Ed Rendell: The Health Plan from Hell
Rendell's Plan, praised lavishly in Sunday's P-G "Forum" by a consultant who helped devise it, will pour more money into health care. Will it increase the number of doctors and other caregivers? Not really. Will it help raise the incomes of doctors and hosptial adminstrators (the suppliers) through increasing demand for their services? Of course.
Question: when demand goes up and supply remains static, what happens? Answer: prices increase to bring the demand/supply equation into balance.
There's one other way to create such a balance, an approach "perfrected" by the Department of Motor Vehicles. It is to handle the heavy demand by making people wait in long lines.
Think back to Dr. David Gratzer's comment in The Cure, where he talks about the day he became disaffected with the Canadian (single-payer) health care system. He took a short-cut through a hospital emergency room, which was so crowded that patients were waiting -- many for days -- on stretchers in a long hallway. He heard many of the patients crying out for water. He smelled the stench of people soaked in sweat and urine. ALL of those people had health insurance, but none of them was getting anything like adequate care.
The PA Plan would cover up to 767,000 unisured people. Gee, are there going to be more doctors and emergency room to provide the increased care required? Nope.
In PA, the costs of providing a lower-level of care, which surely will occur, will be astronomical.
Joe Fahy discusses the kind of people who will be eligible for subsidies, writing that the Rendell Plan calls "for subsidized coverage for people up to 300 percent of the federal poverty level ($30,630 for an individual, $61,950 for a family of four). "
In other words, the state assumes people making up to $62,000 have incomes low enough to make their families eligible for assistance. In a typical PA town like the one where I live -- Ambridge -- the portion of families exceeding an annual income of $62,000 is probably around 2%. (Relax, I'm not one of them)
When you "subsidize" something, you make its cost APPEAR lower. People then demand MORE of the low-cost item, be it draft beer or health care.
Unforunately, when basically everyone is eligible for a subsidy, any Plan to "assist" them is economically unworkable. If everybody gets, somebody -- and something -- has to give.
The best way for the Rendell proposals to become viable would be: (1) get Bill Gates to move to PA; (2) confiscate his assets; (3) spend the newfound billions on health care, until the money runs out.
Who's to provide the abundant subsidies? Small businesses, whom the state presumes have a lot of extra money rattling around, health insurers expected to absorb some of the costs, and of course the ever-flush taxpayers. (On KDKA-TV at this moment, I hear I'm to stay tuned for "Gov. Rendell's proposal to increase the state sales tax.")
What about the lucky folks who make in exess of $62,000 annually? According to the Governor, they would pay about $280 per month per individual. However, Massachusetts and Vermont, with similar plans, estimate the average unsubsized individual will pay about about $380 per month.
Is the PA Plan better than what already exists -- with no Plan? In his article, Joe Fahy saves that pressing question for last.
He says, "In some cases, the unsubsidized cost appears comparable to that of other available coverage. One option available through Highmark, for example, offers coverage for a four-member family of about $759 per month."
Astounding! Perhaps the Governor could give the uninsured the money -- bypassing the middle man -- and let them buy their own insurance. Perhaps he could use the gambling revenues? Oops, forgot: they're already spoken for.
As a society, we need more doctors, more efficient care centers (small, lower-cost hospitals), more information about treatment options and prices, and more patient choice. If we don't get those things, Governor Rendell, along with the next five governors, won't come anywhere near solving the health problem.
If the current Plan's aims are to make doctors richer, fill already-teeming emergency rooms from floor to ceiling, and further diminish the quality of patient care, it will be a resounding success.
Note: I've promised additional comments on Tracie Mauriello's fine Sunday article on legislative cookie-jar tampering, and I'll deliver late today (Monday).