This is part one of a series I am writing on what I would do if I were elected President of the United States.
It is a hypothetical question you will often hear asked in social studies class, at debates, or at the dinner table - “What would you do if you were elected president?”
I know I have often pondered this myself. It is very easy to play armchair quarterback (or president in this case) and spout off the usual defend the nation, create jobs, protect the environment etc. The canned rhetoric we all have heard time and time again. But those aren’t really ideas of what you would or would not do but rather just spouting off what is expected of a president.
Seriously, find me someone running for the presidency campaigning on less jobs. Or someone campaigning on NOT defending the nation. Not going to happen.
Since I have developed a passion for politics (circa 2002 - thanks Howard Dean!) this has been one of those questions I have constantly thought about. If I were to ever run for President of the United States, what would my platform look like?
Well, first off I am progressive, but I believe in being fiscally conservative and efficient as well and not just pissing money into the wind. I believe that the purpose of the government is to provide for the well-being of it’s citizens, to serve as a facilitator of trade, to uphold the Constitution of the United States, and to centrally manage the infrastructure and policies that keeps everything functioning smoothly.
Having said that, here is part one, the first plank of my platform (I will follow up with other planks when I have time over the next couple of months):
Single-Payer Universal Health Care
Single-payer universal health care is not a liberal or conservative idea. It is a moral imperative. No one should ever have to make a choice between eating or buying prescription medicine. And no one should ever have to live a lower standard of life just because they were born at the wrong end of the income scale and can’t afford health insurance.
Health care is also an economic issue. More than half of all bankruptcies in the US are due to overwhelming medical costs.
The soaring costs of health care are having a detrimental impact on small businesses as well. About 52% of the US population works for what is considered a small business (less than 500 employees) and as the costs go up these businesses have to choose between less coverage or less employees. Neither option is appealing.
We are also losing jobs to other nations due to health care costs. For example, health care costs add about $1,500 dollars to every car General Motors produces. They now spend more money on health care than they do steel. As a result, GM is moving more production across the border to Canada where the national health care system makes their health care costs per vehicle negligible.
The biggest culprit in the soaring costs of health care is NOT the lawsuits as claimed by the GOP (malpractice lawsuits account for less than 2% of health care costs) but rather the OBSCENE profits. Between 2002 and 2005 health insurers averaged 66.75% profit margins. That means for every dollar we spend on health care, only 33 cents was being spent on actual care.
There are also the INSANE compensation packages that some of these executives receive. For example, UnitedHealth Group’s former CEO, William McGuire, received over $124 MILLION dollars in compensation for 2005. This is enough to cover the average annual premiums of for an entire town of 30,000 people! In the United States health care now accounts for over 15% of ALL spending. Compare this to other nations such as Canada where health care accounts for less than 10% of their GDP.
If I were elected President of the United States, I would do a complete overhaul of our health care system, starting with the divesture of the health care corporations. Some holdings will be liquidated to provide compensation to shareholders as the industry transitions to a nationalized, single-payer system. All executive agreements deemed excessive will be dissolved and those perks will be forfeit.
First phase would be the most difficult - converting a 2 trillion dollar a year for-profit industry to a nationalized system will take a substantial up-front investment. This would involve the United States government setting up a large (but temporary) transition team to set up the policies and infrastructure which would include implementing a new tax to fund the health care initiative - no cost for individuals making less than $25K per year, capped at a baseline of 3% of gross income for folks making under $250K a year, 5% (up to a maximum of $25,000 per year) for folks making more than $250K a year, and a 5% health care surcharge on corporations. These percentages are less than what most Americans are currently paying, with the exception of the $250K+ income group paying more but not in a way that would substantially impact the quality of life that their wealth affords them. These savings will be achieved by removing the profit and executive perks, as well as the marketing costs from the cost basis.
I understand there will be some investment losses due to the changeover of the industry and as a result we would have to allow investment write-offs to minimize the impact on the investment community.
The second phase of the transition will be implementing a compensation system for those that provide our care - the doctors, nurses, practitioners, surgeons, and all the support staff etc. This compensation system will provide strong pay base (vast majority of health care practitioners will see little to no change in compensation), and will feature merit-based rewards based on success rates in assisting patients with preventative lifestyle choices. For example, help X number of patients reduce their risk of developing type 2 diabetes, earn X dollars more. The merit system will reward making people healthier, as opposed to having to treat them more often.
Third phase will be re-working the pharmaceutical industry model by putting caps on profit margins, executive compensation, and implementing price controls. A program will be put in place for rewarding research into new areas of medicine that best effect our quality of life. Stipends will be paid to pharma research firms based on efficacy of treatments as opposed to patent-driven monopolies and market penetration. Pharmaceutical companies will still be competitive, for-profit entities, but under much tighter regulation and scrutiny.
Fourth and final phase will involve preventive health care. Encouraging people to become more physically active and eat more nutritionally sound meals can have a direct impact on how much medical treatment will be necessary to provide, and as a result this effects our costs. A healthier public will be more cost-efficient to treat than an unhealthy public rampant with heart disease and type 2 diabetes. This can be achieved by starting good habits with the young - reward programs for kids that take good care of themselves including possible bonds to be used for college, etc.
In closing, this post is obviously my opinion, but I think there is some merit to most of what I have mentioned here. The fact that health care costs are soaring, while the overall health of the nation is not says to me we are not getting a lot of bang for our buck.
While I understand and appreciate that we are a free-market system, health care is one area where I feel the free-market system is counter-productive to our desired end result. The fact is the sicker we are and the more we need them, the less likely the insurers are to provide us with the care we need (and have paid for.)
Next part I will be focusing on energy policy.
–Jon