Wednesday, September 23, 2009

Worst-Case Scenarios: Health Care

I touched on this subject a bit last week, and I have been thinking a lot about it recently. Regarding health care reform, what is the worst-case scenario for both sides of the debate?

What is the worst-case scenario for opponents of health care reform? Assuming reform legislation is ultimately executed irresponsibly and incompetently, health care costs could actually end up staying as high as they are now, or even increasing. There may not be enough savings accrued from cracking down on waste and fraud and investing in information technology, prevention, pay-for-performance systems, and other measures that President Obama and Congressional Democrats have proposed. The alternative is new taxes.

Such taxes could take a number of forms. Income tax exclusion for employer-sponsored health insurance could be replaced with a tax deduction. The tax on cigarettes or alcohol or sugar-sweetened beverages could be increased. There could be a “play or pay” requirement on large employers, with a tax for not offering health insurance. Any way you look at it, the government would be taking more money from citizens in all of these cases. (Side note: I believe that disincentivizing unhealthy habits and behavior—possibly in the form of taxes—is a key solution to solving our nation’s high health care costs. Nutrition needs to be looked at more closely as an answer to health care problems, not just addressing the problems in an ad hoc manner.)

Now, you may be saying, “But taxes are not the worst case scenario! The government will pay people to have abortions! Illegal immigrants will get health care paid for by my tax dollars, and my grandma will be put to death by a government panel! You lie!” But don’t you have more important things to do than read my blog, Representative Wilson? Seriously though, none of those things are true.

So what’s the worst-case scenario for the other side of the debate? Well, 46 million Americans will still not have any health insurance. Health care costs will almost certainly continue to increase, which will cost Americans more money in the long run anyway. Key solutions like prevention measures will continue to go overlooked, and Americans will likely increase their susceptibility to obesity, diabetes, and heart disease.

And the bottom line in this entire debate, which no one seems to be talking about anymore: people will be left to fend for themselves when they are sick or injured, or will have to assume a financial burden with which they simply cannot cope. People will go without the treatment they need because they can’t afford it. People will remain injured or sick, and probably get worse. And people will die unnecessarily, simply because their government, whose role is supposed to be that of a guardian and helper, was not willing to protect or help them.

When worst-case scenarios are outlined honestly and juxtaposed like this, it becomes a no-brainer what the ultimate goal should be. Which is exactly why the talk of death panels, socialism, government takeovers, and Hitler have seized the public debate in our country. Because when thoughtful reason (not to mention compassion for one’s fellow citizens—isn’t that what patriotism is all about?) naturally incline voters in one direction, opponents have to combat it with sensationalism and lies.

Images: Obama and Kennedy (, Joe Wilson (Fox News), some asshole (CBS News)

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