2009-07-06

Healthcare Reform 01: Government sponsored health care

A key initiative of the Obama administration is to bring health insurance to the uninsured in one form or another. Whether this is the US finally coming out of the dark ages or the beginning of an apocalyptic slide into communism is a more complicated discussion than I have the energy to get into tonight.

But that won't stop me from opining on the topic.

Here are some assumptions I am starting with, and I think many people are likely to agree.

We already have socialized medicine.


Between Medicare, Medicaid, CHIP, workers compensation, the VA, Federal employment benefits, and assorted other programs, the Federal, State, and local governments already provide millions of people with health care.

A person in need of immediate medical attention won't be denied care at an emergency room. Millions of people already use hospital emergency rooms for primary health care because they can't/won't pay to see a regular physician.

Socialized medicine is here today -- it's just delivered with terrible inefficiency.

We have some of the best medical technology in the world.

The medical schools and technology we have in the US create some of the best procedures, medical instruments, and medication. We have fantastic physicians and they are typically well compensated after years in their profession. Many other health care providers (RN's for example) are not as well compensated as we would like, but are still extremely talented.

The US pharmaceutical industry is a technological leader.

The US drug companies come under fire for their prices and for their defense of patents around the world. But the reason they are so often attacked for not sharing their products with the poor of the world is because they make such fantastic and innovative products.

Employers in the US have an extra burden they don't share with the rest of the world.

The primary provider of health care coverage in the US is the employer. Large companies provide coverage for employees. This cost, which is measured in the thousands of dollars, either depresses cash wages, or it reduces profits. Companies in other countries do not have to pay for health care for their employees.

Any health care plan we implement in the US must meet the following standards:
  1. Preserve the health care technology leadership the US has
  2. Keep and fairly compensate the skilled people in the industry
  3. Make the system more efficient and less wasteful than the current system
  4. Make health care affordable for those who currently can't afford it
  5. Reduce the burden on employers

We don't have to get there in one step. And I've always doubted that health care reform will come from the Democrats. Not because I question their commitment, but because there are too many industries opposing it, and too many varied constituencies within the party to reach consensus on one plan.

The true impetus for health care reform in the US will not come from the left. It will come from the corporate interests on the right. Health care reform in the US will come when big and medium business decides it is time to shift the burden of paying f0r health insurance to someone else.

In the meantime, the tragic stories of individuals will provide headlines, but are not likely to result in a significant changes to the system.

A small proposal

In the interim, here's a way to tweak the system that may help lower individual costs and increase coverage. I am making up the numbers out of thin air, so bear that in mind.

Everyone should have a government provided health insurance program that features a $50,000 annual deductible. Above that amount, the Feds (taxpayers) would cover the costs.

This will mean the private health insurance providers can lower their rates to make health insurance more affordable since their losses will be capped.

This will also lower the costs for employers.

Most people don't spend more than $50K per year on health care, so there is still an incentive for individuals to look for ways to minimize their costs.

The pharmaceutical and hospital industry can continue to operate as they currently do. Doctors and pharmacists don't suddenly become government employees, so the local hospitals don't become the local DMV.

This plan addresses some of the concerns above, but it's not comprehensive. It's a simple plan that provides a step forward. And maybe it will break the current political log jam.

6 comments:

Sandy said...

Wow...I was with ya on the first half of your article. I think it's a terrible that the US, the most civilized country in the world does not provide for it's own. I do agree we currently have (though most would disagree) socialized medicine. The welfare system provides care for those who abuse the ER, which costs us all dearly and provides bad medical care management...but the working poor have zilch. They don't have care and thats wrong on so many levels.

Having worked in the medical field for 22 years, I can say Insurance Companies and the Medical field need to change. Doctors are paid far more than a decent wage, and so are Insurance companies. Drug companies have tremendous waste. Their employees are highly paid, and have lots of perks. Some of the fat from these 3 entities needs to happen. I have no problem with people who are working hard making a good living, I do have a problem with the rich getting richer, and the poor getting poorer.

We need Doctors, Insurance Companies, and Drug Companies to be more accountable. And employers who pay their Executives far more than they're worth, but cheat their regular employees ought to spend some time in their shoes. I do not think the burden they have of insurance is what you describe. I do know many companies who alter hours, and conditions of employment to get around the duty and responsibility of providing insurance for their employees. Firing employees, then hiring them as temps for example. Cutting their hours just a few hours a week to keep them under the radar on legally needed to pay for their insurance. This is wrong, and very unjust. These same companies provide private jet service to the management people for trips that are not business related, vacation homes, expensive cars etc. etc.

I say trim the fat, there's plenty of it, and then providing medical insurance would be a piece of cake.

I might also add, I have 2 family members who work in the insurance industry, and 1 for a drug company...this just isn't my opinion, but opinion based on personal information and experinces.

Sandy
Everytime we treat someone in the ER for the flu or a cold, or sore throat prices go through the roof. And everytime someone ends up having emergency surgery for soething that might have been caught had they been able to visit a family doctor...same thing. Current system is way too costly, both in lives and in $$

Sharkbytes said...

It's all pretty broken, and those of us with just enough money to be poor but not destitute are left out in the cold.

Mike Golch said...

the thing that worries me is will the plan become as bloated with ripoffs atrists like medicare has become.some of the reinbursements that are paid out of medicare are just gross.

grayspirit said...

I think the concept is a reasonable one, but my concern is that there is really nothing in place to manage the cost of healthcare. As long as the government provides reimbursements for healthcare, the industry tends to keep costs high because there really is no competitive pressure to bring prices down. Just my opinion. :)

Pricilla said...

You forget in your plan people who are sick with chronic conditions or who have pre existing conditions. They (ie: ME) cannot get private insurance in the marketplace for any price. No insurer wants the risk. So my husband HAS to work. I am disabled and medicare does not begin to cover my medical costs.

Until there are viable options for sick people in the marketplace the system will not be viable. There are a lot of people with minor pre existing conditions that get them bumped from insurance plans. Major problems like what I have really cause issues.

The system is broken and needs serious fixing. I think you are right about corporate America though since they are paying for it now and basically paying for congress..

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