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Brooks Wilson's Economics Blog: More on Rationing Health Care

Wednesday, February 17, 2010

More on Rationing Health Care

Economics is the study of how individuals through markets or acting collectively through government ration resources.  Everybody cannot have as much as they want, a point that is often missed in the health care debate and the main point of this post.  Before proceeding, I will review a critical moment in government regulation of health insurance.  The demand for health care can be divided into two components: the demand for routine, relatively low cost health maintenance and for extreme, low probability, high cost events such as care for heart surgery.  The two demand components are similar to other goods we insure like our homes or cars.  Consumers generally opt to pay for routine costs out of pocket and insure the high cost, low probability events.  Over time and largely because of government tax policy, the purchase of health care maintenance has been conflated with the purchase of insurance for extreme health care events.  The result has been a quirky, expensive health care system inherently subject to rising cost because it is not subject to market discipline.

As part of its effort to manage the economy during World War II the government passed the Stabilization Act of 1942 that imposed price and wage controls but authorized employers to offer health insurance as a fringe benefit exempt from wage controls.  Employee provided health insurance was granted tax preferences in 1943 by an administrative tax court ruling, and in 1954 by changes to the Internal Revenue Code; health insurance payments were made tax deductible for the employer and tax exempt for the employee.  Copayments remained fully taxable creating an economic incentive to have as many dollars of health care services paid through the employer provided plan.  To avoid taxes, routine health payments and insurance against catastrophic health events were covered by the same policy.  Health care users no longer observed nor cared to observe the full cost of medical treatment because that cost was largely independent of their out of pocket cost or insurance cost.  Payment to providers is made by the insurance company.  Economists frequently refer to this arrangement as third party payment.  The price of group insurance was based on the medical cost of the group, and because one employee's efforts to limit health care expenditures had virtually no impact on the overall medical care purchased by the group, no employee had incentive to economize.  Because they would be paid by the group, health care providers had incentive to provide the best quality care regardless of price.  Price became less important as a rationing mechanism and the health care more subject to rising cost.1,2

Abstracting away from problems caused by government tax policy, and with due apologies for goofy numbers, a well functioning market for health care would look something like Figure 1.  The demand curve shows the amount of health care that consumers are willing to purchase at each price, and the supply curve shows the amount of health care that providers are willing to sell at eat price.  The point at which the curves cross (E) is call equilibrium and it occurs at the price which the quantity that buyers wish to purchase is exactly equal to the amount producers are willing to sell.  There is no waste.  In this market, the equilibrium in which the equilibrium price is $48 per unit of health care and the equilibrium quantity of health care is 24 units.  Total medical expenditures are $1,152 ($48*24) and are depicted as the yellow area in the graph.

For the purpose of this analysis, I divided the market evenly into two types of households, low income and high income.  I have assumed that the only difference in demand between the two is income and that given the same level of income, demand would be identical.  This results in demand curves that converge at a zero price per unit.  Neither household is completely priced out of the market, but the market price of $48 per unit results in a much lower demand by low income households (6 units) than my high income households (18 units).  Low income households spent $288 for health care and high income families, $864.  Although the low income families buy health care at the margin, they may be priced out of some procedures or insurance markets or may believe that they can force others to pay for their healthcare (see "Democrats Ask, Can Health Care Bill Be Saved?" and "She Chose"). 

One proposal that is often mentioned is to allow people to buy health care regardless of the cost.  This proposal is untenable.  Again, the numbers are fanciful, but the direction of their movement is not.  At a zero price (point A on the Demand curve), 48 units of health care are demanded, more than 2.67 times more than upper income households would but for themselves if confronted directly by price.  At a zero price, no health care would be provided.  The price needed to induce health care providers to produce 48 units of health care is $96 per unit (point B on the Supply curve).  Taxpayers from both low and high income households would be obligated to pay $4,608, 4 times the bill that households paid under market conditions. 

The market uses prices to ration goods.  Some have suggested that government established committees could better allocate health care resources.  One solution might be to provide low income households with the amount of health care they would have purchased under market conditions if they had the same income as high income households.  This changes the shape of the demand curve causing more health care to be purchased at each price.  At eqhe Health care providers must be paid $2,048 to produce that level of care.  Assuming that low income households pay only $288, their original expenditure for health care, the remainder must come from high income families who are clearly much worse off.  Under market conditions, they paid $864, under government provision, they must pay $1,760.  The increase in their tax obligation is the same as a reduction in income.  Under market conditions, high income families would respond to the reduction of income by lowering health care purchases, but they are forced to buy more health care for themselves than they would freely choose.

Alternatively, the government could choose to provide the market quantity of 24 units of health care and divide it evenly between low and high income households with both receiving 12 units of health care.  The total health care bill would remain at $1,152 and might be divided as it was under market conditions with low income households paying $288 and high income households, $864.  Again, high income households are worse off.  Their health care expenditures are the same but they can only use 12 units of health care as opposed to 18. 

An easier and simpler approach would be to eliminate the tax advantage of employer provided plans.3  The government would be better off receiving more in taxes.  If health care providers do not respond to changing market incentives, low income families would be no worse off but high income families would be worse off due to the higher tax bill.  But people respond to incentives, even health care providers.  Under existing incentives, they provide high quality care regardless of cost, but under the new incentives, they would provide the highest quality care per dollar of consumer expenditure.  The quality of care would continue to improve but, with health care providers and consumers both more concerned about costs, at a much less explosive rate of cost growth.  It is the only scenario in which the government, health care providers, and all consumers could be made better off. 

1.  The high intensity use of labor is a second reason for the rising cost of health care.  See "Baumol, Cost Disease, and Health Care."

2.  See "Rationing Health Care" for a more descriptive analysis of how the third party payment system distorts market incentives.

3.  Alternatively, the government could extend the same tax benefits to private purchasers of health care that are now enjoyed by those who are covered through employer provided plans.  The improved incentives would be the same for buyers and sellers of health care but government deficits would grow.


  1. If high income households are made to cover the remaining costs of low income healthcare, eventually high income earners will start wondering why they worked hard for any degree they may hold, why they are working hard to make the big money, why they are being penalized for being a harder worker than a lot of the people in the United States. They will wonder these things because they will be paying for the health care of those that don't wish to further their education, or work harder to make more money. Is it really fair to penalize the harder working Americans by making them pay for the low income workers?
    I admit that not all of low income households don't try to better themselves, but a lot of them don't try to make their (low income earners) lives better. If someone doesn't try to make their lives better, why should someone else (high income earners) be forced to better their (low income earners) lives?

  2. I believe it is a noble cause to attempt to get health care for everyone, but would the cost be prohibitive for us to bear? I think in some way we are already providing health care for everyone. A hospital cannot refuse you emergency treatment at an emergency room. I have often wondered who pays for that medical care. The cost of medications, by setting price ceilings on those it hinders research. I know an engineer that works for designing new types of medications and drugs. She told me their budget for research was cut do to government regulation of their prices. So we have less research into possible life saving medicines for short term hits on the pocket book.
    Here is one I would like answered by our law makers. Let’s say they do figure out a way for everyone to have health care (not counting they find a way to pay for it and not bankrupt our country). I guess that would push the demand curve to the right, who knows how much. Well I guess it would be safe to say our supply of doctors, surgeons, specialists, and medical faculties are pretty inelastic right now. I can tell in micro sense from my stand point, there is already a shortage of doctors. My family is about to grow by one, yes that means a new child. Well we are having the child in FT Worth because when my wife went to make an appointment with the OBGYN in our area; they could not see her for a month, is that because that one doctor is swamped? I don’t know, but I caused us to move the birth out of the area (also the hospitals are better in FT Worth). Could we have got one here in Waco, I am sure. But my wife wanted this particular one that was reputable.
    My point being, I don’t think right now there is enough doctors to meet the explosion in new patients if everyone was to have health care. I think it would cause some shortages, lead to discrimination (people with private insurance will have preference over people with insurance underwritten by the government, let’s face it the government is inefficient by nature). It could also lead to black market for medical care (if one does not already exist).
    Anton Slavich

  3. Heidi Carroll21/2/10 4:50 PM

    Health care would just be contributing to the whole welfare fiasco if the high income people had to cover the low income people's health care. If we reward the slothfulness of unmotivated workers, they will always remain destitute. According to Ruby Payne, more often than not, poverty is passed on from generation to generation. Giving them money and health care, while everyone else is paying for it, makes it okay for them to slack off.

  4. Shannon Ferguson

    I think that instead of looking to fix health care through insurance we should be looking at publicly funding our health care system. Any way they go about it the higher income worker will have to take the bulk of responsibility for paying for it. If they want low income workers to pay there fair share they higher income people that are the bosses should pay a fair wage to the lower income people and they would have the money to do so. Either way the higher income people pay more so they should just except the responsibility.

  5. Health care is going to make the higher income people upset cause they will be paying for pretty much others people's health care as well as their own. Then eventually all the rich people will be poor from paying for health care that nobody will be able to pay it and everyone will need to be treated but they wont treat them and then everyone wont be happy.

    Jordan Kelley

  6. In either situation the upper class people are being penalized. They are having to pay for the lower class peoples health cost because they are not motivated enough to pay for their own health cost. If the upper class people have to pay for their own health cost and the lower class people's health cost everyone will end up broke then causing an even bigger problem.

    Kaydi Perry

  7. Laura Hurst21/2/10 11:22 PM

    It does seem quite far-fetched to force higher-income families to pay such an expense in taxes that will help lower-income families to have their own health insurance and it not benefit them at all, but then where does morality or compassion come in? Does it seem so wrong that the people of our country cannot work together to keep everyone healthy? The money we have comes from the same place, is used at the same kind of restaurants or department stores, and then given back out in yet another different cycle in the hands of just another American. This may seem far-fetched itself to some people, but why does money have to overcome civilization? We've become so selfish and it's terrifying to see how people react to the thought of spending money when it doesn't help them in any way, shape or form. Granted, I am pretty careful with my money myself, and I enjoy having it and try my best not to waste it, but it seems that the people in our country have lost the ability to work together anymore. Or at least help one another. This may seem a little extreme, and I can't honestly say I feel this way 100% because I understand the power money has, but this is another way of looking at it I guess. It will be hard and nearly impossible to please everyone in this situation, but keeping everyone as healthy as possible would be a better outcome, I think.

  8. rebecca kolosci22/2/10 10:10 PM

    There are a few reasons I feel we need to be careful on the healthcare issue. First of all, we shouldn't require higher income individuals to pay for health insurance for others. Second of all, if we have health care for all then the doctors and nurses and everyone in the health care field would have a lower income therefore why would the best of the best strive for those jobs. Do you really want just anyone working on you?
    Although I don't believe we should have health care for all I do believe we should have health care for all children. I believe in order to have a healthier nation we need to start with the children. Also, we shouldn't punish children for situations that are beyond their control.

  9. Rina Patel23/2/10 5:25 PM

    Overall, the higher income people are being penalized for being well educated, and for making a good living. By paying for those who are less fortunate. That is not quite fair.

    If you are a higher income family member you will obviously not think this is fair at all, but if we turn the tables and think about those who actually need the healthcare money then they would greatly appreciate it. I feel as though in America we have more people in the lower income category versus those in the higher income category. So overall it is unfair, and if we do this, then the cycle will just continue. Higher income people pay for lower income people, making the higher income people pays two times [for themselves and the others] then the higher income people will soon over time become the lower income people. So then we will all be in the lower income category. And soon after we will all be poor, and unhealthy.

    Rina Patel

  10. Logan Fraser23/2/10 7:12 PM

    After a while of paying for the costly amount that the rich would have to pay, wouldn't the cost have to even out for everyone? The health care plan sounds good on paper, but in reality, only a certian ammount of people are going to benefit from this. Higher income houses would be paying almost three times more than lower income jobs. For a lot of americans, the only way to go up in the work force is to work harder, so does that mean you should have to pay more just because you work harder than others? In about ten years, this plan will be out of date and it can only get worse from here.

    Logan Fraser

  11. Kristina Vlajnic23/2/10 8:03 PM

    Health care has been an issue for a long time. The higher income families basically pay for the lower income peoples healthcare. The question with that is weather that if fair or not. In the higher income peoples point of view it is unfair because the mind set is its my money and why should I pay for someone who isn't as educated or successful. However, in the lower income peoples point of view they are grateful that it is one less thing they have to stress over and worry about. People have become so stingy with their money today that when spending it on something doesn't benefit them in some way it is unfair. It should be taken into account that it is a possibility that the lower income families are in that category because of reasons that impair them from being able to reach the high income category. People ask why should I pay for someone who is lazy and uneducated. Its not that they're all lazy and uneducated perhaps they have financial issues that cause them to not be able to receive and education or family priorities. This could be a way for the higher income families to help out. However this is the case in more than just healthcare. The more money you make the more you will have to pay. For example, the federal tax taken out of a pay check. The greater the income the larger the federal tax taken out. The smaller the income the less federal tax.

  12. In my opinion, this is a case where if the rich paid for healthcare for the poor, it would eventually up in an unfair sitution. I think there has to be a better solution & i too do not think this plan would be the answer. I'm not sure what the answer is, but I think eventually there will be a shortage of healthcare professionals, because there already is a great demand for them & it will only get worse. Nancy Lynch

  13. Kellie Duncan23/2/10 9:07 PM

    Some of the people who cannot afford health care have their priorites out of order and spend their money on foolish things. The system is broken and we know it needs to be fixed, but I don't understand why people expect it to be fixed over night or anytime in the near future. It needs to be affordable, but fair. We also need to make sure that the health care system is strong for today and the future's senior citizens. Everyone wants to reform health care but no one can agree on how to do it or how to fund it.

  14. Jack Williams23/2/10 9:07 PM

    Now I'm not real sure what the final solution to this problem is going to end up being, but one trend I see a lot is mentioned in this blog.

    When people in high-income households are forced to pay higher prices/taxes on a certain good, they tend to pay for the good elsewhere. One good example I can think of is when Bill Clinton approved a yacht tax of ~$10,000. When the bill passed and prices for boats went up ten grand, people started to buy boats in Mexico and Canada. From what I read it hurt boat manufactures and repairmen.

    The best prediction I can estemate is that when price go up for universal healthcare, the rich are going to try their best to not pay for it.

    And that's all I have to say about that.

  15. James Jones24/2/10 12:10 PM

    Health care for all is the Ideal dream, but it is only going to get worse if we penalize someone because of their income range. As of right now their is medical insurance provide to people that can not afford medical insurance. All young adult 18-19 years old can get medicaid. Families that have children and can not afford insurance can also receive it. So their are programs that are being offered.... So really if we tax the high income families it is only going to cause them to find alternative solutions that fit the budgets better... Especially with the cost of traveling to other countries falling high income families my see if it cheaper health care or even treatments some where else.... Their is other possible ways to deal with the situation maybe we can start a nation wide lotto that provides money to the health care system; as the Texas Lotto goes to the education of students in Texas. Health Care is a major issue, and it would be nice to provide it for all; finding new ways to cut cost.

  16. It seems to me that the lower income families' healthcare is already being paid for by the middle and upper class families via Medicare. However, self-employed middle class families as well as those whom do not receive health care from their employer are left out to dry. Purchasing health insurance for these families typically comes with high deductibles, and is cost prohibitive.

    Cole Kirby - MCC distance learning macroeconomics

  17. The way I see it is universal health care is just another form of welfare. What I mean by this is the low income individuals continuing to take gain from the high income individuals who in a sense are the ones paying for their health care. Why should upper class individuals have to pay for those who are indolent? Whether or not uniform health care is the right answer or how it is achieved there will be those who will not be pleased.

    Andrea Garza

  18. Where to begin? Unlimited healthcare for all is considered impossible due to scarcity of unlimited resources. Some equate hard work (and a right to healthcare), with higher pay. The construction worker who sweats profusely in the hot sun, and shivers in the rain and cold might consider themselves as hardworking as the more educated. Maybe the more educated, (and less lazy) can manage without buildings, water, electricity, etc. What if EVERYONE paid a set tax out of their income and the money was pooled to cover basic healthcare for the masses. Beyond this limited basic care, healthcare could be provided on a sliding scale determined by the provider and one's ability to pay. The only "insurance" would come from the collective tax for basic care. The only people exempt from paying the tax for basic care would be those incapable of working such as the severely handicapped, the very aged, and orphans.
    This system would contain elements of equality, and efficiency. Similar systems are in use today, however, insurance(a third party with its own cost) plays a role in restricting choice. We cannot assume that hospitals will serve everyone's need for care, as some people are turned away, and some hospitals close from the inability to collect payment. In a society with "free" items for those unwilling to pay when they are able, people tend to forget that healthcare should and does have cost. While many are unwilling to work for free, they tend to think others should. "Hidden" cost negotiated by insurance companies also serve this mentality. Perhaps the collective tax should cover only life saving care, and lessor items should be paid for by the individual at prices negotiated with their provider based on the patients ability to pay. Even this type of care would need to be limited, as some "life-saving" procedures can be extended into years of care with respirators, etc. In short, scarcity of resources requires limitations. Hope and strive for more, but we must act based on reality.

  19. Pamela Saucedo24/9/10 9:04 AM

    I have to say.. we can not penalize the ones that have worked hard (or maybe some did not work hard ) to get where they are in life and the money they make.. but making them pay more for insurance or having them pay for my kids insurance because I do not make as much, just not sure that is they way to go.. I agree the ones that do not make as much should not have to pay a outrageous amount to have insurance on themselves or their kids, they should be able to get help paying for it.. In my thinking, the government spends way to much helping those that really do not need it, food stamps unemployment, when there are some out there that are abusing those systems… the ones that really need the help is the ones that are out there working and trying to keep their family safe, they are the ones that struggle because they do not make enough to pay for the high insurance and make enough to make ends meet.

  20. Jennifer Townsend26/9/10 10:02 AM

    After reading this post and many of the other post I could not agree with many of you more. I believe that we all need health insurance but at whos cost? I have seen with my own family both sides of the boat with health care. My husband and I both work full time and go to school but for awhile we did not make enough money and my children qualified for Medicaid. But as a earier post stated either the doctors are to bogged up or there is something in the back ground we are not seeing. My children's doctor would only accept so many patients with medicaid. They where on a waiting list. But as soon as they where put on my husbands insurance they said bring them in. So that shows that the poor are not taken care of the same as someone with good insurance. That is why there is a need for everyone to be covered but how? I dont have that answer.

  21. I believe that there should be some type of funding to help those who are not able to pay for the full cost of health care. It is obvious that the lower-class people aren’t able to pay for their own health insurance, which is why so many become extremely ill, for the simple fact that they can’t afford to go to the doctor and get the proper treatment they need. What I don’t necessarily agree with is the debate about why upper-class people have to pay more. Even though it may seem a little extreme but they (the upper class) already make more than enough money, I don’t think that a couple of extra hundred dollars will leave them broke. But I mostly believe that it should come from the bottom of their hearts to actually help those in need, rather than spend their money on unnecessary luxurious things that are only wants and not needs. ~Belinda Varela

  22. Carl Schulz8/2/11 7:48 PM

    Another great example of government trying to help free markets and totally screwing things up. When the government interferes with natural supply and demand the effects are seldom good. Rent-control and minimum wages are classic examples and now health-care is their new victim. Creating a brand new entitlement program, believing that they can cure the uninsured problem of Americans, while the country is 14 trillion in debt is insane. The government has created class warfare between the rich and poor (the middle class is tiny) by imposing more and more responsibility on wealthier Americans and creating an entire class of Americans who are almost completely dependent on the government. Success is penalized under this form of government as we are now more of a socialist/capitalist hybrid. I don't have the answer to the health care debate, but I do know that the government rarely helps free markets accomplish anything.

  23. There are other outside forces at work here to keep health cost care high. One is the lack of tort reform in the current system. In this "sue happy" society, doctors seem to be performing extra tests for defensive purposes in an attempt not to be sued, thereby raising costs to the individual. The second is the lack of competition of health insurers on a state by state basis due to the various state insurance commissions. In most cases there are a few healthcare insurers in each state that have the vast majority of business in each state's markets. It would seem more prudent to implement a common sense tort reform bill limiting damages and opening every state market to all health insurers for them to compete then to create a new bureaucracy regulating a sixth of the nation's economy at an unknown cost that will be added to an increasingly unmanageable fourteen trillion dollar national debt.

    Ken Haltom

  24. Obamacare proposes that every American have healthcare insurance. Numbers have been discussed on how many citizens are uninsured (thirty to forty million). Wouldn't that requirement throw the whole supply demand equation for healthcare out of whack? Let us assume that those uninsured now have insurance. One can logically assume that a sizable percentage of those did not use healthcare before because of a lack of insurance and therefore lack the ability to pay for this service. Now you have millions of Americans using healthcare who never have before without a increase in the supply of healthcare (doctors, nurses, facilities, etc). It would seem to me that this scenario would drive the price of healthcare higher, which is the opposite intent of what President Obama expressed in this debate, that the program would indeed drive down the cost of healthcare, or at the very least slow the the rise of healthcare costs.

    Ken Haltom

  25. Everanit Lopez12/2/11 10:26 PM

    I think that each individual is responsible in obtaining his or her own medical insurance. It is not the responsibility of the tax payer or the high income families to provide it. The government definitely cannot afford it with the already high deficit the country is in.

  26. Andi Thomas27/4/11 7:20 PM

    While I think it would be fantastic if everyone could have health insurance, I can easily see why everyone doesn’t. For obvious reasons we can’t have the government provide all health care because it would cost them too much money and health care providers probably could care less what kind of care they give people. But if you start taxing people with higher incomes, then as Janet Frei was saying, they are going to begin wondering why they work so hard. Why bother getting a degree and making money if you are going to be taxed so heavily to cover lower income people? Why not just forget the degree and be one of the lower income individuals that don’t have to worry about those high taxes? Why would anyone attend school if this was the case? I too realize that there are plenty of lower income households that do not do what is necessary to better themselves but then there are those that do. Not to hype on myself but I barely make $20k a year, I work full time, attend school full time, and I’m a single mom. I’m doing what I can to make more money and help pay for my insurance as well as my daughter’s (she’s moved from Medicaid to CHIPs) but I just can’t do it by myself right now. So if higher income people weren’t paying those taxes, my little girl would be without insurance. I realize that the government doesn’t have the time or manpower to track down every single person with government sponsored health insurance, but if they could at least check on half of them they may be able to save money by catching the fraudsters and privilege abusers. Another tactic that I feel would encourage people to do more for themselves would be to make a time limit for how long any one person can remain on government aid. Maybe three consecutive years?

  27. Laura Ledford17/9/11 7:50 AM

    I think that individuals should be able to have a low cost insurance that is a good insurance. The rich do not need to pay for the lower class. I feel the employers should pay more to employees also so they can afford insurance. If you are even making telve dollars an hour drive for 65 miles one way and trying to raise a family you still can not afford the insurance offered to you. Insurance companies need to make smaller and affordable policies. There is no way I could afford the insurance and then the deductible and copay. I think we should have a state policy where everyone can pay so much and we would all be able to afford it. Even if the rich get taxed and quit getting relief from taxes the states can put money up for this kind of help. Depending on what a person makes to who would receive this kind of insurance.

  28. If many Americans would take care of their own responsibilities and not depend on the government or the rest of America to do it, then I don’t think that the Healthcare cost and Insurance cost would be as high as they are now. I know many people who will take their children to the emergency room for the sniffles and then never pay their bill because they don’t have the money. They can go to the grocery store and buy a $5 bottle of cold medicine and take care of their child. There are so many things that we can do at home to take care of ourselves rather than go to the emergency room for non-emergencies. Even if you don’t have the money to pay the bill right then, you can send them a little at a time, even if it is $10 a month. People don’t believe they need to pay their medical bills and don’t worry about it because they say it does not affect their credit. They don’t realize that it affects not only themselves but the rest of America and then want to complain about rising Healthcare cost. I understand there are other issues but this is one of the problems.

  29. Crystal Stillwell21/9/11 5:55 PM

    If americans could be provided jobs and more people went to college they would get better wages and would be able to afford normal healthcare instead of depending on government. everything would go down. and would balance between the higher income and lower income. but minimum wage and payment would probably go down due to the fact of so many people getting education but you always have to give something to get something. Or even if we could educate amercans in health care a little bit more maby we wouldnt have to be so dependant on other people to take care of us. yes hosbitals are still in need but educate people on colds and flues more often and how to deal with the problem.
    or even if we just made everthing equal between the higher income people and low income people. instead of increasing the price just based off income everything would be equal and harmonous. yes they would still need to pay for taxes but even care could be distributed equal.

  30. Victoria Mendoza22/9/11 5:21 PM

    Why is it that hard working people that work countless hours, put in the hard work, are flexible to their jobs demands are the ones that are paying for those that take the back seat and expect everything paid for just because they can't. I am not saying that those who are less fortunate don't deserve help but those who abuse the system and do the bare minimum to receive the assistance is what I find is wrong with our system. Those who work hard and making just above the cut off for assistance and those who need it are the ones I feel are not able to receive the help that is out there. So having the people with higher incomes pay for those with low is just another way to bail out those who are not willing to put in the hard work to better themselves.

  31. I am considered low income partly I am a student, partly I only work part time since I lost my job in Austin, Texas two years ago. I also am taking care of my invalid mother which makes it very difficult to work a full time job that has the benefit package including health care. I found that if your low income you get good care and certainly the cost is not much. I went to a place in Waco and they gave me what they call the Good Health Card. This card gets me into 7 different clinics in Waco. I only pay 20% this includes dental and prescriptions. When I was working I was paying 750.00 a month for health insurance and this was on a group policy. I am not saying this is right or wrong. There are really a lot of people that can't work like myself and don't have a choice but to use this service.

  32. It seems to me that the military health policy Tri Care is the largest by far than probably any insurance company. I don't know this for a fact just guessing. Seems to me if they went public with Tri Care and offered it for a price that is reasonable and everyone that is on welfare etc buys into the program that everyone could easily be covered. Go by sliding scale makes the decision how much you would pay for the medical care ..guess this is why I am not making decisions on our country!!! What seems easy to me is probably very difficult. Military people are using civilian hospitals now so the paperwork isn't an issue. Easier to figure out then the Obama Care..I wonder how Sim City does it...maybe someone needs to investigate that.

  33. It appears to me that the politicians are using health care to gain favor with certain voters very similar to how politicians use the tax code to do the same thing, without regard to economic consequences. Two examples come to mind in this case. The first example is "Obamacare". It seems one of the main goals is to make sure the thirty to forty million of uninsured citizens have access to healthcare. Here is the problem, if you increase demand for healthcare by 30-40 million potential consumers without a related increase in supply what happens? The same number of doctors and nurses now have a large amount of new customers, so either prices will have to go up, further increase healthcare inflation and causing more and more of the cost to be picked up by the government increasing the national deficeit. Or health professionals get so burned out by the increased work without increase pay they quit, further limiting supply and either rationing or a poorer quality of healthcare will occur.

    Lance Haltom

  34. The healthcare industry is out of control in America and the government should take it over so that the drug companies can stop driving up cost by price fixing. All you have to do is look at other government run healthcare systems to see that our system is a joke. Its funny listening to people say that higher income households are that way because they work harder. Tell that to the guy who works in the field all day or the guy who picks up your trash all day. There are a lot of jobs out there that people work hard at and only get paid minimum wage. I know they can always get a higher education to improve their situation but not all people have the same opportunities as others. Also just because they are in a lower income job doesnt mean they are not happy doing it. It doesn't matter what your job is you should earn a fair wage. If you think a professional athlete works harder to get his income than does a police officer, teacher, farmer or any other person that works in a position that builds America. They deserve all the same benefits as the wealthy and not necessarily by them paying for it but by the system being affordable to all. Lets stop knocking our fellow man and lift him up by telling him that we appreciate the job he does. After all someone has to perform the jobs that a lot of people consider to be below them to do. It takes all types to make this system work low income, middle class or high income. We should want to help our needy regardless of their ability or inability to help themselves. It just makes for a better place in which to live overall.

  35. It is very interesting to read the blogs from two years ago compared to the blogs written in 2012. People have become bitter and increasingly upset with medical insurance. One thing for sure is that there is no such thing as a free lunch. I go to work and provide insurance for myself through work. I think analyzing people's decisions and lack of insurance would be very illuminating. How can a government that is in debt provide a service that costs other people money?
    In litigious America today doctors practice what is called "defensive medicine". This means that if a physician thinks of a test they should order it. It was so bad five years ago that there was not even one obstetrician in Iowa for 15 months due to the malpractice insurance cost in that state. I find this ridiculous, and think that if you are going to walk this Earth than you need to learn to take care of yourself, and not rely on the government. Bear in mind this only applies to competent individuals. Of course folks that suffer ailments such as mental and physical handicaps are not in this equation.

  36. If upper class has to pay higher taxes aren't they the ones being penalized? It seems that it has always been up to them to care of everyone else instead of peple taking care of themselves.