The health care debate has come down to whether or not the government should pay for everyone's health insurance.  While it seems to be a noble cause and idea, it neglects to recognize the fact that health insurance is different than health care.  Health insurance is an important aspect of the cost of the health care puzzle.  But the problem with health care is the rising cost of health care.  Merely providing health insurance by paying for it with taxpayer money does not do anything to solve the problem of the rising cost of health care.

Health insurance is an important aspect of the cost of health care because it is the vehicle within which health care prices are negotiated.  Without such negotiations, people would find themselves in a position of negotiating price of a life saving medical procedure only after they were certain that they needed it.  The health insurance apparatus enables the negotiation of the cost of medical procedures apart from the pressures of actually needing the procedure done.  In other words, if you need heart surgery to save your life, it is worth everything you have or will have to get the surgery done.  But if the prices have already been negotiated by the insurance companies, your cost will be much less to have the life saving surgery.  Without health insurance, it might be common to pay $50 for an aspirin because there would not be a check on the doctors' prices.

Having said that, I understand that there is a relationship between the cost of health care and the number of people with health insurance.  This is because the doctors and hospitals still provide services to people who don't have insurance (that's true, it is against the law to deny someone life saving medical treatment - even illegal aliens).  As a result of these services that are provided for free, the hospitals and doctors negotiate rates with insurance companies to offset the costs of treating those who can not pay.  So essentially the people with insurance are already paying for the care of the people without insurance anyway.  With this understanding, people say that if everybody had health insurance, the cost of health care would be less because it would be evenly distributed.  But these costs are already in the system during the negotiations between health care providers and insurance companies.

Paying for health insurance for all Americans will likely cause the cost of health care to continue to rise.  People will use the services more because they will consider them to be free.  Any time you give something away for free utilization goes up.  So we will need much more capacity to service everyone who has free health insurance which enables them to get free health care.  We will need twice as many doctors, hospitals, emergency rooms, etc. in order to care for everyone equally for free.  The availability of doctors and hospitals is one problem in much smaller countries who have universal health care.  The waiting list to see the doctors in those countries is oppressively long so quality of care decreases.

The current debate is over whether or not the government should pay more for health insurance for children.  The debate has soured into the idea that President Bush's veto denies health care to needy and sick children.  This is far from the truth.  The veto merely prevents the government (your and my tax dollars) from paying for their health insurance.  All of these children can get health care at clinics provided by state governments.  Many of these children already have health insurance on their own.  Most of the money that the Congress is going to use to pay for this 35 billion dollar program is going to come from the poor and middle class who have children on the current SCHIP program.  This is a bad idea because it does nothing to address the issue of the cost of health care.  The only point of this program is to pay for health insurance for these children regardless of lifestyle choices that might make them less healthy such as over eating.

Many people think that the solution to universal health care is Medicare for everyone.  That sounds great because Medicare is a very good program provided by the government.  I wish I could qualify for Medicare because I would have much better coverage than I do now at a lower cost.  However what people don't realize is that the government can not sustain the current Medicare program.  It costs too much.  Also, many doctors and hospitals are charging private insurance companies more to offset the cost of treating Medicare patients much like they do for patients who don't pay.  The Medicare reimbursement rates are much lower than private health insurance companies pay.  Also there are new Medicare Advantage programs where the government is paying insurance companies to get people to opt out of their Medicare coverage and into private coverage that is equivalent or better than Medicare benefits.

The cost of health care is a problem in this country.  Providing health insurance to everyone through tax dollars is no solution to the rising cost of health care.  There are simple solutions that would be difficult to pass.  But they would address the problems instead of merely providing government handouts that pass the buck to future generations.  Three solutions would be prescription drug cost reforms, medical malpractice lawsuit reform, and a non-profit model for health insurance companies.  These solutions would fall far short of the call for the government paying for everyone's health insurance.  But these solutions would actually do something to address the problem rather than postpone the problems for future generations.  These solutions would likely cut the cost of health care in half in this country.  My message to the congress on these 'government provided health insurance for all' debates would be 'It's the COST of health care, stupid'.

Recently the House of Representatives and Senate passed a bill about the federally funded children's health care program SCHIP.  This program was designed to pay for health care of people who make too much money to qualify for medicare, but 'not enough' to pay for health insurance themselves.  The President is going to veto this bill because it will tax the poor and give to the rich.  Since the Democrats knew the President was going to veto this bill, over the weekend, they had a 12 year old sick boy deliver their radio address to the nation.  I thought that the Taliban and Al Qaeda were the only organizations who actively hid behind children for propaganda purposes.  Apparently the Democrats think using kids for propaganda is a good idea too (recall the child of the illegal alien paraded around recently).

Since Congress now follows 'paygo' rules, they have to figure out how they are going to pay for legislation before they can pass anything.  Generally you would think that they would look at cutting some of the fat that would have to be in the budget for less important programs in order to afford something important.  The Democrats would likely think that the military would be the best place to cut funds (as Clinton did and will if she is elected president).  However Congress chose the age old boogie man of 'Big Tobacco' to foot the bill for this new program.  Congress will include a 61 cent per pack of cigarettes federal tax to pay for this bill.  I assume they figure that nobody will complain if it is a tax on evil awful bad tobacco.

However this idea misses the point.  It isn't the 'Big Tobacco' companies that are going to pay for this program.  It is the people who tend to smoke more than others.  The people who smoke more than others would be the poor and middle class working American.  This tax does not discriminate based on how much money you make.  Even if you don't make enough money to pay any federal income tax, this tax will cost you.  Generally the well off Americans don't smoke so they won't feel a tax increase at all here.  If someone is a pack-a-day smoker, this tax will cost them $222.65 per year more no matter how much money they make.

Some people might argue that it might be incentive for them to quit smoking so their health would be better.  I appreciate good intentions better than anyone, but do we really need the government coercing us through taxes like this?  It is as though the government thinks the jizya system (in Muslim sharia law where non-muslims have to pay extra taxes to show themselves 'subdued') is a good idea for certain parts of society.  Another flaw in the argument of 'well if they quit then they won't cost as much for health care' is that once people begin to quit, the 'paygo' model breaks down.  Then they'll have to find the money somewhere else.  Once they successfully make everyone quit smoking, who will be paying the 61 cent tax to provide the benefits for this 35 billion dollar program (government entitlement from tax dollars)?

If we are going down this road to where congress taxes things which are deemed harmful to the personal health of Americans, we can expect to see taxes on motorcycle riding, sky diving, doughnuts, fried food, candy, fat people and many other things that people do which are bad for the health.  Another harmful American activity that is just as destructive health wise as smoking is homosexual activity.  Being homosexual has as high a risk of obtaining AIDS as smoking has a risk of obtaining lung cancer.  So I guess we'll see the day when congress imposes a 'gay tax' to pay for the health care of people who already have health insurance.  I'm not holding my breath for that tax.

If you take the 12 year old sick boy out of the argument FOR this bill, it begins to unravel when you study it.

The portion of the bill that the President opposes is the increase in this bill.  President Bush does not want to get rid of this program for kids who NEED it.  He wants to sign the extension of the current program.  This new addition to the program that congress wants to pay for with a tobacco tax will include people who make up to 80,000 dollars a year in income and already have health insurance.  This new bill will not work to cover people who are uninsured because they can't afford it.  It will cover people who can afford it, but no longer will have to because the smokers will pay for their health care.

The Republican leadership needs to find a family currently on the SCHIP program with a mother and father who smokes a pack a day ($222.65 x 2 = $445.30/year).  I can imagine they have one child on the SCHIP program because they can't afford health insurance (though they can afford cigarettes).  Then the Republicans need to bring out a non-smoking family who have insurance already and explain to the country that the family already on the program will pay for the insurance for the family that does not need the coverage BECAUSE OF THE DEMOCRATS IN CONGRESS.

People downplayed the Bush tax cut a few years ago because it 'only' returned a maximum of $300 to every American citizen.  The Democrats want to repeal that and capital gains tax cuts as well.  However, they don't see any problem with raising taxes on this family who needs the SCHIP program by $445.30/year to pay for the health care of someone who does not need coverage.  It won't help to get the uninsured covered.  I bet people who have to pay this tax will think this tax increase is large.  It is especially large on those people who are poor and middle class America.

This congress is working as hard as they can to take as much of your money as they can.  I hope we can find someone in congress willing to explain to their colleagues that tax money is not THEIR money.  Tax money is OUR money.  The more tax money that congress takes, the more tax money congress will waste.  Federal taxes are supposed to pay for important things that the capitalistic economy can't take care of (ESPECIALLY DEFENSE - unless they want lots of independent militias in the country contracted out for wealthy people).

This program does nothing to address the COST of health care (which is the problem).  This program merely throws more money at the problem and makes the government's role bigger.  This 'tax and spend' mentality is problematic.  And the use of sick children to promote it is abominable.