Could health care bill kill incentive to marry?

I came upon a potentially ominous analysis of the new health care bill that argues the bill's implementation in 2013 could spell the end of marriage. At least it would make marriage seem much less attractive for middle-income earners.

Diana Furchtgott-Roth, who clearly was not impressed with the Democrats' epic push to reform the American health care system, writes about the bill:

"Two singles would each be able to earn $43,000 and still receive help to purchase health insurance, but if they got married and combined their earnings to $86,000, they would be far above the limit. As a married couple, the most they could earn and still get government help would be $58,000, a difference of almost $30,000, or 32%. This looks like a substantial disincentive to getting married, or to working while married."

I agree that this particular reality of the bill is less than desirable, and it's something I'll be forced to deal with if I ever make it back Stateside. It doesn't seem fair for the would-be brides and grooms of the lower middle class to get tangled up in the intersection of tax brackets. But the cutoff for government tax credits has to be somewhere, doesn't it?

I'd also be willing to bet that workers earning a salary of 40-50 grand would have jobs that provide health benefits anyway, and, as so many health-care-reform opponents frequently pointed out, most Americans are happy with the health plans they currently have.

Ms Furchtgott-Roth has a point that workers at this unfortunate crossroad who are thinking of marriage will have a tricky decision to make. What I am unclear about is how employer-provided health insurance is affected by these tax credits and whether or not employers are somehow let off the hook if their employees are receiving credits. At what point are employers required to start paying a fine if they're not providing insurance, and is the insurance employers provide necessarily better or worse than what can be bought with credits? No one ever said this wasn't complex... any ideas out there?

Tender Ankles: A snap shot of health care in Singapore

An article in the Washington Post a couple weeks ago looked at Singapore's health care system in comparison it to the US model. Among other things, it said:

Singapore spends less than 4 percent of its GDP on health care. We spend 17 percent (and Singapore's somewhat younger population doesn't begin to explain the difference). Matching Singapore's performance in our $15 trillion economy would free up $2 trillion a year for other public and private purposes.

Impressive. As the article says, adopting all of Singapore's practices would not really work for American patients -- the country's notoriously intrusive tendencies in personal matters is nothing to admire.

But here's a little anecdote, just for matters of comparison. Earlier this month, I tweaked my ankle playing basketball. I knew it was nothing serious, but a few days later it was still a bit tender . So I decided to see the doctor, just to put my mind at ease.

This is something I would never even consider doing in the US -- peace of mind is not worth the however-many-hundred dollars a 10-minute doctor visit would cost. Such exorbitant cost is not something I have to worry about here, though.

I showed up to the clinic without an appointment and had the doctor look at the ankle. As I suspected, nothing a few more days of rest wouldn't fix. He gave me some cream to rub on the muscle to make it feel better. Since I was there anyway, I asked him about a wart on my toe I've had for a while. He gave me something for that too. The grand total when I left, including all medication, was three Singapore dollars -- less than two US dollars.

In the US, I would have spent half an hour or more filling out gratuitous paperwork, waited another 20 minutes for the doctor to see me, probably gotten an X-ray "just to be safe" because the doc doesn't want to get sued, and who knows what else. One thing's for sure -- I would have felt a lot worse after I saw the bill than I did when I went in.

I doubt Singapore has the best health-care system in the world, maybe not even one of the best. But it sure beats what's on offer Stateside.

And one more thing to respect about the way things are done on this side, from the Post piece:

In Singapore, if a child is obese, they don't get Rose Garden exhortations from the first lady. They get no lunch and mandatory exercise periods during school.

Hoping Kennedy's death eases the insanity in the health-care debate

In another blog posting for the Straits Times, I weigh in on the health-care debate, taking a cue from something Chris Dodd said about how everyone, in Ted Kennedy's honor, should just take a deep breath and talk about health care rationally, minus all the death-panel idiocy.

Not that Leaner readers need much convincing that the American health-care system is in serious need of an overhaul, however it happens, or that all this babble about death panels is nonsense, but here and here are a couple stories to push that argument even further (which didn't make it into the blog post). The first one embodies everything wrong with insurance companies; the second is just a tragic tale of how burdensome health care is in its current form.

As for the blog posting itself, the conversation developing in the comments is refreshingly worthwhile. Have a look.