Friday, July 17, 2009

National Health Insurance

About 50 million Americans have no health insurance, which is why legislation now pending in Congress calls for establishment of a federal health insurance program. To see why this is a good idea, we must take a look at the uninsured:

A. The well-off
This group includes self-employed professionals, successful businessmen, and early retirees. These people could afford to buy private insurance, but would rather pay their own medical bills than deal with insurance claims. If all the uninsured were in this category, there would be no need for national health insurance.

B. Healthy Young Adults and Their Children
Since insurance companies compete for the business of this low-risk group, premiums would be relatively low. Yet, most of them are on tight budgets, and many would prefer to take their chances of getting sick or injured, rather than pay for insurance every month. Unlike Group A above, most of these people have little or no savings, so that when they do incur big medical bills (and every year some do), they declare bankruptcy. In fact, medical bills are the biggest single cause of personal bankruptcy in the US. When this happens, hospitals and clinics write-off the losses, and try to pass the costs along to other patients or to the government. This way, the burden of paying for their health care falls on others rather than themselves.

C. The Sick
Since there is no way to make any money insuring this group, health insurance companies typically reject applications from people with long-term illnesses ("pre-existing conditions.") Even those who qualify for Social Security Disability benefits must wait two years to qualify for early Medicare. If you are too prosperous for Medicaid, too young for Medicare and too sick for private health insurance, you will be uninsured.

Group C needs government health insurance more than anyone else. But if enrollment is purely voluntary, only sick people will sign-up for it. In this case, either the plan will cost the taxpayers a huge amount, or the premiums will be so high that sick people cannot afford them. Making insurance coverage mandatory is the only way to get members of Groups A and B above to enroll; their premiums will not only pay for their own medical bills, but also spread the costs of treating the chronically ill over a large enough population so that the costs can be affordable for all. The State of Massachusetts has done this, and today about 97% of state residents have health insurance.

Free-market advocates object to the government competing with private insurers, but the fact is that the fifty million uninsured either cannot or will not buy private insurance anyway. However, if the government- plan premiums are lower than those of private insurers (and they probably will be), the government plan will take some current customers away from private insurers. This is bad for these insurers, and may even drive some out of business, but it is good for the individuals and businesses that will save on their health-care costs. This saving can make American manufacturers more competitive in world markets, since most industrialized countries have some form of government health insurance, and this cost is not built-in to the costs of their products.

Libertarians will also bemoan the loss of personal freedom that mandatory health insurance will entail. But Americans are already required by law to "buy-into" Medicare and Social Security, and these programs would not have been successful if enrollment had been voluntary.

If we want all sick and injured people to have medical care available, it is only fair that everyone pay their share for this care. That is why I support mandatory health insurance for all Americans, with a government-sponsored option.

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Sunday, July 12, 2009

What Obama Should Write Assad

Hon. Bashir Assad
President of Syria
via US Embassy-Damascus

Dear Mr President:
Thank you for your kind invitation to visit your country this year. However, I have concluded that a state visit to Syria must await the resolution of several important issues between your country and ours.
As you know, the United States supports a two-state solution to the Israeli-Palestinian conflict. Unfortunately, some of the policies and actions of your government are making the achievement of this goal extremely difficult. Most salient is Syrian support for Hamas, which operates openly in Damascus, and receives major supplies of Iranian arms through Syria, including medium and long-range rockets. During my 2008 visit to Sderot, Israel, I vehemently condemned firing these rockets at civilian targets in Israel, particularly Sderot. Israeli co-operation in establishing a Palestinian state is possible only if Israel is secure from attacks such as these.
In addition, your government has been supplying rockets and other arms to Hezbollah, which deliberately provoked a war between Lebanon and Israel in 2006 by crossing an internationally-recognized border to capture Israeli soldiers. Although a cease-fire is in effect, the soldiers have not been repatriated. We are also concerned about the role of Hezbollah in fomenting violence within Lebanon.
The United States supports bi-lateral negotiations aimed at restoring Syrian sovereignty over the Golan Heights. We consider the 1977 settlement between Israel and Egypt a model for attaining this goal. But progress on this issue, too, is not possible while Syria continues to support Hezbollah, whose actions continue to threaten the security of Israel.
We believe that peace and stability in the Middle East are in the interests of your country, as well as that of other states in the region. Accordingly, I have instructed the Department of State to work with your Foreign Ministry to seek areas of common interest between our two countries. However, a significant change in Syrian policy regarding both Hamas and Hezbollah is essential if Syria is to play a positive role in securing a durable and just peace in the Middle East.
If Syria will support our peace efforts with both words and deeds, the United States will co-operate with you. In that case, a presidential visit to your country before the end of my current term in office will be possible.
Aleikum es-salaam.

Yours truly,
/s/ Barack Hussein Obama

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