Wow, what an amazing thing we’re witnessing right now in America. First, the goverment makes a valiant run at healthcare reform. Hard to argue that something doesn’t need to be done. However, leave it to our government to make a mess out of a good idea. Regardless of your place in the political spectrum, I think our democratic process is a beautiful thing (as ugly as it is).
Do I think we need broader coverage? Of course. Breaks my heart to field calls from diabetics with no insurance, knowing they are not giving their disease the treatment it needs to keep them healthy. Not to mention the ultimate cost to those with insurance when the uninsured end up in the hospital because they couldn’t afford preventive treatment. That is one reason why insurance premiums are through the roof.
Maybe I’m just a simpleton, but seems to me there is some low-hanging fruit that would immeasurably improve upon our currents system, without the mess. Here are some thoughts on the matter, in no particular order.
1) What’s going to happen when 20, 30, or 50 million additional people are added to the rolls of the insured and want to go see a doctor – that is, one of the current, fixed number of doctors available. It’s not like the wait to see a doctor is not already too long, in many places. Let’s see – supply fixed, demand increasing by 20%. You do the math.
Well, part of the current demand may be exaggerated (or supply constrained, depending on how you look at it) by doctors doing too many tests, treatments, etc, due to the fear of malpractice. Reduce malpractice risk, immediately open capacity. Enough to cover an additional 50 million people? Probably not.
Therefore, increase the supply by having more doctors, right? How’s that going to work with malpractice insurance increasing, and reimbursements decreasing (have to pay for the newly insured, right?).
Seems like we need to address tort (in this case, medical malpractice) caps. That is completely missing from the 1000-page bill pending in congress right now.
2) Why are we only talking about how to increase government revenue to pay for this bill? Why are we NOT looking for cuts in government spending to pay for this? That would make it much more palatable, in my opinion.
3) Why do our lawmakers feel compelled to add layer upon layer of bureaucracy for every program? Has anyone seen the Rube Goldberg plan, with committees, councils, advisory boards, etc just to administer this? Why is this needed? Why not just expand Medicare? (not exactly an example of lean and mean, well, lean, anyway). I think they would design an artificial limb to fix a paper cut.
4) Why not just allow Private Insurance plans to offer plans across state lines. That will significantly increase consumer choice and competion. What am I missing here?
5) Charge more for lifestyle choices which are widespread and proven to significantly increase health care costs (smoking, obesity, etc). I am willing to pay for my choices. But, offer programs to help people change, covered by their insurance.
In my mind, putting this together, a huge improvement would be gained by elimination frivolous and exorbitant medical malpractice, defining standards of care which would preclude lawsuits; cutting waste in the budget to pay for vouchers to help the poor buy insurance, allowing private plans to compete nationwide, compel everybody to obtain coverage, charging extra premiums for expensive lifestyle choices, and making individual premiums tax deductible.
Simple, right?
Mike
Tags: diabetes, health care reform
