Robert Downes 6/29/09
Recently, a writer from Vogue magazine caused a stir on the Oprah Winfrey Show by noting that people in Minnesota looked like little houses during her visit to that plump and voluptuous state.
Id just been on a trip to Minnesota, where I can only kindly describe most of the people I saw as little houses, Anna Wintour said. Theres such an epidemic of obesity in the United States, and for some reason, everybody focuses on anorexia.
Wintour is right: on the whole, we Americans dont do a very good job of taking care of ourselves, and thats the 900-lb. hog on the table of healthcare reform in our country that no ones talking about.
Who is going to pay for our sins, and how?
Consider that 60 percent of Americans are overweight or obese. The federal Centers for Disease Control reports that obesity will soon be the number one killer in America. Overeating also contributes to diabetes, hypertension, heart disease and cancer.
We also tend to be a sedentary nation of couch zombies. Then theres smoking, drinking, and the effects of junk food, preservatives and hormones in our diet.
By any measure, as a nation, were not a healthy bunch.
So when the Republicans claim that the Democrats healthcare plan will cost $3.5 trillion -- much of which will have to be borrowed -- its not hard to believe them.
On the other hand, the Republicans dont seem to have much of a plan of their own, beyond U.S. Rep. Dave Camps press release promise to cook up some reforms that focus on affordability, accessibility and availability of quality health care for all Americans.
Or to put it another way, the Republican plan involves empty words that are long on alliteration, but short on substance.
The other hairball of healthcare reform in America is our aversion to new taxes to pay for all of the quadruple bypasses, kidney dialysis treatments, liver transplants and hip replacements brought on by our unhealthy lifestyles.
As noted here before, in Sweden, universal healthcare is paid for through a local income tax of around 11 percent, on top of all the other taxes the Swedes pay (among the highest in the world).
But the Swedes, Dutch, French and other nationalities that have universal healthcare tend to eat healthy and exercise. And like the Canadians, theyre more inclined to think of taxes as a civic duty for the welfare of all, rather than a curse.
So there you have it: we have something like 200 million Americans who are overweight and unhealthy (with a trend thats on the rise), and a culture that despises taxation. How do we overcome those problems?
Some recommend the single-payer plan embraced by Canada and other countries. As is the case with Social Security, “single-payer“ means that taxpayers would pay into a single healthcare fund for life, from which all doctor and hospital bills would be paid. The idea is to spread the risk among citizens who are fairly healthy in their youth, paying to support older Americans who need more care with age.
But the single-payer plan does nothing to address personal responsibility and the incentive to stay well. Nor does it solve the political suicide of new taxes to pay for healthcare.
One solution to both problems might be to re-examine an idea from the Bush administration, which recommended a national system of health savings accounts, whereby citizens set aside tax-free funds to pay for their own care.
This approach requires no major tax increase, but does involve some out-of-pocket sacrifice from participants, and thus, an incentive to stay healthy.
We use a variation of this healthcare plan at Northern Express. We contribute $1,500 per year to each employees tax-free health savings account. Employees in turn, can contribute their own tax-free funds into their accounts. You pay for your own doctor bills and prescriptions out of the fund, up to a $2,000 deductible. After that, the insurance company picks up the tab -- ideal for catastrophic events in your life, such as heart surgery or treatment for cancer, which can cost hundreds of thousands of dollars.
The value of a health savings account approach is that it sidesteps the bombshell of new taxes, while encouraging personal responsibility. Stay healthy, and the money youve saved is yours, tax-free.
The Bush administration‘s idea of a national health savings account plan was shot down almost immediately when it was presented. But that was before the recession and the harsh reality that we can no longer pay for all of our entitlements, much less add to them. Perhaps the plan would receive a more favorable reception if it were presented once again.
Of course, there would still be those “catastrophic“ health costs to pay, even with a national health savings account plan. Whatever reform our country adopts, it seems that some level of taxes will be the bitter pill we‘ll have to swallow to have national healthcare.
Check out Bob Downes unplugged with Jim Moore and Acoustic Dynamite, Friday, July 3, 6-8 p.m. on the patio at Left Foot Charley‘s -- behind Bldg. 50, TC.