One Clinton administration official, now an economist at Emory University says that “KerryCare” will cost the American taxpayers an astounding $895 billion over the next decade.
And even at that cost the U.S could not guarantee that every citizen would get health insurance.
In his recent TV ad John Kerry says 43 million Americans currently don't have health insurance.
He quickly adds that "in the richest country" on Earth, health care "oughta be a right that we make accessible and affordable to all Americans."
For sure, everyone should get adequate healthcare. But who pays?
Kerry’s major campaign proposal raises the spectre of Hillary Clinton’s health program – which sought to provide similar blanket coverage – and was roundly rejected by Congress and public opinion.
Now Kerry plans to add another enormous amount of funding responsibility on American taxpayers and the federal budget.
Already, as the Baby Boomers begin to retire in the next decade, current health care obligations of the government are set to balloon.
In their bestselling book “The Coming Generational Storm: What You Need to Know about America's Economic Future,” Laurence J. Kotlikoff and Scott Burns say the U.S. had $45 trillion in unfunded obligations for Social Security and Medicaid/Medicare through 2030. Medicare obligations alone account for $38 trillion of the $45 trillion.
Since President Bush was elected in 2000, health insurance premiums have risen by almost 50 percent for employees, Kerry says. He is, of course, pledging to fix the problem.
The Massachusetts Democrat says he favors a health care plan that "reduces costs." He claims his plan will cut waste, greed, premiums and "cut Americans a break."
Here are some specifics, culled from a number of Kerry's health care-related speeches:
1. "A 25 percent tax credit for people ages 55 to 64 whose salaries fall below 300 percent of poverty.
Kerry's plan also calls for "expanding state-based programs to insure all children and millions of adults."
It will have the federal government "pick up the full cost of more than 20 million children enrolled in Medicaid," and in exchange, "states would have to expand eligibility for children’s coverage to 300 percent of poverty, as well as expand coverage for families up to 200 percent of poverty and for adults up to 100 percent of poverty."
Finally, Kerry says he'll push for "more affordable drugs" by allowing them to be imported from nations where they are cheaper – such as Canada – and by "eliminating waste, fraud, and abuse; enhancing disease management efforts; and making malpractice insurance more affordable."
Author and head of the conservative group Citizens United David N. Bossie, in a new book about Kerry, writes, ". . . There are several problems with Kerry's health care plan, not the least of which is cost."
"If John Kerry is elected president, Americans will spend hundreds of billions more in the form of taxes and other costs to fund his health care plan," Bossie says in "The Many Faces of John Kerry: Why This Massachusetts Liberal is Wrong For America."
Bossie cites a study by Kenneth Thorpe, a health care economics professor at Emory University and former Clinton administration official. Thorpe "found Kerry's plans would cost a whopping $895 billion over 10 years – and still would not cover all currently uninsured people," Bossie wrote.
By comparison, the Bush plan would cost about $91 billion over a decade on a plan that would bring health insurance coverage to about 2.1 million people.
James Capretta, who managed the Bush administration's health and education policy at the Office of Management and Budget until last month, told Scripps Howard News Service "the president plans to cut the federal budget deficit in half over the next five years, mostly through spending cuts."
Capretta, who resigned to become the Bush-Cheney re-election campaign's health policy advisor, went on to say the deficit cuts "would require reform in entitlement programs, such as Social Security and Medicare, as well as controls on domestic spending."
Essentially, the Bush plan, overall, relies on developing policies that lower the cost of health insurance and medical care. And, in passing the Medicare prescription drug bill – a law many conservatives and libertarians abhor – the administration did redeem itself somewhat by pushing for, and getting, Congress to sign off on Health Savings Accounts, which allow Americans to save tax-free funds they can use to buy health insurance or pay health care-related costs.
The competing plans represent "pretty stark differences," Robert D. Reischauer, president of the Urban Institute and former head of the Congressional Budget Office, told The Washington Post.
"Kerry is expansive and wants to preserve and strengthen the role government has played in the economic and social life of the republic, and Bush would like to scale back the role of government to the most basic services of protection of life and liberty and a safety net for those who really have no ability to care for themselves."
"Healthcare is the primary cause of increased government spending," writes Richard E. Ralston, executive director of Americans for Free Choice in Medicine, a non-partisan, free market-oriented think tank. "It confronts Americans with the greatest threat of increased government intrusion into their daily lives. Health care and politics are a toxic combination for a life and death issue."
In short, that means everyone pays for health care, in one form or another. How much they pay individually depends, by and large, on the political whims of today's policy – and lawmakers.
For his part, Kerry's plan is long on promises but lacks detailed specifics. At a quick glance, it appears as though any savings Kerry is promising consumers will ultimately have to be paid for by them in the form of taxes – many of the new taxes – since the money will come from federal government sources.
Kerry has said to pay for his plan he would eliminate the Bush tax cuts for the highest 2 percent of wage earners, but policy analysts have said that plan wouldn't raise enough money to pay for Kerry's ambitious programs.
"Everyone agrees with America's resources we have too many uninsured people," says a policy analysis at the Heritage Foundation, a conservative think tank in Washington, D.C. "But all Democrats really mean when they say, 'We need to address the uninsured,' is to have government pay for it," which is notoriously inefficient and expensive.
There are other problems with Kerry's approach, not the least of which it involves more government involvement.
Some experts have said that subsidizing employer-provided health insurance with tax breaks won't necessarily lower rates. In fact, they say, government guarantees of funding – such as taxpayer-funded college loans – actually cause prices to rise, because institutions and facilities on the receiving end know they will be paid.
And inevitably, these experts say, if the federal government is calling the shots there is likely to be a whole new range of regulations and red tape employers, employees and insurance companies will have to negotiate. That will mean higher costs for patients and providers alike.
Still, it remains an important issue. As in the case of Ralston, Thorpe also believes in the primacy of health care in this year's presidential matchup: "Health care is likely to be the key domestic policy issue of the 2004 presidential campaign," he told Scripps Howard News Service.
Joe Antos, a health policy expert for the American Enterprise Institute, told NewsMax.com Kerry's plan "spends a lot of money" but involves the federal government and could lead to a wealth of new restrictions.
"If the government says it will pay for all health care costs above $50,000, it's going to want to know how you got there," Antos said. "That means there will be a lot of people – auditors, examiners, and the like – looking over a company's [medical] expenses.
"That's a short step away from the government having an national price list," Antos said.
Regarding Kerry's lack of specifics, "details are minor things that you worry about if you get elected," Antos said with a chuckle. But overall, "he wants to spend a lot of money to cover a lot of people, and he makes no bones about it."
"To a lot of business people, [Kerry's plan] probably sounds really good," Antos said. "A lot of business owners might imagine, 'Well, this is going to give me some real relief.'"
However, he says, "if the government is taking over after a certain amount, nobody is going to be concerned about the kind of care those people are going to receive."
Though in many venues health care in the U.S. isn't stellar to begin with, Antos speculates "if no one has clear responsibility financially or any other way," patients who must now deal with government officials will likely become very frustrated very quickly.
"You have to remember, this is the government speaking," Antos said. "If they're going to be picking up the tab after a certain amount, they're going to want to know how they got to that point to begin with." That will "unleash an army of auditors, checkers and other bureaucrats," because Uncle Sam's first instinct "is not to believe
Antos says Americans "would like to see some improvements" in the nation's health care system, but the changes "cannot come all at once." The system is too large and too complex to do that.
"We might have to make big changes," he said, "but they should be done over time."
Some Republicans say the GOP has already gone too far in expanding the government's role in health care – even to the point of reinventing "HillaryCare," the pet name given by critics to a plan introduced by then – first lady Hillary Clinton, during her husband's first presidential term.
Detractors panned the plan as a massive version of socialized medicine that would eventually consume one seventh of the giant U.S. economy.
"In a late-night vote. . . the Republican congress managed to do what Hillary Clinton and Ted Kennedy tried to do ten years ago: take the next big step toward socialized medicine in America," Rep. Ron Paul, R-Texas, wrote July 1, 2003. "More specifically, Congress voted for a huge expansion of Medicare that enriches pharmaceutical companies, fleeces taxpayers with billions in new spending, and forces millions of seniors to accept inferior drug coverage."
"A better approach would utilize Medicare Medical Savings Accounts (MSAs) to provide flexibility and choice," Paul – himself a physician – wrote.
David Gratzer, writing for The Weekly Standard, says Kerry hasn't done much to "distinguish himself" on the issue of health care.
"Since the collapse of HillaryCare, Democrats have avoided sweeping initiatives. Kerry, thus, proposes small ideas, and a whole lot of them. Most notable about his effort, however, is the price tag," Gratzer says. "The basic problem with KerryCare is its impracticality."
Michael F. Cannon, director of Health Policy Studies at the libertarian think tank CATO Institute, said of Kerry's health care plans: "Americans should beware."
"Kerry's platform represents perhaps the greatest threat to health care and patient sovereignty since the Clinton health plan," he says.
Though the Massachusetts Democrat says his plan will reduce costs and improve access to health care and health coverage, Cannon said "his two-pronged health plan would have the opposite effects, for it would bring America several steps closer to a system of socialized medicine, with all the increased costs and rationing of care that follow."
Noting that Thorpe, a former Clinton administration health official, found Kerry's plan would cover millions of Americans, Cannon said they "may be disappointed with what they get."
Health Savings Accounts are one new way Americans can take more responsibility for providing for their own health coverage, and are supported by a number of policy experts and lawmakers – but not Kerry.
Ralston, of Americans for Free Choice in Medicine, says Kerry demonstrated his contempt for them recently in an interview on "Good Morning, America."
Kerry "decided to attack Health Savings Accounts (HSAs), the only redeeming feature of the horrible Medicare Prescription Drug bill that was signed into law a few months ago," Ralston wrote in Capitalism Magazine. "He indicated – with a sneer – that HSAs showed the Bush Administration only wanted to help 'people with money.' Senator Kerry said that, if elected, his policy would have the government provide health care to 'people with no money.'"
While Kerry wants more government, to fix health care and its related problems, Antos advocates less. He says curbing insurance and government-mandated regulations, along with limiting medical malpractice suits – in both scope and cost – would go far towards lowering the price tag for insurance.
"We need to do something about insurance regulation in this country," Antos said. "The only insurance that effectively is regulated and burdened with all sorts of mandates and so on is the kind of insurance that low income people buy."
Kerry's plan does attempt to fix high drug prices. Some analysts say that allowing Americans to purchase drugs abroad could help eliminate foreign price controls and reduce the cost of medicines, eventually, "through a more equitable international distribution of the costs of researching and developing new drugs," says Cannon.
However, it is U.S. companies that are doing most of the research and development for new, miracle drugs. A plan like Kerry’s could drive prices down to a point where it is no longer smart business to invent new medications.
Kerry's plan doesn’t address the chronically slow and expensive drug approval process, but it will try to bring generic versions of drugs to market more quickly. Of course, this paln presupposes that drug makers extend patents by manipulating generic drug approval, and could dis-incetivize firms to invent new medications if they feel they will not see a return on their research dollar.
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