Bush's proposals include an extension of tax breaks for individual medical spending and an expansion of tax-free health savings accounts, sources say. The goal is to make medical markets more efficient and give consumers an incentive to shop more carefully for health care.Uh, Mr. President, there are two huge problems with health care (actually three, but we'll get to the other one later): people who can't afford insurance and people who can't afford care despite having insurance. How exactly do these proposals help those people? They don't.
Obviously, people who cannot afford health insurance cannot afford to stash a meaningful amount of money in a tax-free health savings account. And tax breaks on medical spending don't solve your problem when you have $50,000 in health care costs and a $40,000 annual income.
Bush's plan encourages people to insure themselves by saving and spending their own money for health care. Who will have the most to gain from this? Healthy people, of course. And that will leave only the unhealthy in insurance programs whose premiums will skyrocket. The basic principle of insurance is spreading the risk among many. Healthier people subsidize the care of sicker people. This is both a social good (not letting the weaker among us die for lack of care) and a personal investment (eventually the healthier people will get sick, counting on healthier people to subsidize them). When healthy people's personal savings accounts cause health care premiums to rise, even more sick people will fall through the cracks because they cannot afford insurance.
Like everything else in America, though no one wants to talk about it, it all comes down to economic class. The wealthy will save money by paying a portion of their health costs from tax-advantaged accounts, while the poor, if they can even afford insurance (forget about personal accounts for them), will pay more for it. The wealthier get to save money and the poorer get to spend more money. Sound familiar? Every major program the Bush administration has pushed aims to accomplish these two goals.
And here's the third problem, the 800-pound gorilla that Bush ignores. Our health care system is among the worst out of all industrialized nations by numerous criteria. Market efficiency may save us some money, but it isn't going to save our lives.
Conservatives don't have any good solutions for health care; they never have. I hope that after Bush's social security privatization debacle and countless other miscues (war under false pretense, FEMA incompetence, domestic spying, et cetera, ad nauseum), the public won't drink any more of his Kool-Aid.
Like social security, the health care problem is huge and needs to be fixed. But these aren't the people you want to fix it.