More on Health Care
I am home sick today with a nasty head cold that has migrated into my chest, so it is a particularly apropos time to reflect further on the health care “reform” bill. As I indicated in my previous post, I am not opposed to health care reform in general (obviously the system as it stands isn’t working — our costs are much higher than the rest of the industrialized world and by numerous measures our outcomes are much poorer — a double negative which does NOT make a positive) and I believe there are much worse solutions than a public option. To sum up my opinion of the current Senate bill: this is much worse.
The Good:
Increasing competition among insurers by allowing consumers to choose plans across state lines can only be good (note that this would be de-regulation, not added regulation!).
Limiting the ability of insurance companies to drop coverage of or deny coverage to consumers with pre-existing conditions is a positive.
The Bad:
Keeping the current system but increasing regulation doesn’t really address the root issues. We need to reform the whole system, not patch it up and keep doing what we’re doing now. Preventative care has to be moved to a more prominent role.
All lifestyles are NOT created equal nor are they equally healthy, and people who choose to engage in risky behavior should be charged for their risky choices accordingly. We can use cold hard facts (as in, promiscuous sexual behavior increases health risks) without moralizing to put in place economic penalties for risky behaviors. A slippery slope? Maybe. But I’m gettng off topic here.
The Ugly:
Without a public option to spur competition and drive innovation (yes, I did say that out loud) there will be no cost reductions. There is no incentive for insurance companies and the health care industry to reform if they aren’t forced to do so. There is no way the current Senate bill will pay for itself.
What are your thoughts? Please share.
September 29th, 2009 at 9:49 am
I partially agree and disagree with your comments.
First, I do think we need a complete overhaul. I also agree that de-regulation is the answer. Competition across state lines is an excellent start. Second, we need to unlink employers and health care. If an employer wants to pay for health care, great, but do it in a form of a monthly stipend where the family still picks and buys their own insurance. This creates portability when changing jobs and increasing competition for insurance companies. Each family gets to decide the best type of insurance for themselves. The insurance companies would now have to compete for every worker instead of just trying to woo a VP of a large corporation.
I disagree with your pre-existing condition statement. I do feel bad for some people with health problems that are not their fault, but allowing them to have the same insurance will only raise health cost. I think that many of the people in this situation could be covered under charity, maybe even as a part of the insurance company do good works. This would allow us to weed out scammers and people who have brought it on themselves. I really don’t like my insurance premium paying for someones AIDS treatments who “lived it up” in college.
De-regulation to allow people across state lines to also form co-ops with their own set of rules would also help. Like I think I mentioned in my previous comment, why can’t a subset of people form their own insurance co-op with it’s own rules for membership. I would join the “High Deductible, Emergency Only Insurance for Athletes with a Healthy Annual Full Physical(low blood pressure and cholesterol) Co-op.” I bet my premiums would be really cheap (even cheaper if you excluded sports injuries in the rider). If you can’t tell, I agree with your lifestyle statement.
Speaking of high deductibles - Insurance should only be for larger, unexpected medical cost. It should not pay for my doctors visits when I have a cold. Way too many people go to the doctor way too often, because its free, or really cheap. I do think insurance covering the cost of preventative check-ups is a good idea, because it will benefit the insurance company to keep people healthy, but that would be up to the company.
The beauty of de-regulation is that it can increase competition by allowing new products and competitors into the market.
I also like the idea of insurance companies setting rates for procedures, but not negotiating with doctors. Let the negotiated rates be between a doctor and his patient. You need an MRI - insurance pays $500 dollars for MRI’s - St. Sarah’s hospital for the rich charges $1000 for MRI’s, General Joe’s MRI’s and Gunshop only charges $300, you get to pick which one you go to. Maybe if you talk to management at St. Sarah’s they’ll fit you into an opening for $500.
In other words, make health care providers compete, instead of working out wonky deals with the big insurers.
Now, for the public option. Will it compete like the USPS competes now for First Class letter delivery? USPS has a monopoly on mailboxes, PO boxes, and first class mail, and they still are losing Billions (BILLIONS!) of dollars a year. Is this really a cost effective solution to mail delivery? This is my fear of a public option. What is the difference between a public option and a non-profit co-op in terms of competition if the public option is self-sufficient and plays by the same rules as insurance companies? There’s the rub, in no way do I believe the public option will play by the same rules or be self-sufficient. If it is, then it will end up more expensive than insurance companies. Why? Because it’s government and it has no profit motive.
There are my thoughts, right or wrong. Good to see you post again!