I was away on a vacation for a few days, and, as I basically was able to ignore the news for much of that time. I’ve learned that missing a few days of is actually good for the soul.
Now that I am back into the fray, I was astonished to see how much vociferous opposition there is to Health Care Reform. Both sides are using scare tactics, and there seems to be a tendency toward hysteria. If you are a proponent of reform, you are talking about the fear of rising prices, and inability to get health coverage, and if you are an opponent, you are talking fear of an expensive new bureaucracy, loss of freedom and choice. The public debate has lost any semblance of true debate, and has become a battle of slogans, rhetorical cleverness, name calling, fear mongering, and hysteria.
Which, I think is too bad, because there really is no debate, now; it is all about destroying the opposition. And that has the potential of killing any Health Care Reform, for many years to come, when we really do need some kind of reform, now.
Personally, I don’t like the idea of the Federal government, or the State government, for that matter, controlling my health care. The current Plan, as proposed, will effectively control my personal health care, so I do oppose it on those grounds, alone. I don’t believe that any government controlled program will be effective; government is not known for it’s efficiency.
And I really don’t care what other countries have done; I’m tired of hearing about the UK, and Canada. We are Americans, and we do things our way, and we do them pretty well.
Everyone seems to agree that health care is too expensive. It is no secret that a single medical emergency, or serious illness, would probably impoverish most families. It is a genuine, and rational, fear.
In the beginning, health insurance was meant to allay those fears, much in the same way that automobile liability insurance helps protect us from impoverishment. So, health insurance, per se, is a good thing to have. The problem seems to be that instead of protecting us from financially catastrophic financial ruin, the insurance companies have tried to take on the roll of Health Care Providers by attempting to meet all our health needs and concerns.
And this just can’t work. The health insurance companies have to make a profit, and they can’t do so if the costs of medical care are wide open, and out of their control. Their only recourse is to try to control costs by limiting reimbursements to health care practitioners, and by denying treatments, and care, and denying coverage to high risk individuals.
I’d like to see health insurance companies get out of the business of trying to provide health care, and go back to providing Accident Insurance, and/or Catastrophic Illness.
If insurance companies stopped being providers, then individuals and families could pay cash for their own routine care, such as doctor visits, medicines, immunizations, etc., and then pay a Health Protection Premium to based on the desired level of catastrophic coverage. Premiums could vary widely, just as automobile premiums vary, and the rates could include different factors, such as chronic health conditions, pre-existing conditions, disabilities, etc. As far as I’m concerned, rates could even include life-style considerations, such as obesity, or smoking, etc, and even occupational factors; construction workers may need more coverage than an office worker.
The rate structure would be subject market pressures, and competition between insurance companies. Everyone would be able to shop for coverage based on their personal circumstances.
The cost of routine care would drop, dramatically, because doctors, and other health care practitioners, would not have the expense of dealing with the insurance companies; it would be back to a cash and carry business. (At one time, I used to pay cash for my doctor visits, rather than file an insurance claim, because it was much cheaper, and there was little chance that I would surpass my annual deductible.)
My guess is that there would be less doctor visits because it would be an out-of-pocket expense, people would think twice before running to the doctor with a cold, or the flu.
Individuals would no longer be tied to their employer, for the sake of maintaining health coverage, because their insurance would be between them and the insurance company; the employer would be out of the loop. Of course, to be competitive, employers could still offer to subsidize the premiums.
And for those individuals who are simply not insurable, then we could do the same as we do now with individuals who cannot purchase automobile insurance, they become an ‘assigned risk’; i.e., the State will assign that individual to an insurance company that must accept them.
We do need a law that prevents health protection insurance companies from dropping coverage for high risk individual.
Individuals who have health protection policies should not have to pay income tax on their premiums, and those who do not have a minimum policy must pay additional income taxes equal to a premium payments.
And for individuals who do not purchase health insurance protection, and, instead, seek medical attention from the public health system, then they would be billed for such services, and those bills should be exempt from bankruptcy laws.
The Federal government can effect the cost of health care in other ways, without creating yet another huge bureaucratic institution. For instance, a major component of health care costs at the point of delivery, is when a patient visits their doctor. Doctors are forced to practice defensive medicine to avoid malpractice lawsuits. This means that a doctor may need to order an array of tests, rather than a single test, just so they can have a defense in court if they are sued for malpractice. This is obviously a big expense.
Another consequence of defensive medicine is that doctors, and nurses, and other medical practitioners need to pay hefty malpractice insurance premiums. Again, this is an expense that ripples through all health care costs.
So, if the government really wants to reduce a major component of health care costs, we would see some sort of tort reform in any health care reform plan. In the proposed plan, their is no tort reform, and President Obama has specifically said there will be no tort reform.
I’m not suggesting that doctors shouldn’t be held responsible for their mistakes. We just need a system that stops enriching attorneys, at the expense of our overall health care system. My guess is that attorneys are having a greater deleterious effect on our overall health care, than does medical malpractice.
The lack of tort reform, alone, should make anyone suspicious of the proposed health care reform plan.
Another way to reduce costs is to encourage competition among insurance companies. Insurance companies should be allowed to do business across State lines. If a well-run and efficient insurance company in Maine, can offer cheaper insurance to an individual in California, then so-be-it. This will surely increase competition, and decrease insurance premiums.
I would like to see a health care plan that is actually oriented toward patient care, rather than cost. I think the government should subsidize health care much in the same way that we now subsidize farmers. For example, I’d like to see the Federal government study true Health Care Providers, as versus health insurance companies, who provide the best health care, based on surveys of the patients, regardless of cost. And then subsidize those providers to reduce their costs, and increase their profits, so they are on a par with providers who are less effective when it comes to health care, but who make larger profits.
This will provide capital for the best providers to expand by lowering premiums, and attracting more patients. This will also encourage the lesser health care providers to provide better services, and better coverage, or lose business to the better providers.
And that is just my opinion.
Spencer Holly
www.AngryCalifornian.com
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