Monday, June 1, 2009

Our long term fiscal health is knee deep in the health care crisis....

Economist Mark Thoma sends us over to Richard Green's blog post, Mark Zandi worries about the Long-term Fiscal Picture

The question, then, is what to do. Like others, I don't think Social Security is that worrisome, and that commentators who conflate Social Security with Medicare are basically trying to scare people in an intellectually dishonest way. For those of us who don't need to use our backs for our work, raising the retirement age a bit should be perfectly acceptable. For those of us who are lucky enough to earn more than the maximum on which social security is taxes, a rise in that maximum should also be perfectly acceptable.

It seems to me (and a lot of other people) that there are two big issues: the cost of health care and the inadequacy of tax revenue. The first point is especially thorny, and I should disclose two things: I support a single-payer option (it seems to me that private insurance creates loads of deadweight loss) and I am married to a primary care physician. I am not sure how to reduce health care costs in a politically acceptable manner, but I do know: (1) the current medical reimbursement system encourages procedures and does not encourage preventative care and (2)we have done a lousy job of coming to grips with end-of-life care issues. The second of these points will require a great deal of soul searching on the part of us all, and I don't particularly see a political "win-win" situation for dealing with it.

As for taxes, the issue is how to raise revenue without screwing up capital formation, which is necessary for growth. I should note that the tax code during the Clinton era seemed to work just fine. But as part of a grand bargain for putting the country on a sound fiscal footing, it might be worth revisiting some of the principles of the Hall-Rabushka Tax.

I've posted on this issue before... Remember its the health care crisis that is the long term drag on the budget...  and Obama is not the problem... underfunded government and a heath care crisis are...

Personally I oppose single payer health care--I believe market competition, with individuals given the opportunity to choose a public plan if that fits their needs is all we need to fix the health care crisis. The fact is limiting choice to for-profit insurance is how we got into the mess--we need real competition brought about by the far more efficient administration of medicare to the massive purchasing power the government brings.

Capitalism thrives on competition it always has always willl--its why markets work. The more healthcare choices the American consumer has to choose from the harder the healthcare supplier will work to be chosen. We need more incentives to cut costs and provide better service.  A government option is part of that solution--its the only one we have unless we want the the federal budget to go bust over the long run.

Lets do a Health Care Reform Reality Check and join the rest of the industrialized nations with major health care reform.

 

Posted via web from jimnichols's posterous

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