Sen. Tom Coburn, an Oklahoma Republican, is again sponsoring a health-care reform bill -- the Universal Health Care and Access Act.  His reform bill is largely based on the Swiss health-care system.  Sen. Coburn’s plan can be found at coburn.senate.gov.  
    Like all the other national health-care plans, this Congressional bill is complicated, controversial, and with luck, not going to become law anytime soon.

      The bill's key elements include using the Swiss' idea of tax credits to pay for individual or family insurance.  Everyone in Switzerland is required to “buy” health insurance for themselves and their dependents, choosing a plan from various approved insurance companies. The cost of Swiss health-care insurance is off-set with a credit against the individual’s federal tax liability.

      As with many of the other universal health-care reforms being touted, Sen. Corbun’s plan ignores the obvious.  In this instance, the Swiss health-care plan may work well in Switzerland–but the Swiss aren’t saddled with our IRS tax-code, our immigration issues, or our Congress (not coincidentally, the former two issues are driven largely by the later).

      1)  A “tax-credit” based universal health-care system assumes...nearly universal taxpayers. IRS tax records show the majority of taxpayers pay only a small portion of the total tax bill. With the "earned income" tax credit, a large number of tax filers receive a "refund" larger than the sum of their taxes paid. Many lower income families pay little or no federal income taxes.  How does the Swiss "tax-credit" funded system accommodate those paying no taxes--let alone all those whose refunds exceed tax payments each year?

      2)  The Swiss don't have 12-20 million (and growing) under-educated illegal aliens living within their boarders. The current “health-care crisis” is the direct result of a growing number of uneducated poor constantly flowing across our boarders and swelling the list of “uninsured.”

      A MAJORITY of those in the US without health-care don't have health-care coverage for a reason: their lack of education and marketable skills relegates them to working at lower-paying "entry-level" jobs in small businesses. Such low-paid workers will never pay enough taxes for a “tax-credit” to have any meaning. Those that don’t fall into this group are anecdotal as a percentage of the total in the US without medical coverage.

      Frankly, neither illegal immigration nor health-care would be national issues if PhDs, engineers, chemists, dentists and physicists were coming across our boarders in anywhere near the same ratio as the number of unskilled and under-educated who enter the US each year.

      3) Can ANYONE name ANY government program setting standards for organization and efficiency? Look at all the games Congress plays with ear-marks on the annual "Defense" budget (including...subsidies for beekeeping operations in California???).  Because of the political wrangling going on, Congress still hasn’t passed an appropriation for the 2008 fiscal year that starts in two weeks.  It will be several more months before a bill is signed.

      What sane person thinks that similar games and political pay-offs won't be maneuvered into a new $2-4 trillion a year government appropriated health-care program?

      4) As long as medical treatment is "free," there will be waste and abuse. As long as doctors and hospitals are forced to practice "defensive" medicine, there will be waste and abuse. As long as the co-pay for a prescription drug is cheaper than over-the-counter remedies, there will be waste and abuse. As long the number of medical schools and students are being limited by regulation, supply will not meet demand.

      Until these issues are addressed, health-care costs will elude control. The only true solution will be a system where access is limited for non-payers, where users are financially incentivized to economize, where government intervention is both focused and limited, and where the supply of doctors is permitted to be in balance with demand.

      No universal health-care plan has yet acknowledged these realities.  While the current market system is flawed, it has a better chance of eventually overcoming these issues than any political/government solution will.  
    None of the endless crop of currently proposed “political” fixes is about making health-care affordable or even more available.  Each is simply another approach for socializing medicine, whereby the federal government obtains more control over our income and then apportions a part of our money back to us in the form of a government controlled “benefit.”

      The US Department of Agriculture has almost twice the number of employees as the 2000 census says is the total number of US farmers.  How many years will it take before the number of bureaucrats managing a national health-care program will exceed the total number of licensed doctors and nurses?  With this kind of government program, will we get more services or less services when our medical costs are “washed” through a regulatory process in Washington DC?  In what manner will any of us be better off when a faceless and distant bureaucrat gains control over the decision of who gets what medical treatment and when? 

     There are a LOT of problems to be solved in our nation's private health-care system and a lot of changes are needed so that everyone has affordable access to medical treatment.  But is nationalizing the system going to make things better for the majority of us?  When an HMO or insurance plan gets too expensive or become too bureaucratic, most of us now have the option of changing our medical plan.  If and when the US government gains total regulatory control over the nation’s private health-care system, what alternative will we still have available to us–moving to Switzerland?