Trump Said Something True

(Bernie Sander's reaction to Donald Trump praising Australia's healthcare system)

It is really funny.  This is the kind of funny conservatives have a hard time getting, but it is really funny.  Yesterday, the President was doing the obligatory quick, post-meet-and-greet press conference with Australian Prime Minister Malcolm Turnbull, and he says to the PM, "I shouldn't say this to our great gentleman and my friend from Australia because you have better health care than we do."

Here's the simple wiki on the subject of Healthcare in Australia.  As you can see, they have universal healthcare, with most of the funding, about two-thirds, from their version of Medicare, or as they call it, Medicare.  It's a mixed system, public and private, but the tax scheme for the Medicare is pretty much of the opposite of what we do.  Instead of capping the payroll tax for Medicare so you only pay on your first $127,000 of income, in Australia the tax stays the same, and can rise with higher income, with a conditional 1-1.5% penalty added.  This is actually to encourage use of the private system by the wealthy.  If they use the private system, they don't have to pay the extra.   If you are making a lot of money, you could imagine that 1-1.5% being higher than what you'd pay for private insurance, but you'd have to be really raking it in, and here in America, you'd have to be well up in the six-digits, at least.

Here's the thing...

Australia's healthcare system, when it comes to costs, is far more efficient than ours.  They spend, per capita, almost half what we do.

The WHO ranking, which has really only to do with outcomes, puts Australia a little ahead of us, but in pretty much every category, they have it better than us.

The Australian government, the taxpayers, spend about the same as we do on healthcare, but it covers 2/3rds of all costs, the rest is private insurance and out-of-pocket.  We spend a fortune on private insurance, but our government only covers 45% of all costs, and that's only because getting old is expensive, and we only universally cover people 65 and over.  By covering everyone, you can see the effect of the offset on the higher costs for the elderly in those numbers.

So, we spend double what Australians spend, we live shorter lives, we die unnecessarily at twice the rate, even our infant mortality is higher, therefore I can honestly and with humility admit Trump said something true.

JMJ

"If you like..."

"But I like my health insurance company!"

"If you like your doctor, you can keep your doctor. If you like your health care plan, you can keep your health care plan."

If you click the "If you like your doctor" link, you'll see all the iterations.  It's the infamous "lie" Obama told us all to sell us Obamacare, the Big Government "takeover" of America's healthcare "system."  Of course, it was not a lie, but rather a very hopeful though politically careless thing to say.  Of course, some things were going to change, and Murphy's law has an exponential relationship with change.  And it was far from a takeover of far from a system.

All the ups and downs of Obamacare aside, here's a peek at what Paul Ryan (Rep, JackKempTopia, WI) and the GOP in the House, has in mind for us now...

Our proposal will then create a new, advanceable, refundable tax credit to assist with the purchase of health insurance on the individual insurance market. The legislation creates a new code section – 36C— to do this. The credit is:

•Universal for all citizens or qualified aliens not offered other qualifying insurance

•Age-rated

•Available for dependent children up to age 26

•Portable

•Grows Over Time

The credit is not based on income. This will help simplify the verification process and expand access for Americans who have been left behind by Obamacare. Additionally, a universal credit does not create the same labor market distortions and perverse incentives as President Obama’s law did: according to CBO, the Obamacare income-based subsidy system resulted in so many lost labor hours it would be as if 2 million full-time equivalent workers left the labor force in 2025. A universal credit fixes this unnecessary disincentive to work and makes sure our tax code is built for growth.

Older Americans will receive a higher credit amount than younger Americans, reflecting the higher cost of insurance for older Americans. Taxpayers can receive credits for their dependents – including children up to the age of 26. The credit, however, is limited only to citizens or qualified aliens. Incarcerated individuals are not eligible for the credit.

The link will bring you to their policy paper.  They want to retract Medicaid, put out "advanceable, refundable" tax credits (at one point is says "monthly"), have them flat for everyone and only progressively adjusted by age, oh and override state laws (?) to open insurance markets interstate.  That's really the crux of this.

I know I haven't been posting diligently, as I've been a little out-of-it, but I beg of someone out there to explain to me first, how this is not the federal government taking over healthcare by superseding state laws, second, how this will not lead to a few big, awful, national private insurance companies who survive the race to the benefits bottom, and third, finally, WHO THE FUCKING HELL LIKES FUCKING INSURANCE COMPANIES IN THE FIRST PLACE?  That last one, I will never understand, so you can skip that one.  The only thing I can make of it is that the American private health insurance raison d'etre is a hedge against labor inflation.  It serves no other purpose.  It has nothing to do with HEALTH.

JMJ