Improving on the Bush health plan

President Bush has finally come up with a truly good idea: a plan to restore the market for healthcare in this country, a plan that reduces moral hazards and the subsidies for wage slavery. Alas, he waited until his own party lost its majority in both the House and Senate before putting forth the plan. So, is the plan dead on arrival? Will the Democrats hold out for a socialized healthcare system, giving us all the efficiency and performance of the public school system?

Message to Democrats: please don't hold out. But do feel free to put your own imprint on the plan. You can make it more progressive, while making it simpler and more effective.

How? Replace Bush's $7500 tax deduction with a tax credit - say $2500. This is obviously simpler than a tax deduction. It is also more progressive, since the poor get just as much benefit as the rich.

I could hear some right-wingers whining as I wrote that last sentence, "Not another wealth transfer to the poor! We can't afford to give every insured person a $2500 tax credit." Indeed, such a tax credit would cost the IRS more money. But it might not cost the government much more. It might even save money. What is lost as tax credit would be at least partially made up for in less welfare payments. If an uninsured well off person gets sick, there are many assets to tap before that person resorts to government aid. The government gains little by making sure such people have health insurance. On the other hand, if a low income person gets very sick, it isn't long before that person is resorting to government aid or abusing the emergency room.

Why do we grant a tax break for the well off to buy health insurance, anyway? The well off have far more to lose if they get seriously ill without healthcare coverage. If you have nothing, you can simply declare bankruptcy and go on the dole. If you have home equity or money in your accounts, this is a major financial loss. Thus, we can expect the well off to buy at least catastrophic coverage even if there was no tax benefit.

But suppose the well off decided to self-insure. That would be better! We would have people shopping for major treatments using their own money. The market for serious care would improve greatly. If anything, it would be in society's interest to penalize wealthy people for buying health insurance.

It's the uninsured lower classes that gum up the system. They are the ones who cannot pay their bills when the bills get high, which drives up overall expenses for doctors and hospitals - and ultimately for paying customers. If we are going to use the tax code to encourage the buying of health insurance, we should target the lower classes as much as possible. A tax credit is a big step in this direction, and is simple to boot.

Source





Second lung cancer drug not made available to NHS patients

Another new cancer drug has been rejected by the Government's value-for-money watchdog. Roche, the healthcare company that makes Tarceva, used to treat lung cancer, said that it would appeal against the decision by the National Institute for Health and Clinical Excellence (NICE), which it said was perverse and disappointing. It claimed that the evidence Roche presented had been assessed "neither fairly nor appropriately" by NICE. Tarceva has been approved for use in Scotland since June 2006.

The NICE guidance said it did not believe that Tarceva (erlotinib) was the best use of resources in the care of sufferers of non-small cell lung cancer. It said that the drug would be reviewed again next year. Andrew Dillon, chief executive, said: "After considering all the evidence available, as well as the comments received during consultation on the earlier draft, the independent appraisal committee concluded that erlotinib is not an effective use of NHS resources when compared with either docetaxel or best supportive care. The committee was also concerned that erlotinib would not be as effective as the existing standard treatment, docetaxel.

"However, given the rapidly changing evidence base for erlotinib, the committee advised that the guidance should be considered for early review. Therefore this guidance will be reviewed in February 2008. "The committee also recommends that further research be undertaken into subgroups for whom erlotinib may provide greater benefit." Subject to an appeal being received, final guidance to the NHS is expected in April.

Mike Unger, chief executive of the Roy Castle Lung Cancer Foundation, said: "We are obviously severely disappointed and disillusioned with NICE's decision not to approve Tarceva purely on economic grounds. It's the second blow that NICE has dealt to lung cancer patients in a month, following the announcement to decline Alimta - so there are now very few options left for lung cancer patients."

Mr Unger added: "This leaves massive inconsistencies in treatment options for lung cancer patients in the UK. It's absurd that Tarceva is available to certain patients in Scotland, but not the rest of the UK. Tarceva is used as a standard treatment in many other European countries and this should be the case here." Tarceva has been hailed by the medical profession as a big advance in a neglected area of cancer.

Source

***************************

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?

For more postings from me, see TONGUE-TIED, GREENIE WATCH, POLITICAL CORRECTNESS WATCH, FOOD & HEALTH SKEPTIC, GUN WATCH, EDUCATION WATCH, AUSTRALIAN POLITICS, DISSECTING LEFTISM, IMMIGRATION WATCH and EYE ON BRITAIN. My Home Pages are here or here or here. Email me (John Ray) here. For times when blogger.com is playing up, there are mirrors of this site here and here.

***************************