Ethan: Ever since Gov. Paul LePage donned a blue tie in his State of the State address as a gesture of goodwill toward Democrats, he seems to have developed a big government streak with all this new borrowing for roads, prisons and hospitals. But the biggest is his about face on Obamacare and his openness to accept federal dollars to expand our health care roles. Should I get him a change of party affiliation card?
Phil: Wouldn’t it be interesting to watch the media covering Rep. Chellie Pingree, D-1st District; Rep. Mike Michaud, D-2nd District; and Senate President Justin Alfond, D-Portland, welcoming LePage into the party? Back to reality. I’m trying to figure out why he would want to put, what, 30,000 or so more people on Maine’s welfare program? How are we going to pay for this?
Ethan: 30,000? More like 55,000. And don’t worry, Obamacare pays for 100 percent for three years and ratchets down to 90 after that. LePage wants 100 percent for 10 years, though. Amazing how a little money can turn even the grinchiest heart a couple sizes bigger.
Phil: It’s so true. Offer free stuff, and people will flock to you at the ballot box. Problem is, Maine already can’t afford the free stuff it gives to eligible people. How can we afford to add 55,000 more?
Ethan: How can we afford not to? We pay for them one way or the other. This way is cheaper because we cover preventative care instead of simply emergency. My sense is LePage sees this and realizes he should seize the moment.
Phil: You assume welfare recipients will choose preventative health behaviors. Evidence shows current recipients use the emergency room as their primary care provider. Indeed we must change this mindset.
Ethan: Certainly we must educate everyone about the healthiest ways to use our health-care system. It is not just the poor with unhealthy habits.
Phil: So if LePage is flocking to Obama for the free health care, where is Obama getting the money to pay health-care providers?
Ethan: Again, you are assuming we don’t pay for it now. But of course we do in the form of higher premiums, deductibles, co-pays, etc. The system gets its money. The decision we have to make is whether we pay upfront in a more efficient manner. Or do it the same crazy way we have in the past.
Phil: Many readers will ask if you understand that those of us who pay for our own health insurance now are also paying for those who get it free through our taxes.
Ethan: That’s the point. You (and I) are already paying for the health care of others, except we’re doing it in the most inefficient way possible.
Phil: How can you proclaim that government can make health care more efficient when it already runs Medicaid and Medicare? Neither has lowered costs (my premiums are still climbing even after Obama said Obamacare would bend the cost curve) or changed lifestyle choices by welfare recipients. All the while we are still borrowing more than $3 billion dollars a day now to run D.C.
Ethan: Our current system is the most expensive per capita in the industrialized world. According to the Washington Post: “In 2009, Americans spent $7,960 per person on health care. Our neighbors in Canada spent $4,808. The Germans spent $4,218. The French, $3,978.” And yet we have the fewest insured! If we had the cost curves of these countries, (and remember these systems are controlled almost entirely by their governments) our deficits would disappear. Maybe it is time to try something different and insure everyone.
Phil: I’m not convinced that my taxes, or my health-insurance premiums, are going to come down using your rationale. Let’s really try something different by giving everyone a Health Savings Account. For those who need welfare, we can create subsidies. Then we unleash hundreds of millions of cost-conscious consumers who can choose their own health-care providers. And if they don’t use it all, when they pass on they can will it to whomever they wish. Why wouldn’t that work?
Ethan: I am certainly in favor of more consumer choice and pressure in health care, but, unfortunately, deciding which cardiac surgeon to use when you are having a heart attack just isn’t the same as choosing the blue Ford over the red Toyota.
Phil: That’s what I would call a reason to seek the nearest emergency room. No price comparison needed. And, by the way, a proper role for a regulator to assure monopolistic or price gouging is not present. Meanwhile, however, premiums keep rising; there’s no possible avenue for ideas like mine to be implemented; a new government health-care bureaucracy is just beginning to multiply; and America’s debts keep rising. Remind me again why LePage is considering “free health care” from Washington?
Ethan: Because it appears “the Grinch’s small heart grew three sizes that day” as he finally heard the people of Whoville, Maine, plead for health care. And, as a businessman, he understands that more people covered is fiscally responsible. Are you saying you would not accept funding to insure 55,000 more Maine people if you were governor?
Phil: I’m saying someone in D.C. needs to show me how “we the people” are going to pay for all this free stuff so we don’t end up like Portugal, Ireland, Greece, Spain and now Cyprus.
Ethan: Well, we’d actually love to have their health-care systems…
Phil: Really, can’t someone do basic math rather than taking the money for their state, leaving us, the same taxpayers, dealing with a crisis? Hello, can anyone hear me? It’s we the people out here.
Ethan: The governor is in Jamaica. Maybe he’ll hear you when he returns.