**This an interesting commentary on the Obamacare fiasco: **
eppc.org/publications/pubID.4126/pub_detail.asp
James C. Capretta
Wednesday, April 7, 2010
Excerpts:
If allowed to stand, the new health-care law will tether America’s middle class to the federal government in ways that will fundamentally alter - and not for the better - the relationship between citizens and the state. The result will be worse health care, distorted politics, less medical innovation and economic vitality, and depleted wealth. What benefits? What rights? Little of real value has come immediately into effect, and most of the plan’s provisions won’t be implemented for more than three years
Beginning as early as 2011, well before new coverage is extended to anyone, millions of seniors will see large cuts in their Medicare benefits as deep reductions in Medicare Advantage payment rates force insurers to scale back their coverage or drop current offerings altogether.
To offer the country an alternative vision: That vision should include the promise of repeal, the case for which will have been bolstered by the tax increases, premium hikes, and Medicare cuts that will have kicked in The starting point must be a commitment to build a functioning marketplace in the health sector. That’s the only way to simultaneously address the cost and improve the quality of American medicine. Today we endure misallocated resources and expensive and inefficient care principally because of misguided governmental policy. In particular, open-ended subsidization of health insurance - through the tax code, Medicare, and Medicaid - has largely undermined the incentives for productivity improvement or cost-conscious consumption. The result is cost growth that far outpaces the nation’s general rise in income.
An effective reform program would begin to address the cost problem by making changes throughout federal health-care law. But the trick is to do so in a way that allows for gradual change and decentralized decision-making.
The basic framework should be a federal partnership with the states. The federal government would take steps to address problems in the Medicare program and the tax treatment of health insurance, as well as provide the base funding needed for state-by-state initiatives. Individuals buying insurance outside of employment would get a tax credit. In Medicare, beneficiaries would be given more choices, including the option of taking their entitlement in the form of catastrophic insurance and a deposit into a Health Savings Account. They would also be asked to make modest co-payments for any services they receive outside the normal network they have selected for their care, even if they have Medigap coverage (which means they now pay nothing at the point of service, regardless of where they get it).
