business provides the jobs that allow us to afford life's basics. Let's encourage more job creation, not additional expenses that hurt that basic business mission.

If we consumers own our own health insurance, as we own our automobile insurance, then we keep it even if we lose our jobs. Also, our unemployment is less likely if the government doesn't burden businesses with mandated expenses.

There should be tax breaks for buying basic insurance and for health savings accounts, paid for by no longer allowing tax breaks for business-supplied health insurance. Since the latter includes Cadillac plans for executives and unions, the savings should be substantial.

We should be able to choose from many health insurance companies across the nation to maximize competition. And, we should be able to organize in our own groups small business, baseball fans, redheads to allow for economy of scale, just as seniors do for AARP services.

Another way to cut costs is to address malpractice insurance paying patients for avoidable mistakes and clear negligence, but not for the assumption that we are all entitled to every test. And for truly frivolous suits, the loser should pay all court costs.

2.) Pre-existing conditions. Clearly, if insurance companies must cover all pre-existing conditions, then no one would buy insurance until he was sick! No one would pay into the system until it was time for him to take out of the system.

So the only way to cover pre-existing conditions is to mandate that everyone get insurance and that there are companies for everyone to choose from.

When we own our own policies, with Oh!BarbaraCare, anyone who has been paying all along for health insurance will be covered, at the level they originally chose, when they get sick, even if for some reason they have changed policies.

For those who make a case that it is unconstitutional to force citizens to get insurance, Oh!BarbaraCare would allow them to opt out of this requirement if they sign a statement that they will not expect the system to pay for their care. They can self-insure, or when necessary, roll over and die. However, compassionate Oh!BarbaraCare would provide hospice care to make the end easier for them.

Which takes us to the controversial ...

3.) End-of-life counseling. It's true that extraordinary costs accrue during the final months of some patients' lives, when they are kept alive with extraordinary efforts.

Oh!BarbaraCare would advocate living wills and more choice for patients who want to leave peacefully on their own terms. Death is natural, we should learn to accept and embrace it when the time comes.

However, Oh!BarbaraCare would provide legal assistance to elderly patients who were being pressured by family or providers, rather than counseled.

So there it is. Of course, I'm always open to bipartisan negotiation with anyone who doesn't lie.

The comments made and opinions expressed in her columns are those of Barbara Anderson
and do not necessarily reflect those of Citizens for Limited Taxation.

Barbara Anderson is executive director of Citizens for Limited Taxation. Her column appears weekly in the Salem News and other Eagle Tribune newspapers; bi-weekly in the Tinytown Gazette; and occasionally in the Lowell Sun, Providence (RI) Journal and other newspapers.