The current health care debate is a real mess. I suspect that whatever plan the Democrats end up pushing through will cost much more than they claim. Moreover, it won't likely do much to solve many of the real problems in this nation with health care such as rising cost and lack of real choice for individuals. The Democrats may end up covering more people and eliminating some of the insurance industries more dubious use of things such as pre-existing conditions. However, their plans will likely raise premiums and reduce coverage for those who already have insurance. Worse yet, once they commit the federal government to what is in effect an entitlement expansion, there is little chance it will be cut back as entitlements rarely if ever are cut back. This means bigger government and a larger budget deficit-a very dangerous proposition for a government that already spends nearly 10% of its budget on the INTEREST of its debt.
As usual, the Republicans don't seem to have any genuine alternatives to this, though at least almost all Republicans in Congress won't support the Democrats. If I was in charge, here are some of the changes I would make:
1) Employment needs to be disconnected from health insurance. This is one of the biggest problems today and neither side seems to want to discuss it. Employers should stop offer health insurance and should simply pay workers more so they can go buy it for themselves on the free market. At the moment, one of the biggest problems is that health insurance companies can be jerks. But the insurance companies know good and well that people can't drop their health insurance as they could their auto insurance because they get it through their employer. If they dropped their employers' insurance, they would in affect be turning down hundreds of dollars each month in pay from their employer and would be forced to buy insurance at a higher rate on their own, something most people simply can't afford to do. The system we have now isn't capitalism. It is a quasi-monopolistic system. Real competition, which along with disconnecting employment with insurance coverage would also including allowing people to buy health insurance across state lines, would go a long way to changing things.
2) The federal government should allow everyone to have a tax-free health savings account as some companies currently have. Individuals should be allowed to contribute as much as they want each year and deduct it from their taxes. They should also be allowed to roll over what they don't use one year to their account for the next year (though for taxes they should only be allowed to deduct contributions made for each year). Individuals could use their savings accounts to purchase health insurance and pay for out of pocket expenses. This would give people a great deal of freedom to manage their own affairs.
3) Everyone should be required to purchase some form of "emergency" health insurance that covers things such as cancer or terrible accidents. It is outrageous that people go bankrupt in this country because of medical bills. There really should be insurance to prevent this. Those who are too poor to pay for this should be given a subside to buy their own insurance or receive it through Medicare or Medcaid.
4) The way we pay doctors needs to change. At the moment, they are paid for all the tests and procedures they do. This needs to be changed to how things work in other countries such as Britain where doctors are paid (and even given bonuses) for results, i.e. getting patients well instead of for procedures. Doctors should be well compensated. But they need to be paid for results, not simply having expensive tests and procedures done.
5) We need to stress wellness and prevention more. Is it any wonder that we have such high health care expenses in this country with our obesity rates and the poor diet and exercise that causes obesity, heart disease, diabetes, etc.?
Much of the above is similar to the system in Switzerland, which is cheaper, has universal coverage and gives individuals more choice over their health decisions than is currently the case in America with health insurance companies and their quasi-monopolistic practices or if the government took more control over the health care system, especially if we went to a single payer system. Americans don't like answering to a health insurance bureaucrat. But answering to a government bureaucrat wouldn't be any better. The choices we have in America between the left and right today are false choices.
I believe many of the above ideas make sense. Which of course is why they probably won't be adopted.
The Babylonian Trick
5 years ago
