Distilling the Resistance To Its Essence

This entire debate on health care can boil down to the following:

What's in it for me.

For the 85% of Americans who have insurance, they want to know two basic things - will they get to keep their existing coverage, and how much more in taxes are they going to be hit with.

For the 15%, how much will it cost?

So far, the President has done nothing to explain how much this will cost - and that's the key factor in all this. He can't come up with a realistic figure unless he admits to higher taxes.

And as for just how many people are uninsured, this site claims 46 million under 65 are uninsured, which with a population size of 300 million means that 85% of all Americans are insured, either through Medicare, Medicaid (for those over 65), SCHIP or similar government insurance programs for poor and/or children, or private insurance. This multitrillion dollar overhaul would try to increase the insurance coverage to the remaining 15%.

Most of those who are uninsured are those who no longer get covered by their parents (18/21 yo cutoff) and haven't found full time jobs that include health insurance coverage. There's no breakdown of how many of that 46 million are illegal aliens, though there is a figure that the number of Hispanics who are uninsured, which is significantly higher than the percentage of uninsured among the general population.

The 85% want to know what's in this overhaul for them. They're the ones most likely to vote, and will be most likely to bear the burden of any cost shifting.

Flowing from that core question are additional questions, that explain how this program will supposedly work, what it will cost, and how it will change existing health care delivery.

These questions include the following:

1. How is it that you can put together a health care bill without knowing how to pay for it? As admitted by Members of Congress (Ben Cardin), no one knows how this will all be paid for. Wouldn't it make more sense to know first where the money comes from and design a system than try and throw everything and the kitchen sink and realize later you have to raise taxes?
2. Where are you drawing the line on the income level of those who will see an increase in their taxes as a result of this plan?
3. Is there a penalty for people opting not to obtain health insurance, and what is the thinking behind limiting personal choice in that fashion. After all, if that person doesn't want to pay for the health insurance, and is penalized, that's a back-door tax.
4. How much will this realistically cost, given that every other government program has gone staggeringly over cost projections?
5. How long will I have under my existing program until the government health care forces me into the public plan?
6. Why should public health care improve quality when we've got examples from other countries where care becomes far more restrictive and quality of care is substandard in US government health care programs like the Indian Health Service and the Veterans Administration?
7. Cash for clunkers anyone? If you can't manage a $1 (now $3) billion program adequately, how can anyone expect the government to do a better job with a significant portion of the US GNP. No one understood how many vehicles were in the pipeline for rebates or where the balance stood. The same can apply to the billions utilized under TARP. How can you manage costs when the government can't even keep track of the money on its books.
8. One of the big selling points you've made is that this will be cost effective and save money. How exactly can you make that argument when not even the Congressional Budget Office buys that argument?
9. 9) Medicare and Medicaid are prime examples of government health care programs run amok. They're tens of billions of dollars in debt, and yet this program would apparently expand both significantly, all while further constraining the charges - something has to give.
10. The final question goes to motive. What is the specific reasoning behind your demand that health care reform had to be completed by August recess? After all, access to health care isn't ending at that (or any point), and we've been living with this system for decades. The demand to have this change practically overnight, with limited debate - and without reading (as admitted by many members of Congress) suggests that the Administration is less than honest in what your ultimate aim is here.

Curing the health care system doesn't require killing the patient (the health care system). Yet, that's precisely what it looks like to many people who want to know why the Administration is pushing this as a crisis when few people are devoid of health care options.

President Obama has clearly stated that he will not sign any bill that will add to the deficit. Really? I'd like to see how he can keep that particular promise when he can't adequately explain how this proposal will be paid for in the current year, let alone adequately provide for funding in future years. It's simply unknowable, but based on prior government health care initiatives, one should take any claims of cost savings and/or cost containment with a grain of salt.

After all, we have clear examples of how the US government has failed to properly account for health care costs. Take the prescription drug program for example. The Bush Administration pushed through that program, and understated the costs by half.

If that's any guide, we're talking about hundreds of billions of dollars in understated costs (on a trillion dollar program) at a time when we simply cannot afford any such thing.