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Title: Blog by Novelist William S. Frankl, MD

The Senate Healthcare Follies

I predict future happiness for Americans if they can prevent the  government from wasting the labors of the people under the pretense of taking care of them. – Thomas Jefferson

The senators are beginning a contentious debate over the Senate’s 2074 page Healthcare bill. It’s a terrible bill. Let me tell you why.
Healthcare in the United States is the best in the world. But it suffers from many inefficiencies. Therefore, it is expensive. However, this 2074 page Senate bill, as well as the 2014 page House bill, expands these inefficiencies enormously by adding hundreds of new provisions, regulations, mandates, committees, and other bureaucratic inventions. There are 118 new boards, commissions, and programs. All of these produce an overregulated, overbureaucratized, arbitrary, and inefficient system.
There are mandates with financial penalties, even jail time. Insurance companies are told exactly what to charge and are mandated to increase the premiums of the young to 50% of the premiums of the over 60 population. There are sliding scales for health insurance subsidies that will radically raise marginal income-tax rates for middle-class recipients.
The bill cannot be fixed. It cannot even survive on life support. It, and the House bill, should be junked, and both houses of Congress need to start all over again and do it right, one reform at a time, each simple, each aimed at reducing complexity, arbitrariness, and inefficiency. So, how can this be done?
First, tort reform. $500 billion per decade is wasted by exorbitant legal fees, and unnecessary tests, procedures, and referrals done merely to prevent law suits.
Second, abolish the prohibition against buying health insurance across state boundaries. Some states have very few health insurers and the rates are high. So why not promote Interstate competition? And this would eliminate the need for a public option that the Democratic Party wants as the first step to a single payer system.
Third, tax employer-provided health insurance. It creates a $250 billion annual loss of federal revenues. But, the unions oppose this and the Democrats cave in. However, these monies could insure the uninsured with plenty left over.
It would take 20 or 30 pages, not 2000, to write the bill containing the provisions outlined above. And it wouldn’t wreck both the United States health system and the United States Treasury. So, here is my Christmas wish list for Congress: Throw out the current bills. Develop a bipartisan approach to health care policy. And wake up the Democrats from their dream of controlling the health care system before that dream turns into a nightmare for the United States.

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