Friday, November 6, 2009

Health Care Reform and Medicare

Dean was visited by someone to the left of us, Joe Markowitz, after Dean posted an article opining that "everyone in and nobody out" was the one of the worst political slogans of all time. Mr. Markowitz also commented on some TLT articles; hooray for readers and commenters. He called us out on an issue to which Republican politicians can't respond well, but to which I can. Here's what he said:

Either you should support the abolition of Medicare AND Medicaid AND the VA, which I do not hear any politicians suggesting, or you should be working constructively with supporters of reform to help fix those programs and put them on a better financial footing. But you can't be against government health care and then at the same time try to scare seniors by saying that reformers want to try to find some cost savings in the program.

As a principled libertarian/conservative I agree. I support the abolition of medicare, medicaid and the VA in their present form. The reason the Republicans can't say this is that Medicare, at least, is a popular program. It is popular with seniors, because they get more from the program than they ever put in to it. And seniors vote in greater percentages than youngsters. But Medicare is not sustainable, and this is well known. Better not to have embarked on an unsustainable program than make promises that will eventually be broken. Further, why do we encourage generational wealth transfer from the relatively poor and young to the relatively richer and older?

With respect to the VA, that system does not work well for the veterans. I am a veteran, and abhor the lengthy waits and red tape to obtain service. I do not use the VA as a result. It would be better if the government gave veterans an opportunity to get treatment in the private sector for their service related injuries through a private insurance plan, and cheaper too.

I work for the Federal government and I know from first hand experience the difficulties of performing one's duties within the spirit and the letter of the law. Not a day goes by that I have to bend rules or not be in full compliance to be able to actually execute the mission I am given. A health care bureaucracy would be run by people like me, dedicated to their mission, but given an impossible task of obeying byzantine rules. But the consequences will be that the costs for such a system will spiral out of control, because all of the rule making is intended to control costs. Because of my first hand knowledge, I dread any increased growth in the scope of government because I know that the competing political pressures of law, mission and leadership always results in less than optimum solutions. Do I think the private sector is perfect? No, but the pressures to bring efficiency and effectiveness are much greater, because politics does not intrude.

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