AMA: Buy insurance or face tax penalty

The Australian government already does exactly that

Hoping to prod an estimated five million uninsured Americans into buying health insurance, the American Medical Association Tuesday backed a tax penalty for individuals and families who make enough to buy medical coverage but choose not to. The AMA's policymaking House of Delegates vote in favor of what it called "individual responsibility" comes as state and federal lawmakers are weighing similar ideas in the form of legislation in Congress and statehouses across the country.

In the past, the .. AMA has shied away from government mandates as a way to provide health insurance coverage for more Americans. In this instance, the group acknowledged Tuesday at a press briefing that its support of tax penalties to encourage people to buy coverage would be a "significant shift" in the organization's thinking on matters of covering the uninsured. The vote at the group's meeting in Chicago this week means the AMA will put its lobbying clout behind state and federal initiatives that advocate a tax penalty for uninsured individuals making $49,000 or more a year and for families of four who make $100,000 or more if they do not buy medical coverage.

Under the AMA plan, individuals and families earning greater than 500 percent of the federal poverty level "would be required to obtain a minimum of catastrophic health care" coverage. The AMA would not specify the amount or specific kind of plan people should buy.

It's the latest of a growing number of legislative and political proposals that would require people to have coverage. In Massachusetts, Gov. Mitt Romney signed legislation two months ago that made his state the first to require state residents to have health insurance just as drivers must have auto insurance.

Although Romney's proposal is financed through hundreds of millions of dollars in assessments on insurers, penalties paid by employers and state Medicaid funds, the AMA's proposal is devoid of details. AMA officials did not offer a specific amount of tax penalties that would be levied against the uninsured. "This is our policy that would be used at the federal level to get uninsured people covered," said Dr. Ardis Hoven, a member of the AMA's board of trustees and an infectious disease specialist from Lexington, Ky. "I'd like to think of this as the carrot."

But the the plan's stick would most likely be wielded against those making a living wage--many of them younger individuals and families. Hoven and AMA officials said "young, relatively healthy individuals" account for most of the 11 percent, or about 5 million, of the nation's more than 45 million uninsured Americans. Passage of the measure by the AMA's House of Delegates was not without opposition among doctors and critics of such proposals in Washington. On a voice vote, AMA officials said it passed by a "large majority" of its 544-member House of Delegates. A specific vote count was not taken.

Critics of the AMA's move say the doctors are merely worried about their own bottom lines. "The AMA has a long history of sacrificing consumer freedom when physician incomes are threatened and they are doing that with this tax increase," said Michael Cannon, director of health policy studies for the libertarian Cato Institute in Washington. "They are trying to crack down on nurse practitioners because they don't like competition and I have not heard of any resolutions they have offered to make the health-care system more competitive, like opening your office longer or lowering your prices. These would be consumer friendly responses to competition."

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Socialized medicine is still a threat to freedom

We hear a lot from some legislators working hard to bring us peace in the world, jobs back to the U.S, higher wages for everyone, an end to terrorism and the health care we deserve. Of course, you know that health care is defined as somebody else paying for it and "free" health care is bound to cost more than anyone can afford.

When Hillary and her cronies failed to take over our health care system in 1993, they never gave up. They have been inching toward universality ever since. During that debate in 1993, we heard a lot about the Canadian Health Care system and how that should be our model. According to later articles in The New York Times and The Washington Times, the wonderful Canadian Health Care system developed serious problems.

Long waits are customary in Canada and sometimes death intervenes while awaiting the care one needs. In Toronto, overcrowding one day forced hospitals to turn away ambulances at 23 of the cities 25 hospitals. The New York Times said that a Toronto man distraught over his sick infant's condition, took a doctor hostage at gunpoint to avoid the long wait to see a physician. The police arrived and shot the man to death. No word on whether or not the infant received the care his father was seeking for him.

A 58-year-old woman who had been waiting for open-heart surgery for five years, spent the night prior to her surgery on a gurney in the hallway of the hospital. 66 other patients, spending the night in the same hallway joined her. In Vancouver, some reports are that delays are so serious that 20% of heart attack patients who need treatment in 15 minutes, are forced to wait one hour or longer. Many Canadian doctors are urging their patients to come to the United States for treatment. You don't suppose we Americans will be forced to pay for Canadians health care too, do you? Just asking.

In Canada, however, there are no problems or long waits for dental care or veterinary care. You guessed it. Both of these services have not been taken over by government and allow for private treatment. People who are required to wait for long periods of time to receive MRIs, are going to their local vet clinic in order to get them right away. In Canada, one can receive treatment for a toothache much faster than for cancer. The demand for free health care has outweighed the supply. Unable to reduce the demand, the suppliers have had to reduce the services. Results ---- long waits. It's not rocket science, folks. Lets call it The Law of Supply and Demand 101.

Remember when you hear someone say, "everyone deserves health care." Where do you draw the line? If you fall into that trap, then doesn't everyone deserve food, shelter, clothing, perhaps a new car? Our healthcare system is the best in the world. But it will eventually collapse under its own weight. It doesn't have to be this way. Most insurance covers everything from doctor visits to heart transplants and everything in between. Therein, lies the problem.

What I want is low premiums and coverage for catastrophic illness. I'll pay my own doctor visits and routine costs, thank you very much.

This started me thinking. My homeowners insurance and auto insurance is such a plan. When my plumbing goes out, I call the plumber and I pay him. I do the same with the HVAC. But if a fire or tornado comes through, I'm covered. It's the same with my car. I pay for oil changes, brakes, transmission repair, etc. I even replaced my engine a few years ago and never depended upon my insurance company. Imagine that. But, once again, if an accident happens, my insurance is there. I'm in "good hands."

Why can't health insurance be the same? Companies always pass through the cost of doing business. When you lower the cost to the consumer..voila.more is consumed. Low co pays for doctor visits equals more doctor visits and someone else paying for it (insurance companies). Then insurance companies recoup the costs in increased premiums. Around and around we go.

We haven't even mentioned the additional cost to the healthcare industry by lawsuits and skyrocketing malpractice insurance costs. Many communities across the country have no physicians because of this very real problem. We'll have to save that for another day. Just remember nothing is free. So when it's "free", we certainly can't afford it.

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For greatest efficiency, lowest cost and maximum choice, ALL hospitals and health insurance schemes should be privately owned and run -- with government-paid vouchers for the very poor and minimal regulation. Both Australia and Sweden have large private sector health systems with government reimbursement for privately-provided services so can a purely private system with some level of government reimbursement or insurance for the poor be so hard to do?

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