The principal contribution of this technical proposal to the United States Congress and The White House is to structurally build-in the current de facto health care cost shifting de jure into the private health insurance market by making health care legislation a pure public good to significantly lower the cost of health care to government.
This paper has benefited from useful concurring analysis on the various factors which make up the cost of health care in the Journal of the American Medical Association (JAMA) by Victor Fuchs of Stanford University, a past president of the American Economic Association (AEA).
I am, however, dissenting below with the analysis of Victor Fuchs in his conclusion that health care cost shifting does not reduce health care costs.
Structurally legitimizing the shift in health care costs through the private health insurance industry progressively up the income distribution, in fact, reduces health care costs because it creates a disincentive for the more influential and higher income interest groups to pay higher health care costs for the same services the rest are also provided. These groups are then expected to act in their own self-interest to alter the cost structure of the health care industry as a whole.
Arthur Brooks @arthurbrooks
Incentives matter, including in Medicare: http://ow.ly/d2ugO
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5m 1776 @1_776
@arthurbrooks I am lobbying @whitehouse, Congress to shift health costs to private insurance price structure across income quintiles.
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4m 1776 @1_776
@arthurbrooks We will then have no need for Medicare and Medicaid or higher taxes or health insurance exchanges or Obamacare for that matter
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2:46 PM – 17 Aug 12 via web · Details
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Speaker John Boehner’s House of Representatives quite appropriately repealed Obamacare. The repeal of the the law of the land according to the United States Supreme Court – Affordable Care Act (ACA) – cannot, however, be fully justified unless it is replaced.
ACA cannot be afforded by the United States of America. If it cannot be afforded by the government, it cannot be afforded by the people. Health care costs of the United States government are expected to rise by 2032 and after, to pay for boomer retirements and the rising ranks of the American poor, to the current size of the entire federal budget or about $4 trillion with GDP not expected to rise as fast. The federal budget, if the status quo continues, is going to be about $8 trillion out of an expected GDP of about $25 trillion by 2032 or about 32% of national income, cumulatively adding to the indebtedness of the United States government which currently stands at $60 trillion in obligations, on and off-balance sheet, of the United States Treasury: $1 of national income is produced by incurring $4 of national debt. This ratio, again, should the status quo continue, is not expected to change in any time horizon.
The Obama administration is proposing raising taxes on the top 20% to pay for the bottom 80% and for instituting health insurance exchanges for those who cannot afford health insurance in the private markets.
Cost of and to government to pay for a non-pure public good is the problem with American health care, not its quality.
The Congress, in a bi-partisan manner, can indeed build on Speaker Boehner’s repeal of Obamacare in the House if the United States Senate introduces a bill, preferably in this Congress before January 20, 2013, to completely shift health care costs from the government to the private sector by requiring insurance companies to provide price quotes based on the applicant’s income for the same health care services across all income quintiles in compliance with the legislated principles in Obamacare.
The top 20% can afford to pay more in health insurance to carry the rest of America, progressively down the income ladder.
Medicare and Medicaid will not be necessary nor will health insurance exchanges. The federal budget will eliminate at least $500 billion in annual health care expenditures which can makeup for the shortfall in social security by augmenting increase in the Old-Age, Survivors, and Disability Insurance (OASDI) payroll tax revenues by lifting the annual income ceiling on social insurance taxation to $500,000.
The poorest of the American poor will get free health care for any ailment from any insurance company and from any pertinent doctor, general or specialized, including for terminal ailments.
“I WILL NOT USE my medical knowledge to violate human rights and civil liberties, even under threat; I MAKE THESE PROMISES solemnly, freely and upon my honor.”
Oath to Hippocrates, 1948 to Now, Geneva.