BISMARCK -- Sen. Kent Conrad's recent viewpoint supports the Baucus health care plan and tries to reassure people in North Dakota ("Baucus plan works for N.D.," Sept. 27, Page D3).
But rather than reassured, I feel misled.
If the size of the number of uninsured Americans compels us to act, let that number be accurate. Stating that 46 million Americans are uninsured, as Conrad did, is incorrect. There are 46 million uninsured people, including 10 million noncitizens such as illegal aliens.
That's why President Barack Obama spoke of "more than 30 million American citizens" in his Sept. 9 address. And even that number ignores millions of Americans who are not woeful victims but who can afford health insurance and choose not to buy it.
Conrad states the plan will decrease the federal deficit $49 billion over the next decade. A closer look at the Congressional Budget Office Web site shows $47 billion of that will come from fines the government imposes on individuals, families and businesses for noncompliance with regulations of the government-mandated insurance.
ADVERTISEMENT
The maximum fine per family is $3,800 per year.
The 10-year total cost of the Baucus plan is $774 billion. Subtracting $274 billion in government charges for fines and new taxes on health insurance plans, this plan will then cost $500 billion. This cost supposedly will be entirely covered by spending changes in Medicare and Medicaid. Many of these changes are severe cuts in hospital and provider reimbursements.
Conrad claims that the plan will save $1.3 trillion in the second decade. The CBO indicates no such thing. In fact, it claims that it appears the plan will not increase the deficit by more than $5 billion in that decade.
The office says predicting any savings beyond the first 10 years is impossible. Furthermore, this bold claim by Conrad means that the savings would jump from $16 billion in 2019 to an average of $130 billion per year, every year for the following 10 years. That certainly requires suspension of disbelief.
The CBO also says it has not included the costs of government implementation and oversight of the programs. Based on typical government inefficiency, these are bound to be huge costs, yet they haven't even been included!
Where government has been involved in health care, we have such outcomes as the impending bankruptcy in Medicare, an "abysmal" system in Indian Health Services and rampant fraud, waste and abuse in Medicare and Medicaid.
There are ways to improve our current system without throwing the baby out with the bath water.
First, remove regulations that prevent shopping for insurance across state lines. This would allow free-market competition and lower insurance premiums.
ADVERTISEMENT
Second, make insurance portable -- across state lines and from job to job.
Third, make individual health insurance premiums and contributions to health savings accounts tax-deductible.
Fourth, implement liability and tort reform. Eliminate the huge costs of defensive medicine, where providers make decisions for "medico-legal reasons" rather than solely in the patient's interest.
Last, fix Medicare. We should do that anyway and return the savings to the American people.
Dr. Becker, a graduate of the UND School of Medicine, is a plastic surgeon in Bismarck.
