OK, so here's an alternative plan. Any comments?
PLEASE EVALUATE THIS PROPOSED SOLUTION. PLEASE TRY TO BE OBJECTIVE AND NON-PARTISAN. PLEASE LET ME KNOW WHAT YOU THINK -- CONSTRUCTIVELY
Once again, the solution is not to take away more control from the consumer (the patient, the taxpayer, us), and give it to some government bureaucrat. Nor is it good to allow the insurance company bureaucrats to keep control, either!
I think the solution is to give the consumer more choice, and give them an incentive to try to reduce the costs THEMSELVES.
I think the problem of rising health care costs is primarily a result of patients not bothering to think about the costs at all because they don't think they have to. Patients typically don't care, because they know that the insurance company is going to pay. Patients don't ask simple questions that any normal consumer in any other market would ask like "how much will that cost?", "why is that so expensive?", "do I really need that?", and "isn't there a cheaper way?"
Let me try to illustrate this with an example:
If you walk into a supermarket and you can either buy lobster for $15/lb. or hamburger for $4/lb., how likely are you to buy lobster every night for dinner?
If, on the other hand, you knew that somebody else was paying for your groceries, you might be more inclined to buy the lobster, even though the hamburger may, in fact, have better nutritional value. In fact, you might even be more likely to buy the lobster JUST BECAUSE you know that other people could buy it on YOUR insurance premium dollar, so "why not". After all, it will only increase your insurance premium by a couple cents, when spread out among all the other shoppers. Besides, those other shoppers are probably eating lobster on my insurance premiums, so why shouldn't I?
Now, let's extend that analogy to health care. if we could incent the patients to be more efficient with their healthcare spending, we wouldn't need the bureaucrats at the insurance company or in the government to ration the care, and the cost would be much lower. The patients would take responsibility for their own choices, and expect more from their doctors, drug companies, and diagnostic equipment, for the same money.
You might also find that people take better care of themselves because they don't want to spend more money on health issues later.
So, I'm thinking that increasing the deductibles is a major part of the solution. First off, it will make the insurance premiums cheaper right off the bat. Secondly, it will incent the patients to bargain with their medical providers and ask the difficult questions about necessity and price, rather than just saying, "sure, let's do it, what the hell". Then, the costs are lower, the providers would have to compete for business (always a good thing), and the providers would strive to come up with better, and/or cheaper methods to provide the same service.
Now, remember the money saved on the insurance premiums because of the higher deductibles? GIVE THAT MONEY TO THE EMPLOYEES in order to pay for their regular health care. You know, the stuff that doesn't exceed the deductibles: Regular check-ups, etc. The only restriction should be that they can ONLY SPEND THAT MONEY ON HEALTH-RELATED EXPENSES. If they manage to save enough, they can use it to get their teeth fixed, to get breast enhancements, whatever. Let them accumulate the money year after year and save up for costly stuff that they want done like lap-band surgeries, whatever.
Getting the costs down will help with Medicare and Medicaid, and the VA Hospitals, too. All the learned efficiency from trying to keep the patients happy will lead to cost reductions ACROSS THE BOARD, and will lead to doctors, drug companies, hospitals and medical device manufactures innovating more in order to generate more profit and to make the patients happier.
Sure, I haven't ironed out all the details, but this idea sounds a hell of a lot better to me than anything I'm hearing from that mess of a health care "reform" bill so far.
So, what do you think? Does this start to meet the needs? Does it encourage innovation? Does it preserve our excellent health care system for everyone? Does it make health care more accessible? Does it make it better for EVERYBODY?
If the liberals are so concerned about the poor, then why the assumption that the government should control it? Why not set up charities and take care of them directly?
You know why - when the economy tanks and the charity actually needs the money to do it's work the donations are not there. Thus, a crappy long term solution.
Ed, your proposal makes sound economic sense, but it supports the rich over the poor. Let's use another analogy:
A rich man and a poor man buy the same model of car. The car develops a high-pitched squeaking noise from the right front wheel. The rich man immediately takes it in for the mechanic to look at it. It turns out it's a wheel bearing which is going bad. The wheel bearing is replaced for a hundred dollars and the car continues on for many thousand more miles.
The poor man puts it off and puts it off and puts it off because hey, it might get better and besides I can barely cover rent, I don't have the money to pay the mechanic to take a look at it right now. He put it off so long that eventually the wheel stops spinning while on the way to work and he runs off into the ditch. He has the car towed to the mechanic, the mechanic takes a look at it and has to replace the entire front end which costs many thousands of dollars.
Raising deductibles would work, but it places a heavier burden on those who would be less able to pay for it. Putting off a car repair is one thing; putting off a checkup because you notice a spot on your arm is something else entirely. It could be nothing, or it could be cancer. "Better safe than sorry" is fine if you can afford the higher deductible for an office visit, but what if you can't afford it? It's obviously not going to be better off for EVERYBODY as you suggested.
I don't know much about the health care issue, and I'm not taking anyone's side, but I do think I know a thing or two about poor people.
The chap in the above example probably can't afford to get his car checked because he buys the expensive $6/pack cigarettes. He probably eats out a lot. He probably buys lottery tickets by the handful in the hopes that he will never have to work again. He probably has cable TV, and the expensive package at that. His car he probably bought new instead of used. And he probably has to have a new one every few years. He probably buys T-bone steaks instead of hamburger. I bet he has the newest video game X-box or whatever it is. He probably has his heat turned too high in the winter, and his AC too cool in the summer. He can't afford to have his car checked because he has that money already spent on nonsense (
not his rent, in fact, he's probably
behind on his rent).
In short, poor people are usually poor because they don't handle their money well. They make poor decisions. Conversely, wealthy (
wealthy, not necessarily "rich") people usually make good financial decisions.
It has
little to do with income. Don't believe me? I am a graduate student. I make $20,000 on a
good year. Yet I have saved about $30,000 in the bank. I have a modest house that is bought and paid for. I paid cash for it. And I put myself through college (I worked for 8 years in a machine shop and saved my money so I could do this, while all my coworkers complained about their circumstances and wasted their money). I currently have no debt and I'll never be in debt again. Want to know what my parents did for a living? My dad was a boiler operator at a hospital, and my mom drove school bus. They tried to farm on the side (cows, sheep, pigs, chickens, you name it) which usually took away any profit they made from the other jobs. My grandpa was a fruit farmer with only an 8th grade education. These were not rich people. And they didn't know much. But they taught me how to save and not squander my money.
And I've had bad things happen to me too. I had a drunk driver total my Jeep and I got a measly $735 for it (long story). (It was worth a lot more, plus I had wanted to drive it for another 10 years.) I was married to a woman that spent money like water (and will forever be in debt). I went through a divorce. And I have a chronic medical problem. But I refused to let these things keep me down.
Like I said, I don't really know what is best for the health care issue, but poor people are poor because they do the things like what are in my example. I see it all the time.
