Misdirected Healthcare Reform
The United States has been increasingly debating “reforming” the health care system. The initial talks began some 20 years and have grown to a flaming war of political might. Some in this country believe that the opposition to the current proposals is political in nature and are trying to impose the success or failure of the rapid passage of a 1,000 page bill as a referendum on the efficacy of President Obama.
I have been asked my thoughts on the matter by a variety of poeple and will outline them here as best I can:
1) What was once a perq (employer provided health insurance) is now seen as an entitlement. I’m not sure in its purest form it is, but I agree that no one should be denied access to medical care. Much like pension plans have proven to be unsustainable and 401k programs have become dominant, employer sponsored healthcare also seems to me to be unsustainable.
2) The hospital emergency room is not the playing field where basic healthcare is provided. I have unfortunately been in the waiting room for the E.R. at a couple of different hospitals and have seen first hand those individuals with non-emergency afflictions occupying bed space because that is where “those who cannot afford healthcare” go. Deep down I wonder whether most people know how much a doctor visit really is. I have looked at the EOB (explanation of benefits) for visits where lab work was not required and the visit was less than my co-pay.
3) We all benefit from improvements in healthcare. I am fortunate to be a healthy individual. The unwell people covered by my same insurer are reaping the benefits of the premiums I pay in terms of care today. But at the same time I will benefit from the advances in treatment that the doctors learn from those experiences.
4) I should have choices. No one dictates to me who should insure my car nor who should insure my home. No one should dictate to me who can insure my health. Furthermore, I should be able to choose my coverages much like I do on my car and home. Why should this be any different?
Examining these four basic beliefs leads me to wonder whether the reform program is misguided. Rather than increasing the level of government involvement in my health care, why wouldn’t a reform program increase my own level of involvement? Why do most Americans not go to the doctor for annual physicals between the ages of 18 and 50? These are the areas where a shift in thinking is required. So far I have not seen any government proposals that would put my in charge of my health. And that’s just wrong.
A simple approach would be to mandate that everyone have health insurance, and those that cannot afford it receive a subsidy from the government. Let’s assume that there are 30 Million people without health insurance (a reasonable estimate). And for the sake of argument, say that none of them can afford it. Let’s also assume that this pool of individuals is less healthy than average and should pay a higher premium – $25,000 a year. That is a ludicrous number, right? That comes out to a $750 Billion expense. $250 Billion less than the proposal currently on the table.
So what exactly has Congress proposed? There is no telling. My simple plan is straightforward and solves the underlying problem – have healthcare coverage for all Americans. Let those people who currently are covered continue to be covered under their current approach. Provide the ability for the uninsured to be covered via government subsidy. This would be a less expensive and less invasive first step toward revamping the system and would keep the door open to allow individuals to make their own medical decisions.
We will have to wait and see how this round shakes out in Congress.