Health Care

Former Mayor Giuliani offers little in his "plan" for health care (A free-market cure for US health care system, Boston Globe, Aug. 3rd., 2007, A13).

First the tax free exclusion of $15,000 will do little for the near poor who are ineligible for Medicaid.

Second, encouraging people to personally pay for "minor expenses" will have the adverse effect of encouraging people to self-diagnose so as to avoid meeting those minor expenses, which add up over several family members. Self-diagnosis is dangerous as some serious diseases have

similar initial symptoms to minor ailments.

Finally, as Kathy Schwartz of the Harvard School of Public Health has pointed out, genetic research is changing everything. The time will come when our knowledge of genetics will enable us to accurately assess the probablity that a given individual will have a dangerous and expensive disease. Even with current knowledge, Insurance Companies do a good job of selecting for coverage the healthy members of the population. With our increased knowledge, only a system with universal coverage and no possibility of "cherry picking" can be appropriate in the United States.

This, I think, means a single payer system.

Sent to Boston Globe