Wednesday, July 22, 2009

A Reader Question

Reader Jon takes one of my comments on health care -- that is should be affordable-- and asks what we should do about it. Good question-- here are my ideas:

1. Let people buy insurance from anywhere in the country- competition is the #1 problem- we need a huge pool of Americans in many plans to help bring down cost of insurance. You should be able to go online today and get quotes from dozens of companies competing for your business based on what you need and what you don't need.

2. People should pay out-of-pocket for regular appointments (annual exam, pediatric appointments, "do I have the flu?") insurance should be for hospitalizations, surgeries, cancer-care, etc. Paying at the doctor's office- that day- like most other businesses, including dentists- would save an enormous amount of money and when it's that transparent you can easily comparison shop doctors.

3. Move people off Medicare into private insurance plans-subsidize poor elderly where necessary

4. Raise Medicare eligibility age to 70- eventually 72 (should adjust with life expectancy)

5. Move to individual-based insurance vs. employer based by shifting tax benefits to individuals-- people should not be tied to jobs because of insurance, and employers should be paying the market rate for an employee not including the cost of insurance. There would be a transition period to make this happen.

6. Expand/encourage HSA's so people can see what they're paying and hold providers responsible for costs-- also covers larger deductibles which drives down monthly premiums-- this money can be accumulated over time to pay for larger expenses

6. Tort reform like that in TX where a board of physicians reviews cases before they go to court with caps on punitive damages

7. If you're on Medicare or Medicaid- and are obese- you should be required to lose weight in order to maintain eligibility. (Same could go for smokers, drinkers, other risky behaviors-- people have the freedom to live how they choose, but not if they're on a government plan-- hence the bigger issue with Obamacare.)

8. Stop providing state-funded health care to illegal immigrants- we can't afford it

9. Eliminate provider taxes- state taxes on the gross-receipts of a practice/hospital

10. Resident Physicians should be paid via the private sector-- not the government

11. Provide tax credits to individuals who pay insurance premiums for their parents, grandparents, children-- anyone they want--

12. Provide incentives to insurance companies to provide optopms for patients with pre-existing conditions

13. Anybody with an iPOD or Blackberry gets immediately removed from Medicaid

But most importantly, get the U.S. economy moving NOW by drastically cutting spending, cutting business taxes, cutting individual taxes so that we can get some jobs created other than "windmill builder."

If people have good jobs, they can afford health care insurance.

Look, I'm married to a doctor- I get that I have a bias. But, you know what? If all of this happened, I can guarantee you he'd make less money, not more. That's what would happen by moving toward a free market. But, he'd be taxed less too. Overall, he'd probably come out about even. Or- we can go the route we're going down now- he'll make more (because Obama's buying off the Docs as we speak), he'll be taxed more and we'll just keep printing the money to make it all happen.

This is just stuff off the top of my head and took me about 3 minutes-- wouldn't you think all the really smart guys in Washington could come up with something other than "Government pays for everyone who wants it?"


Jim said...

How about the government stays out of healthcare... that's too easy, I suppose. How on Earth did America function before the 60s brought us Medicare (which is well on the way to ruining our economy, but it's not a "crisis" yet, so we'll ignore it... or better yet, acknowledge that it will bankrupt us and "reform" it by spending even more money on more people)?

raisingmykidsright said...

Please run for office. We need you, you seem to be one of the only people that really gets it.

Sheila said...

Medicare is most certainly the issue Jim-- and now the Boomers are coming. It is completely unsustainable and now we want Medicare for all.

Jon said...

Thank you for your thoughtful and extensive response. I think the question I ask, at least it's the one I usually ask, is how do we reduce the cost of health care, not health care insurance. The cost of insurance and availability of insurance depends on the cost of the care provided, not on the competition for insurance plans.

Concerning insuring the cost of regular doctor visits, that is a policy issue, but it is an objective fact that the providing those services is something people want, and therefore makes plans that offer those services more competitive in the marketplace.