Back to Basics

The democrats’ approach to reforming the health care system makes about as much sense as amputating an arm because someone broke a finger.  Instead of addressing the problems in smaller doses they are going to turn the entire system upside down.  I don’t know if they have been listening, but the United States has the best health care in the world.  Why would you want to destroy that?  They want to model it after systems like Canada, but have they listened to the complaints and problems Canada has?  People from Canada come to the United States for treatment because they can’t get it in their own country!  Canadians also have to carry secondary insurance because the government insurance isn’t good enough.  They also pay a HUGE percentage of their income (and not just the “rich”) to pay for these programs.  Is this really what we want?

Even in our own country the state of Massachusetts has their own version of universal health care.  Just recently they reported a cut in coverage to certain groups of people because they don’t have the money to keep the system running.  People who once had good coverage are complaining because they now have to wait to see a doctor or get treatment.  Sure, they may brag that they have the lowest uninsured population, but having the insurance and obtaining care are not the same thing.  The Massachusetts system has started failing in 3 years!

So I ask again – are the democrats listening?  Repackage, renaming or doing whatever creative means to disguise the same bill is still an attempt at passing the same bill.  We are getting tired of the democrats and president trying to sell the same used car with a different paint job.

Reform should start with the very basics and address the problems of the system.  Take it a step at a time, making changes to address the critical problems first, and then continue to monitor the system to see how much more is needed.  Treat the system like a patient – don’t do radical surgery when medication or a change of diet may solve the problem.

The uninsured is one of the current issue.  There are a good percentage of uninsured that have chosen to be uninsured.  They are people who are making a decent living and have made a personal choice not to obtain insurance.  Perhaps they are young and don’t feel the need for it.  They may be a family who does not have the children covered but the parents are.  Whatever the reason, it is their choice.  The government should not force them to purchase insurance.  However, if they have chosen not to obtain insurance then taxpayers should also not have to foot the bill for their medical issues.

The government has caused one of the problems in the system today by passing a law stating everyone has access to health care through the hospitals whether they can afford to pay for it or not.  This law allows anyone, including illegal immigrants, to visit their local hospital and obtain care for anything.  Many of these visits are for something that should be taken care of in a doctor’s office or clinic, but because they don’t have insurance they visit the hospital.  If insurance reform is made, then this law should be revised to only include life threatening illnesses or injuries only to citizens or legal immigrants.  Any minor health issues would be seen as long as the person could pay for the services, or should be referred to a clinic or doctor – which also would require payment.  So, if the person makes the choice not to purchase health insurance then they would have to deal with the financial consequences – not the taxpayers and not the hospital.

I am not talking about the citizens who simply cannot afford insurance.  Part of any reform should include government subsidies to help those people obtain insurance.  Many are now eligible for Medicaid or a state health care system, so they are not without coverage.  If they have not applied for that coverage you cannot blame the system; you have to hold the individual responsible at some point.  These services should continue, but should be limited to citizens or legal immigrants only.

The second group of uninsured are those with pre-existing conditions or chronic illnesses who cannot afford coverage or have had coverage cancelled or been declined coverage.  Congress has already passed a bill that allows states to set up high risk pools to provide insurance for these individuals.  The system has already been established, but many states have failed to create that system.  Some states have done a great job, others have struggled.  You have to start holding states responsible.  Take those states that have created the system that works and make it mandatory for all states to create a system that models the ones proven to work.

Another group of uninsured are those whose employer does not offer health insurance or the small business owner.  There are some policies offered to cover these individuals, but in my own search for a policy I found it difficult to find, more expensive with less coverage.  There is no reason creating new pooling systems to provide insurance policies to these people cannot be done.  The insurance companies need to be responsive to the need and demand for these policies and they need to be allowed the opportunity to create such pools.  The policies should be equivalent to those offered to large corporations at similar rates.  Further, anyone that pays for their own insurance policy should be given some sort of tax advantage, similar to what employees receive when they purchase insurance through their employer.

Insurance policies should also be customizable to individual needs.  Your basic insurance plan needs to be established to cover all the basic medical needs anyone may encounter.  The individual should then be able to determine and purchase additional options to customize their care.  If you are a single male or a female beyond childbearing age or have had a hysterectomy, then you would not need to “add” maternity coverage to your policy.  If you don’t smoke or drink alcohol then you wouldn’t need to add coverage to address those issues.  You may want to “add” chiropractic services to your plan, maybe naturopathic medicine, children’s well care checkups, hair replacement treatments, or any number of other options that would meet your needs and personal beliefs to address your health issues.  Other options would include what deductibles you want to set, co-pays for office visits or other services, and the percentage you want to be responsible for.  In this manner people would be paying only for the services they want and need instead of some inflated policy covering medical issues they will never use.  These policies should be made affordable and each individual would have control over their costs.  If they can only afford the basic coverage, then that would be their choice.  If they really want cosmetic surgery covered, then maybe that is an option they could add that they would also pay an additional premium fee for.  The choice should be up to the customer – not the insurance company or employer.

The insurance billing practices also needs to be addressed.  Have you ever tried getting the cost of a procedure before it is done?  Other than your typical office visit co-pay, it becomes very difficult to get the fees being charged.  If you ask your insurance company they will tell you it depends on the procedure and how it is billed.  If you ask the medical provider they will tell you they don’t know what your insurance company will allow.  You cannot obtain fee information!  This practice needs to stop.  The fees should be published and available to everyone.  Depending on your insurance coverage you should be able to determine your percentage of the cost.  Why are medical providers charging the insurance company $1000 for a procedure, to have a $600 reduction in the cost made by the insurance company, and then you pay 20% of the $400 balance?  Granted, the medical providers make contract agreements with the insurance companies, but why?  This type of billing practice only hurts those without insurance since they will pay an inflated fee.  You would never go into the grocery store, fill your cart, and not know how much you are paying for anything until you check out, only to have the cashier ask for your grocery card to determine if you will pay $2 for that gallon of milk or $3 for that same gallon depending on your “grocery” coverage.  If we wouldn’t put up with this type of pricing scheme in our retail or any other market, then why should we continue to tolerate it in the health insurance market?  Prices should be posted, consistent and the only factor should be what percentage YOU CHOSE to contribute based on your insurance policy purchase.

The prescription drug industry definitely needs reform.  Why does a drug cost $90 in the United States and $5 for the same drug in another country?  Why does the drug industry need to advertise their product to the public on television, radio and other media?  This should be a doctor/patient decision, not one driven by advertising.  Do we really need to be sold on a disease because someone has discovered a drug for it?  I know I’ve been recently “diagnosed” with a disease and when I looked it up it was recently “discovered” by the WHO and the drug industry.  Fortunately my doctor doesn’t believe prescription drugs are the answer to everything, so I will not partake in their current propaganda.  Why can’t an individual obtain the drug their doctor prescribes instead of a generic the insurance company or drug industry decides will work the same – they aren’t always equal.  So the drug industry really needs to be reformed.  Just like the tobacco industry, their advertising should be banned from the public media.  We do not need to instill in our youth that the solution to all problems is one drug or another.  We already have an illegal drug problem – are we supporting this by pushing legal drugs on the television?  Advertising costs money, let’s save those funds and reduce the cost of the drugs to the patients.  Bring the drug costs in line!

So instead of turning the whole system upside down, do it one step at a time.  It doesn’t need a government takeover.  By addressing the problems instead of the symptoms, real reform may take place.  One might even discover taking such actions benefits everyone.