If the CNN Obamacare debate between Senators Ted Cruz and Bernie Sanders taught us one thing, it is that both participants come from very different philosophical points of view, are deeply passionate about what they believe and don’t let the facts get in the way of their positions. In the hairsplitting department, Sanders believes that health care is a right, equal to life, liberty and the pursuit of happiness, while Cruz believes all Americans deserve access to health care, which is not the same as actually having health care.
Because he perceives health care as a right, Senator Sanders expects the government to absorb the cost of providing it, no matter how great the financial burden. While Sanders believes the top 1 percent of the country to pay for it, he forgets that he himself is a part of that group. His income as a Congressman alone puts him in the top 1 percent of earners. Is Bernie ready to pay for our health care? According to Senator Cruz, if we confiscated all the wealth from the “wealthy,” we would not have enough revenue to carry for one year the additional costs of a single-payer system. So, if we confiscate the assets of the rich, who would provide health care to all Americans after the first year?
According to Ted Cruz, “What we should care about is access to health care, not insurance per se.” This means that all people should have access to health care, but they still should pay for it themselves. With insurance costing at least $10,000 annually for a family, along with deductibles in excess of $5,000, how is the average family going to afford their care? Cruz thinks that allowing insurance companies to compete across state lines and reducing regulations will do the trick. The insurance companies, because they would be making more money, would, out of the goodness of their hearts, pass this increase onto consumers by reducing their prices. This would result in reduced costs for the family. Since insurance company margins have never been greater, this scenario is a bit far-fetched.
Both parties acknowledged our obligation to assist those who need help; an agreement at last. They also concurred that it is insurance companies and drug companies that are the bad actors in the story of escalating health care costs. Both acknowledged that, as a way to gain on-board support for the Affordable Care Act, the administration decided that the government couldn’t negotiate prices with drug companies. The price they quote is the price we pay. It was Ted Cruz who reminded us that, since the passage of the ACA, health insurance profits have doubled and insurer’s margins have dramatically increased. This means that the profits on each policy sold are greater now than before the legislation was passed. Yet, when it came to tackling the problem of rising costs, both looked to the uncontrolled insurance companies to provide us with a solution. Neither debater proposed any controls on costs.
Economist Jonathan Gruber, one of the Obama administration’s advisors responsible for passage of the ACA, in his post-debate interview on CNN said, “The problem with Obamacare was that insurance companies were not given the protections they wanted in order to participate in that market.” Both Senators Cruz and Sanders would dismiss this as ridiculous. Bernie thought insurance company executives were making enough money and didn’t need more. It was Cruz and the Republicans that voted against releasing an additional $7-plus billion to insurance companies to cover losses on Obamacare policies, at a time when those same companies were experiencing record profits.
A key takeaway that they didn’t discuss? The position each was advocating has already been proposed, attempted, and failed. In Congressman Sanders’ own state of Vermont, a single-payer system performed so poorly and cost so much that less than a year after it was enacted, Vermont pulled the plug. Based on the state’s one year of experience, state income taxes would have to be raised 10% across the board for all taxpayers, in order to cover the costs of the single-payer plan. A 10 percent increase in taxes didn’t seem to make sense, especially since that would only cover needs for subsequent years if there were no cost increases. Cruz’s plan, establishing high-risk pools, has also been tried. Since the AIDS crisis, high-risk pools have been available to allow people with preexisting conditions to obtain coverage. The problem is that individuals still have to pay for their insurance and those who are seriously ill can’t afford the premiums, even though they are subsidized.
So, expanding markets, single payer, giving people more choice of carriers, all the proposals that were made are still insurance-based products run by insurance companies. If affordability is the key, the only way to achieve it is to rein in insurance costs. This will only happen if we regulate the percentage of administrative costs allowed by subtracting from the premium dollars received the money paid for medical expenses and services rendered (money in minus money out).
What also came out of this debate is proof that neither Ted Cruz nor Bernie Sanders are familiar with the laws they have already passed. A woman asked what would happen to pregnancy and newborn coverage if Obamacare were repealed? Sanders said she would be uncovered if Obamacare was repealed. Cruz was simply silent. Neither noted that we already have legislation on the books that protects pregnant women and children. In 1997, Edward Kennedy and Orin Hatch, the odd couple of health care, worked together to pass the Children’s Health Insurance Program, administered by the United States Department of Health and Human Services. For families with incomes that are modest but too high to qualify for Medicaid, the CHIP program provides coverage for pregnant women who do not already have pregnancy coverage, as well as coverage for all uninsured children. For those whose qualify for Medicaid, pregnancy is covered automatically, as is coverage for any children born of Medicaid recipients.
A viable, non-Obamacare health care solution is hard to propose because emotion, philosophical bias, and lack of familiarity with the facts keep getting in the way.