You should do a google search on Canadian medical treatment wait times.

The vaunted universal health care system you desire consistently treats patients worse and makes them wait longer for critical diagnositc tests and treatment then the US system does.

Your faith that the government could do things cheaper and better is touching. It also indicates you have never had first hand experience with how government programs actually work once implemented.

President Bush intends to use the State of the Union address on Tuesday to battle the rising cost of...

The fact that many of these programs already exist underscores my point. We, as a society, have concluded that it is better to pay for schoolchildren to have their vision checked, because that heads off the enormous social problem of ill-educated people with bad eyesight. And we've decided that immunization is important enough to socialize. So all we need to do is expand our thinking a bit to encompass all of the various kinds of health care which could give us a positive socioeconomic return on investment.

Throwing an enormous amount of money at health insurance firms is not exactly out-of-the-box thinking.

If I understand this, you would have the health care costs provided by your employer (and I assume pension plan) taxed. But everyone could deduct a certain level of health care costs from their taxes no matter who payed. Those who are paying their own health insurance get a break and those who have plans costing in excess of the deduction would see a slightly higher tax rate.

One thing I would have liked to see is how an estimate on how many have "gold plated" plans and how many have health insurance that they can't deduct (e.g. own your own business and you may be able to deduct it that way).

On the insulation vs insurance, I think a step would be to differentiate between routine and extraordinary health expenses. A baby that goes into intensive care would be pretty hard for any one to deal without the cost having been spread via insurance. And lawyers like Edwards have helped run up the cost of 'routine' birth with extra tests/procedures to ward off lawsuits. My health insurance specifically excludes pregnancy from the coverage. If I want to have that covered, I have to pay a larger premium. I can live with that.

Jeffb,

Perhaps you should take a look at Mass example where their "free" health care estimates went up by about 1/3 as they start dealing with real world situations. As far as some of the things on your list, child immunizations are required to go to school in our state and "free" ones are provided by county health departments (actually they are paid for by tax payers). Go into any emergency room and they will set your broken bone in our state. If you can't pay, the hospital gets the money by overcharging other patients or a local hospital tax on property. About the only thing that Texas doesn't have on your list is the free dental/vision. But then, many health insurance plans don't have those. Are the current ways of delivering the 'free' service the most efficient? No, but the way things are set up you have to really need the 'free' service before you go that route.

The Massachusetts and California plans seem to be mostly targetting universal coverage and it will be interesting to see how they perform. I suspect they will have the perverse effect of increasing costs.

That's almost inevitable: if you have more people consuming more services without an expansion of the supply of services prices will rise. I presume that the hope is that by enabling people to use relatively less expensive pediatricians and internists as primary care physicians rather than relatively more expensive emergency rooms it will tend to control costs.

That was the idea behind TennCare and it succeeded in that: people covered under the plan used emergency rooms less. However, Tennessee has kicked the system out because costs were out of control.

Single payer is (to my mind) a meat-axe approach to achieve cost control by cutting insurance companies out of the picture. It's a one-off and can only achieve a 10-15% reduction in costs best case. At the present rate of increase that savings will be absorbed in a couple of years. That's not enough of a savings to stave off the meltdown that's ahead of us.

Practically nobody is pitching a BNH-style program. When people talk about an emerging consensus on healthcare this isn't it.

So why the vehemence? I can only guess that there's an alliance among employers who want to get employee and retiree healthcare costs off their backs, folks who want universal coverage for “social justice” reasons, folks who believe that single payer will solve more problems than it actually will, and folks who want a BNH-style system for reasons I won't even guess at.

The goals of these groups are so different I can't imagine the alliance being too durable.