If I Were Reforming Healthcare

If I were the person writing the healthcare reform there are several things I would do. These are probably dumb ideas but they are ideas that I think fit within the framework of the nation and would not violate the constitution, would protect states rights and preserve the free market system. I also believe these ideas would actually help with the cost of healthcare.

One of the main problems with the US system is the fact that the real cost of healthcare is hidden from the consumer. Because most people have health coverage from their jobs, and the insurance company pays almost all the costs patients have no idea how much anything costs. This lack of knowledge prevents the consumer from being able to participate in the decision making process with all the information. It also means that most consumers have no idea how things got to where they are today. Hiding costs from consumers is bad for the system and is not a free market concept.

Another problem with employer provided health insurance is the lack of choice in the coverage. Most companies will offer one heath insurance option and the employee is stuck with a take it or leave it approach. The quality of this coverage almost makes no difference because you have not other options - nothing to compare it to. The quality of employer provided health insurance is decided by an HR rep negotiating with the insurance company for a plan that provides the most benefit to the company and not to the employee.

In my view employer provided health insurance must be one of the first things to go. Individuals should shop their health insurance options just as they would any other insurance product. My job does not provide car insurance or homeowner’s insurance so why health insurance? This one change would force insurance companies to change their focus from negotiating with a few HR reps to having to provide hundreds of more options geared towards appealing to consumers. This would completely alter the health insurance landscape.

Naturally, companies would no longer have to pay the employer portion of this coverage and would have a bunch of money that they are not longer paying out. Since this money is part of the total compensation package for the employee the company should give each employee a raise in pay equal to the amount of savings. This will allow the employee to have greater financial resources with which to purchase coverage. The savings to the company will come in the form of elimination of maintenance of the health benefits for the employees.

Another problem with the US system that makes a public option attractive is the issue of portability of coverage. A public system would not worry about a pre-existing conditions because, well, they wouldn't have to. Insurance companies have an issue with covering people that have a medical condition that has already been diagnosed and treatment started. This is very much the same issue as a car insurance company have with making repairs for damage that happened while the car was insured by another company. The difference is that cars rarely need ongoing treatment for an issue the way people sometimes do. A car is either broken or not. Once health insurance is detached from employment then the need for portability drops dramatically, but there should be rules in place to protect both patients and insurance companies.

Another issue that comes up is the insurance company’s refusal to offer coverage to certain individuals. This is usually associated with the portability issue mentioned above. With the reduced need to change insurance there is less chance of this happening. There should be some strict rules setup so that in the rare instance of it happening there are protections in place. People should not be refused service by insurance companies for all the usual discrimination scenarios but this should also include age and physical condition. This is a tricky area that needs to balance consumer/patient protections with logical standards to ensure one insurance company is not unfairly shifting the expense to another company after collecting the premiums.

It is common for health insurance policies to have limits on how much can be paid out over the life of the policy. Once this limit is reached the patient is usually dropped from coverage. In most cases this limit would increase as savings are realized in other part of the system. There should also be regulations that limit the ability of an insurance company from dropping a patient. One sensible rule would be that a patient cannot be dropped from coverage while being treated for an existing condition.

A huge area of cost drivers in the current system is the area of malpractice insurance. The current laws allow for nearly unlimited cash awards to patients who have been the victims of doctor incompetence. While malpractice is a real problem the huge cash awards act a transfer of funds from one set of patients to another, filtered through insurance companies. You see doctors pay insurance companies for malpractice insurance at huge premiums. The costs are rolled into the cost doctors charge their patients, and by extension the patient’s insurance companies. Which, in turn, drives up the cost of health insurance.

Previously I mentioned the fact that costs in the current system is hidden from the consumers. Most people do not realize that doctors and hospitals are more than willing to negotiate process for services with their patients. You see, filing and insurance claim is very expensive for the doctors and hospitals. They will frequently have large staffs of people who work solely on insurance billing. This increased cost means that higher prices are charged to insurance companies to offset this additional expense. Insurance companies are also notoriously slow at processing claims. If patients were to take a more active role in paying the bills they would be encouraged to work with their doctors on the price. This, in turn, lowers the costs throughout the entire system. Patients could then purchase insurance policies that cover a greater amount of catastrophic medical conditions that will have higher total payouts for the policies.

The same situation is true for pharmacies. They, too, have to bill to insurance and have huge amounts of expense for this. They would also benefit from customers paying more out of pocket but they may not be as will to negotiate the prices the way a doctor might.

This is all well and good but what about the poor you ask? Isn’t the point of reform to help those who cannot help themselves? If a person can’t afford health insurance today why would these reforms change that? The fact is there will always be people who cannot or will not purchase health insurance. For the people who will not I say tough, you got sick so now you need to pay the bills. For the people who cannot afford it (and there are very few of these people) then the government can provide some sort of assistance for these people. Any of these programs should be managed at the state level and not at the federal level. The states are much more responsive to their people than the federal government and will have a better idea of the needs of their people. These types of programs for the poor should ne means tested and carefully monitored for fraud. Ideally they would involve reimbursements to patients rather than doctor or hospitals billing to the program. Most states already have these types of programs in place and they tend to work better than federal options such as Medicare.

What about Medicare and other federal healthcare programs? I think that eventually all federal healthcare programs, such as Medicare/Medicaid and VA medical benefits, should be phased out and converted to the private sector. These could be transitioned by way of vouchers to allow people to purchase private insurance rather than be on the public system. They would also need a grandfathering as many people who depend on them today would not have the ability to transfer off the system.

If you think these changes would not work keep in mind that Congress as excellent healthcare…and it is provided through private insurance companies that provide lots of coverage options. You don’t see Congress rushing to eliminate their coverage. If it works so well for them why wouldn’t it work well for everyone else?

Summary:

1. Eliminate employer provided health insurance
2. Individual consumers purchase own coverage based on their needs and budget
3. Insurance companies forced to compete for customers on an individual basis
4. Protections for pre-existing conditions
5. Restrictions against refusal of coverage or dropping coverage
6. Tort reform to lower the cost of malpractice insurance
7. Encourage patients to negotiate prices for common services with their doctor and pay those costs out of pocket.
8. Phase out federal healthcare programs in favor of private insurance

Ronald Reagan's Thoughts on Socialized Healthcare

This was recorded in 1961! He could be talking today about events of today. Reagan was an incredible political mind. You MUST listen to this.

http://www.youtube.com/watch?v=fRdLpem-AAs

The Real AstroTurf campaign

Michelle Malkin had this post yesterday about the dem's AstroTurf campaign in support of the healthcare bill - http://michellemalkin.com/2009/08/10/better-astroturfing-through-craigslist/

The best link is to this post on Verum Serum about ads on Craigs List for protester jobs - http://www.verumserum.com/?p=7742. Looks like these pay pretty well...

The connections here are amazing and, once again, no one from the MSM is talking about his.

Healthcare Bill Part 1

My mom has been going through the Healthcare bill and here is a list of interesting points from the first 170 pages or so.

• Page 22: Mandates audits of all employers that self-insure!
• Page 29: Admission: your health care will be rationed!
• Page 30: A government committee will decide what treatments and benefits you get (and, unlike an insurer, there will be no appeals process)
• Page 42: The "Health Choices Commissioner" will decide health benefits for you. You will have no choice. None.
• Page 50: All non-US citizens, illegal or not, will be provided with free healthcare services. Really? Pgs 132-133, line 16. Page 143-line 3 contradicts this.
• Page 58: Every person will be issued a National ID Healthcard.
• Page 59: The federal government will have direct, real-time access to all individual bank accounts for electronic funds transfer.
• Page 65: Taxpayers will subsidize all union retiree and community organizer health plans (read: SEIU, UAW and ACORN)
• Page 72: All private healthcare plans must conform to government rules to participate in a Healthcare Exchange.
• Page 84: All private healthcare plans must participate in the Healthcare Exchange (i.e., total government control of private plans)
• Page 91: Government mandates linguistic infrastructure for services; translation: illegal aliens
• Page 95: The Government will pay ACORN and Americorps to sign up individuals for Government-run Health Care plan.
• Page 102: Those eligible for Medicaid will be automatically enrolled: you have no choice in the matter. Can't tell about Medicare here.
• Page 124: No company can sue the government for pr ice-fixing. No "judicial review" is permitted against the government monopoly. Put simply, private insurers will be crushed.
• Page 127: The AMA sold doctors out: the government will set wages.
• Page 145: An employer MUST auto-enroll employees into the government-run public plan. No alternatives.
• Page 126: Employers MUST pay healthcare bills for part-time employees AND their families. I could not find this.
• Page 149: Any employer with a payroll of $400K or more, who does not offer the public option, pays an 8% tax on payroll
• Page 150: Any employer with a payroll of $250K-400K or more, who does not offer the public option, pays a 2 to 6% tax on payroll Starting page 153, line 19 - read this - penalties
• Page 167: Any individual who doesn’t' have acceptable healthcare (according to the government) will be taxed 2.5% of income. Line 5
• Page 170: Any NON-RESIDENT alien is exempt from individual taxes (Americans will pay for them). They won't be taxed because "they are not covered"...see Page 50 above

Keep in mind that this is a 1000 page bill. Look at what it does in less than 200 pages. If you would like to read it yourself go for it! http://frwebgate.access.gpo.gov/cgi-bin/getdoc.cgi?dbname=111_cong_bills&docid=f:h3200ih.pdf You know your Congressman won't be reading this.

Edit: I just wanted to clarify that much of this information was forwarded to my mom from some friends in Fort Wayne, IN who's church group has been going over the bill. Their comments are all mixed together so it is a true group effort. No flagging here just trying to give credit where credit is due! Thanks everyone!

Some interesting links about the health care debate

Peggy Noonan at the Wall Street Journal has a very interesting editorial about the public response to the health care reform debate - http://online.wsj.com/article/SB10001424052970204908604574334623330098540.html. She is right, the dems are terrifying people.

Michelle Malkin linked to the amazing photo essay of the health care reform protests in Denver - http://www.lookingattheleft.com/2009/08/pelosi-astroturf-healthcare/. Take a look and tell me who you think the real grassroots protesters are and who the AstroTurf protesters are. Don't read it first, just look at the pictures. This is extremely enlightening stuff.