National Debt & Deficit Spending Health Care
I believe our health care system is the best in the world. Our quality is very good, our emphasis on wellness is without compare, and the technology we apply to medicine has reaped benefits beyond our dreams.
Yet most of the proposals to "reform health care" that are on the table amount to castor oil: "here, you know it’s good for you, just take it."
So what is the problem that causes so much bleating about inequality?
Quite simply: who pays and how much.
Access to health care in this nation is assured, if one has the money. What this means for most is that if you have insurance, access is assured.
So why are so many without insurance in a nation that knows how to build effective and sound insurance?
Our current structure of health care stems from World War II. It is based on one's employment and is not very portable from one job to the next. The current system was established in an era when wages were frozen and the way businesses competed for employees, was by their benefits package.
To be sure some changes have been made along the way. For example when moving from employer to employer insurance can be bridged by COBRA, yet the cost of carrying that insurance during a period of unemployment between jobs is nearly prohibitive.
A new health care system would provide true portability of insurance as the wage earner moved from job to job. The current system is not portable in the sense that you do not carry the same insurance from job to job, it simply bridges the gap in employment.
In our current system, the medical profession is caught between running sound businesses and their Hippocratic Oath. In private practice only people with insurance, or otherwise able to pay, are accepted thus sidestepping this question.
Hospitals that receive federal funds must accept the underpayment that comes with government funding. Health clinics that accept insurance sometimes require additional funding from patients if the insurance payment involved does not cover their costs.
Unrecoverable costs are then offset against other patients. The result is that these costs are forced onto that group with the least ability to avoid excessive charges, those without insurance.
There are many proposals, some of which amount to a grab for bigger federal control of our lives. I believe that the federal government should allow the states to pursue their own systems. The federal government could accelerate this process by several actions:
First: Make premiums paid for health care insurance deductible from federal income taxes. To ensure that this is as broad as possible, it should appear as a reduction in income so that all people filing tax returns may benefit.
Second: There are those that may choose to self-insure. These people should benefit also. There are current Health Savings Accounts that are close to what is needed.
People that self-insure should be allowed to also benefit from the proposed reduction of income. This money should then be put into a new Health Savings account. The money in this account may only be used for health care expenses. The financial system today has the ability to track and verify legitimate expenses and refuse improper expenses.
States may have to require health insurance be obtained by all. States should have freedom with regard to such choices.
Third: The insurance industry must be able to build up reserves across a person’s lifetime. At 25 years old, a person is “bullet-proof” and sees little need for health insurance. At 55 years old that same person may well need serious and expensive health care. A sound insurance plan must be allowed to build up reserves.
Similar to Life Insurance, Health Care insurance will be based upon known risks and inflation rates, hence if a person begins young, the cost should be much lower per month than a person beginning an insurance program later in life. This will be an essential feature.
Fourth: The system must make room for those truly indigent and incapable of funding an insurance program. Similarly, there are those with serious health problems, sometimes genetic, that will require care. These are a known portion of our population and can be accounted for in the costing of insurance plans.
Fifth: Quality assurance responsibility should be placed squarely on the shoulders of the health care industry by allowing the insurance system, and private individuals, to refuse payment for errors and omissions by health care providers.
Sixth: The health care system put in place must affirm the decisions made by doctors. The practice of “Defensive Medicine” raises costs and reduces the responsiveness of the system.
The current proposal of some in the world of politics to create a “national health care system” propose themselves as paragons of compassion, as they propose a system that they will never have to live under. What they really propose is to move yet another facet of our lives under another federal bureaucracy.
The reality of any all-encompassing and government run health care system is rationing. Those with "pull" in the system get cared for immediately, the rest get in line. This is not what this nation needs.
Note that these "paragons of compassion" will never have to "take a number" since they are able to afford private health care.
Congress must comprehensively review all health care legislation and amend, rescind, or enact new legislation that will provide an incentive for people to provide their own insurance, focused on their needs as they see them, and unrelated to employment. People should be encouraged to participate in wellness by allowing deductibles.
The states should have room to experiment with solutions unique to their situation. Wyoming’s need is to ensure rural health care is readily available.
Finally, our Congress must have a sense of how poor legislation can place a drag on the productivity of our health care industry with excessive requirements, inappropriate administration, and poor costing.