Cuba was a small island nation that once was the biggest producer and exporter of sugar in the world. Once La Revolución got its paws on it though, it was systemically destroyed to the point that the island cannot even produce enough to supply its own populace with the sweet spice.
Venezuela:
Enter Chavez with his Revolución Bolivariana, and in a few short years they have gone from one of the biggest producers of some of the best Arabica coffee beans in the world, to now facing, for the first time in history, the prospect of having to import its coffee.
The genesis of TennCare has many parallels to the situation in which we find ourselves today. It was a public option plan designed to save money and expand coverage. In the early 1990s, Tennessee was facing rising costs in its Medicaid program. TennCare was designed to replace Mediaid with managed care and use the promised savings to expand coverage. By 1998, TennCare swelled to cover 1.2 million people. Private business dropped coverage for employees and forced them onto state rolls. By 2002 enrollment had swelled to 1.4 million people and forced Tennessee’s Governor to raise taxes and ultimately propose an entirely new state income tax to cover the unforeseen costs. Governor Bredesen was ultimately forced to dramatically restructure a program he has since called “a disaster”. By 2006 Bredesen had disenrolled nearly 200,000 people and slashed benefits.
This is a great editorial with lots of bullet points explaining everything that went wrong with TennCare. This is exactly the kind of case we need to be making – a case based on past experiences, instead of on rosy rhetoric.
ECM sent me this post from the National Review where K-Lo interviewed Marsha about her editorial.
Excerpt:
LOPEZ: Should there be such a thing as a national health-care model? Or is this something states can tackle?
REP. BLACKBURN: A one-size-fits-all approach to healthcare would seem to me to be unworkable. Both health care and medical care should be personalized to the patient. While some reforms on cost, access, and insurance are needed, it would be difficult to have a national model.
There should be a hard look at federal regulation of insurance. What is Washington doing that forces costs to rise? Representative Shadegg has a tremendous bill that would alter federal barriers so that a broader spectrum of entities can offer coverage and individuals are encouraged to buy coverage privately. That will bring health-care costs closer to market forces and expand coverage. As insurance is reviewed, liability reform should also be addressed.
Instead of taking control of health care, maybe we should solve the actual problem of rising health care costs.
Consumer choice guided by transparency. We need a system where individuals choose an integrated plan that adopts the best disease-management practices, as opposed to fragmented care. Pricing and outcomes data for all tests, treatments and procedures should be posted on the Internet. Portable electronic health-care records can reduce paperwork, duplication and errors, while also empowering consumers to seek the provider that best meets their needs.
Aligned consumer interests. Consumers should be financially invested in better health decisions through health-savings accounts, lower premiums and reduced cost sharing. If they seek care in cost-effective settings, comply with medical regimens, preventative care, and lifestyles that reduce the likelihood of chronic disease, they should share in the savings.
Medical lawsuit reform. The practice of defensive medicine costs an estimated $100 billion-plus each year, according to the American Academy of Orthopaedic Surgeons, which used a study by economists Daniel P. Kessler and Mark B. McClellan. No health reform is serious about reducing costs unless it reduces the costs of frivolous lawsuits.
Insurance reform. Congress should establish simple guidelines to make policies more portable, with more coverage for pre-existing conditions. Reinsurance, high-risk pools, and other mechanisms can reduce the dangers of adverse risk selection and the incentive to avoid covering the sick. Individuals should also be able to keep insurance as they change jobs or states.
Pooling for small businesses, the self-employed, and others. All consumers should have equal opportunity to buy the lowest-cost, highest-quality insurance available. Individuals should benefit from the economies of scale currently available to those working for large employers. They should be free to purchase their health coverage without tax penalty through their employer, church, union, etc.
Pay for performance, not activity. Roughly 75% of health-care spending is for the care of chronic conditions such as heart disease, cancer and diabetes—and there is little coordination of this care. We can save money and improve outcomes by using integrated networks of care with rigorous, transparent outcome measures emphasizing prevention and disease management.
Refundable tax credits. Low-income working Americans without health insurance should get help in buying private coverage through a refundable tax credit. This is preferable to building a separate, government-run health-care plan.
These are conservative solutions – they will preserve out liberty and prosperity.
Bobby Jindal is my pick for Secretary of Health and Human Services in 2012, if he isn’t elected President. So remember his name!
WINTERY KNIGHT 