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Tuesday, November 30, 2004

Pawlenty's health care plan

Governor Pawlenty is a consummate politician, no question about it. He is no slouch. So it's not really surprising that he just unveiled a new health care plan to try and control costs. Equally unsurprising is that it is essentially toothless. Saddening is that part of the plan would be nothing more than a giveaway to the wealthy.

This plan, in a nutshell, would band together the state and other large employers to exert market pressure on health care providers to lower costs and streamline things. As usual, savings will supposedly come from eliminating "fraud and waste," something we've supposed to have been doing for more than a decade now. This group would not have any real powers, though. While handing out smart cards to patients that contain their health insurance eligibility is a fine idea, that's not going to cut costs substantially. This plan is cautious and uninspired.

The worst part of the plan, however, is the push for medical savings accounts. MSAs are popular with Bush too, and it's not hard to see why: money put in these accounts is tax free, meaning more tax cuts and less revenue for government. Proponents say that this will allow more people to buy into health insurance, but the numbers don't bear this out. If you're a single adult laboring at a job that pays you too much to qualify for MN Care but has no benefits, you don't have any money to put into these savings accounts in the first place. To think that people who don't have insurance because they can't afford it are going to be able to afford (1) catastrophic health care coverage, even at low rates, and (2) contributions to medical savings accounts to pay for routine doctor visits is crazy. If these people wanted catastrophic coverage now they would get it! Of course, for people who are making lots of money and are simply looking for a place to stash cash tax-free, then this is a great idea. No wonder Republicans support this.

It's time to stop beating around the bush. Banding together health care consumers is not a bad idea, but why not take it to its logical conclusion? Why not band together every resident of the state, say, and have a representative of those people negotiate health care coverage? It just so happens that we have a representative body already in place: the legislature. Right now, we have a system that rations health care, prevents people from choosing their doctors, allows bureaucrats to make medical decisions, and costs a bunch in administration. Universal health care, according to its detractors, would ration health care, prevent people from choosing their doctors, and allow bureaucrats to make medical decisions. In other words, it's the same system we have now, only cheaper. If anybody can explain to me why that wouldn't be an improvement, I'd like to hear it. And that's just the worst-case scenario. Lots of countries have proven that this can be done. When will the U.S. jump on board?

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