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Columnists
Brugger: I'm a liberal. Here's why single-payer won't work

It is time for you all to solve many things that have been bogged down by partisan posturing, including health care. I am afraid that the extreme of one-payer health insurance will overcome the other extreme of everyone for themselves. It is time to build on the middle ground of the ACA and construct a plan that provides complete medical care for all within a true insurance structure.

I haven’t abandoned the idea that I am a liberal thinker. I believe this is a progressive position because it is moving forward from where we are. The United States government cannot run health care. Our country is too large, and we have too many people. Various regions of the country have diverse health care challenges. Depending on the federal budget, with its ability for deficit spending, is asking for unrestrained cost and fraud. That is not to say, however, that the government should forgo the costs of income-relevant subsidies of insurance cost, medical education, research and, especially, rural infrastructure. Because of the strategic necessity of having a healthy population, government has a requirement to set standards for the health care of the nation.

The health insurance business model uses mathematics to assess risk and puts a dollar figure to the shared cost of that risk. Most of the insured population will not use all the care which is covered, but they can be sure of having health care with no or minimal cost whenever they need it. Insurance has been a market-driven sustainer of freedom from risk to life and property for centuries. It stabilizes our society at our most basic need for security.

We cannot trust government to run an insurance company. Just look at Social Security. It started out with a realistic actuarial basis, but a growing accumulation of money, which a private company would hold for reserves to pay claims, was seen as a surplus which could be used for other government spending. The spending may have been worthy, but the money was not actually available.

My vision is for an insurance exchange that covers everyone plus a requirement for mandatory insurance. If you don’t sign up, we will tax you. I want to do away with Medicare, Medicaid, Chip, children who are not dependent on their parent’s policy; everyone. People would choose and sign up for their coverage. Employers would choose the amount they would contribute to each employee’s plan with the same tax structure now in place. The government would set the subsidy for people with less-than-adequate income and the disabled. The truly indigent could sign up for a plan with a small premium or a small co-pay, which would be significant for a non-life-threatening emergency room visit. Perhaps states would cost share with the federal government.

Small business and the higher-income self-employed would not be paying the premium they are now because of the fact that their risks are assigned over a small pool. Medicare recipients would have more choice. They could pay higher premiums for less cost share; their prescriptions would be covered without the need to visit SHEBA counselors every year or the dread of significant changes mid-year.

The crucial point is, there would be market, not political, drivers in place. The insurance industry would incentivize healthy living and work with providers to lower costs. Companies might find that a not-for-profit model would give them marketplace advantage. With a regulatory cap on the ratio of claims paid to premiums collected, there would be no incentive for companies to collude in price fixing. There would, however, be an incentive to work year over year to minimize risk by encouraging better health and lower costs.

I remember, in the ‘90s, as Communism was breathing its last, that people who had lived under those regimes had the most problem with the freedom of choice. It is important, I think, not to take away the privilege of having to figure things out. Health care is a participatory process. We cannot buy health, but we can buy the means to make ourselves as healthy as possible. Things that are free of cost have no meaning. Keeping the insurance model in place makes sure that everyone has skin in the game.

As always, I invite discussion.


Mailbag
Letter: Trust the American press, not Trump

So, I am watching the reporters on TV as they help Americans see first-hand the devastation in Texas and then again in Florida. I watch these dedicated people risk their lives to not only bring this news to us but try to eek out a living for their families. Then I think, how dare the "leader" of our country call it "FAKE NEWS!"

Look back in history and you will see that the very first thing a dictator does is discredit the people who keep him or her honest in the eyes of the people they are trying to dictate to. The news media have to keep their reporting as honest as possible because their livelihood depends on it. Plus, they have editors and bosses to keep their reports honest and true — unlike our president who seems to relish in telling a lie and having no one call him on it, except maybe a reporter or two. Tee hee!

I, for one, appreciate the chances reporters take so I can see firsthand what is going on in my country and around the world. I don't need a proven liar to give me his version.

Sue Harr

Buhl


Columnists
OTHER VIEW
Other View: If the mainstream media is so fake, why did Bannon go on '60 Minutes'?

President Donald Trump’s former chief strategist, Steve Bannon, rarely speaks publicly and is known to egg on the president in his trashing of the mainstream media.

But when he decided to break that silence, Bannon chose the venerable Charlie Rose as his interviewer and the CBS flagship Sunday night show, “60 Minutes,” as his venue. There could be no more mainstream choice.

Trump himself is a constant critic of the establishment press who delights in disparaging the (“failing”) New York Times and the (“Amazon”) Washington Post.

But last spring, when he wanted to put his own spin on the decision to withdraw the Republican health-care bill, he quickly made two phone calls to break the news: to The Post’s Robert Costa and the Times’ Maggie Haberman.

And when Trump wanted to get his message out about the firing of FBI Director James Comey, he sat down for an Oval Office interview with Lester Holt of NBC News.

“It’s a combination of stunning calculation and deep irony,” said Frank Sesno, director of the George Washington University School of Media and Public Affairs, speaking of Bannon’s appearance on “60 Minutes.”

If the mainstream news media is the Trump administration’s archenemy, you’d think these fraught-with-significance appearances would go to friendly media outposts like Fox & Friends or Gateway Pundit or Alex Jones’s Infowars. Or perhaps even to Breitbart, headed by Bannon himself.

But the calculation dictates otherwise: “They know where the numbers are, and where the reach and the clout is, “ Sesno said. As usual with this president and his cohort, it’s all about the ratings.

And, Sesno added, the irony is clear: “They’re wading about as deep into the mainstream as they can get” after making media hatred the poisonous centerpiece of the Trump campaign and presidency. Stoking his base’s resentment of the news media sometimes seems to be the only constant for the ever-changing president.

The Bannon appearance on “60 Minutes” brought to mind Trump’s late November visit to the Times building in Manhattan, where he gave an extensive on-the-record interview, sat next to publisher Arthur Sulzberger, and made glowing remarks about the paper.

“I will say the Times is—it’s a great, great American jewel,” he gushed. “A world jewel.”

After Trump gave a scoop to the Times in July—saying that he would never have appointed Jeff Sessions as attorney general if he had known that Sessions would recuse himself from overseeing the Russia investigation—MSNBC’s Chris Hayes observed: “The sheer thirst that the president has for the New York Times approval is something to behold.”

Sometimes, of course, the technique backfires, or at least doesn’t go quite as planned.

Rose’s skillful questioning drew an extraordinary assessment from Bannon that he probably didn’t set out to make: that Trump’s firing of Comey was perhaps the worst political blunder in modern history.

And Holt extracted from Trump a damning explanation for why he fired the FBI director: “In fact, when I decided to just do it, I said to myself, I said, ‘You know, this Russia thing with Trump and Russia is a made-up story. It’s an excuse by the Democrats for having lost an election that they should have won.’ “

In short, neither Charlie Rose nor Lester Holt was a pushover. They did their jobs well.

The big picture, though, is troubling.

When Trump and his allies constantly disparage the press—attempting to turn citizens against reality-based journalism—they undermine democracy.

That they do so, and then blithely turn to the very same news organizations to take advantage of their credibility, what we’ve got can be summed up in a single word: Hypocrisy.