How Should We Pay For Health Care In the U.S.?

The national debate continues to be a contentious one regarding just how we will pay for universal health care.  What seems clear is that at current costs, it will be virtually impossible to come up with a workable plan.  So, let’s just assume that we have figured out how to trim costs appreciably (you might want to check out my plan as discussed in previous entries, including the last one, June 24, 2009) and we are ready to implement the plan whatever it might be.  Who will pay for their health care?  The answer is clear- all people with sufficient income to cover the costs.  These people will by necessity be required to cover their own costs and also those of people who are unfortunate enough not to be able to cover the costs.  Who can’t afford to cover their own (and, perhaps other family members as well) health care costs?  The answer is that more or less, it’s the same people who now can’t pay for their health care by virtue of low income or, perhaps, no income, with one big exception- people who now would purchase health insurance if they could but at current costs, they can’t afford it.  Thus, if we can lower costs appreciably, the individual who does not have health insurance coverage through his employer, may be able to afford it.  At any rate, the burden for providing health care coverage to all will fall on those who can pay.  That’s just how it is.

Payment options

So, now I hope it’s  clear that the collective “we” will be paying for our health care.  There are only so many ways to come up with the bucks to pay the bills.  Let me list the ways:

1. Payroll tax for employers and employees

2. National consumption tax (a sales tax)

3. Higher income taxes

I can’t think of any other ways to pay for universal health care.  None of the ways are likely to be very appealing to very many people, but what else can we do?  My libertarian friends tell me that we should just drop all government and employer involvement in health care and let the market “do it all.”   Their hypothesis is that if we just “let go,” the market will “re-equilibrate” with dramatically lower costs for all.  Sure thing.

Right now what I see is that all the major players (e.g., Congress, President Obama’s team, the health care industry) are working around the edges with this proposal and that proposal to trim health care costs.  None of them really address the rather fundamental need for a real plan as to how we will pay for what we supposedly want which is universal health care.  I’m not optimistic that we yet have the political will to what we need to do to get where we want to go.  Too bad since the destination is a very nice place indeed.

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