OK, I realize health care reform has become a tired subject but I must address it again. I still believe the root cause of all opposition to reform is money. The insurance industry is afraid of loosing profits. People who have health insurance are afraid they will have to pay more. Legislators are being pressured by money to support the opposition. Rich people (compared to me) are too greedy to pay more taxes. Doctors are afraid the Government will set prices for services. Drug companies are afraid of loosing research subsidies. All in all it is just money and greed.
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Here is my proposal. I realize no one asked for it but you’re getting it for free so don't complain.
The current health care system has the following failures:
The costs are steadily increasing and each price increase eliminates some people from access.
Even employer-provided insurance plans are increasing in cost; both for the employers and the employees.
As plan costs continue to increase increasing numbers of employers are forced to stop providing health care for employees.
Millions of people with chronic conditions are denied coverage even from employer-provided plans.
Disguised costs such as increased co-pays, higher deductibles, and coverage limits are being used to keep front end premiums down by adding the costs to the insured’s back end.
If you are happy with your current plan it is going to cost increasing more to keep your current setup. Sooner or later the cost will exceed your ability to pay or the plan will change in ways you can’t tolerate.
The problem of someone choosing your doctor instead of you is already part of your life. How many of you have to pay more to see a doctor “out of your network”
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Government alone has the power to fix this. There is no possible fix from the private sector.
We need a health care tax. This can take several forms but the purpose is to finance a public option.
The public option will cover people who for whatever reason are not and cannot be covered by private insurance – either by employers or privately funded. This means all the high cost patients can be eliminated from private insurance coverage. Private insurance premiums can be drastically reduced. Employers whose insurance plans deny coverage for certain employees will have to pay the equivalent premium into the public option fund. What this does is reduce the premium costs to businesses while keeping everyone covered. Private insurance providers will be able to tailor coverage to their clients’ needs. A standard will be developed for plan coverage where highly restrictive plans will be taxed at a higher rate than more inclusive plans. This tax will also be part of the funding of the private option.
Drug companies can and should do without any government subsidies.
Agreements between coverage providers and service providers for reducing costs will be encouraged.
This is just the basics of my proposal and there is nothing here I have not said before. I just have to say it again.
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6 comments:
I think if you take a listen to this radio program your ideas on healthcare will change dramatically. http://www.thislife.org/Radio_Episode.aspx?episode=392 (I learned a lot listening to it.) It is not kind to either the standard liberal or the conservative opinions and shows how little the proposals on the table are helping. Much of what you say is on track, but a public option will always have funding problems. The problem is not just insurance companies but the interactions between insurance companies, drug companies, doctors and hospitals, and us as patients as each of us acts in our perceived "best interest."
Eric,
I am listening to the show right now.The piece on the drug companies vs insurance companies points to one reason why all the people screaming for smaller government are wrong. When you let any industry pursue profit with impunity the private person always looses. In this case the insurance companies and the drug companies war with each other and everyone looses. They will never stop the escalation without a more powerful entity interveneing.Either a government intervention or a much more well informed public. Some of my earlier posts on this blog have described us as lazy unimformed Americans and this is another example.
Part two of the show- Yes the system is broken. Yes it grew out of a series of seemingly unconnected events and yes it was a response to the pursuit of profit by businesses.
President Obama said early on in this debate that the present system is unacceptable but the pain and cost of creating a new system from scratch is too much to bear. We have to try to fix or at least improve the current system usine the compromise options we work out.
And one other thing...A public option will have a huge client base to negotiate with to get a lower cost. This will reduce the per-patient cost for the high cost patients covered by the public option. These same high cost patients are not covered by private insurers allowing higher profits at lower premiums to the buyers of private insurance.
I support a need to dramatically change healthcare in this country. The main reason I am looking for an alternative to the "public option" is that the government is not good at containing costs. Obama's plan essential expands medicare and medicaid they are horribly underfunded according to future budget projections (worse than Social Security). I agree that the Government has to be involved because the big companies will just run over all of us without any Government Regulation. The best ideas I have heard, in as much as I understand them, would be a combination that everyone has to buy health insurance and we use some version of Maryland's approach in which the government can dictate some of the pricing. I would also like to find some way to reward providers that have better outcomes 1 and 5 years out. I have not heard a strong proposal from either side that I think will actually reduce costs. I believe costs are the real problems. My problem is that the Republicans want no regulation and the Democrats want to tell everyone exactly how to do things.
You would think that a large pool of applicants would make the negotiating easier (and cheaper), but Congress told the folks running medicare and medicaid that they could not negotiate drug prices while Bush was in office. (Not sure which party was in control of the Congress at that time.)
But I agree whole heartedly and completely that the current system is really screwed up.
I just wonder why doctors can't get paid a salary like everyone else as opposed to fee for service we currently have. I have known quite a few persons who have gone into medicine. The primary motivation was money. I'm sure that there are a few doctors who go into medicine for more benevolent reasons but a comprehensive study maid in New England (I think it was Maryland, but not sure. Heard about it on NPR) in the 70's determined that the main factor in medical decisions by doctors was how much money the doctor would make. In anycase, the American system is practically primitive. Everything is set up so that individuals can make money off of others suffering. How does that make sense?
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