Although Obama likes to set up the dichotomy of "my plan or nothing," there are other ideas out there. Here are my health care reform recommendations:
- Medical malpractice reform, to reduce frivolous lawsuits and the unnecessary procedures that doctors perform in order to avoid these lawsuits. This "defensive medicine" is estimated to increase medical costs by 10%. Texas has had good results from its medical tort reform.
- Allow people to buy health insurance across state lines. A lot of states impose ridiculous mandates on their health insurers, requiring them to cover acupuncture or in vitro fertilization for everyone. These mandates drive costs up. People shop nationwide for car insurance and mortgages, so why not health insurance?
- More use of "retail health clinics," like those located at CVS or Wal-mart. There, people can get quick, low-cost, walk-in service for minor ailments, usually from a nurse practitioner. These clinics reduce costs, free up emergency rooms, and expand access. Of course, doctors' groups oppose them.
- Tax employer-provided health insurance. There is currently not much of a link between the people that use health care and those that pay for it. People don't think about what procedures cost, because insurance will cover most or all of it. Similary, when people get insurance from their employer, they usually have no say in what plan they get. Taxing employer-provided insurance would push more people to get their own insurance, in which case they would buy the plan that is best for them, not for their employer. At my last job, my employer was definitely paying more for my insurance than I would have paid for a basic individual plan.
- Related to the above point, I'm not sure about offering tax credits for people to buy health insurance. It seems like offering such credits could cause inflation of premiums, cancelling out whatever good the credits do. Maybe these credits could be offered exclusively to the poor and/or the young.
- More use of Health Savings Accounts. These accounts allow people to have tax-free savings accounts to use to pay health costs, and are used in conjunction with high-deductible plans, which create incentives for people to shop around for health care and question the benefit and necessity of costly procedures.
- Much is made about the benefit of being in a group plan versus an individual plan for spreading risk around and decreasing costs. Currently, this is done by getting insurance at work. It seems like people could instead get insurance through other types of groups. For example, there are credit unions for people who work in certain fields or live in certain areas. Similar groups could be formed to get health insurance. People could also buy into plans through their college alumni association, for example.
But what about people who can't get insurance through work and can't pay for an adequate individual plan? These are biggest problems in the American health care system. It's not about the people having premiums that are a little too high, it's about the people who go bankrupt when something goes wrong with their health.
ReplyDeleteYour employer was paying more than you would have because you are a young, healthy guy with no kids. At my dad's work, they talked a young guy into coming onto the health insurance plan because he actually brought down the cost for the entire group even while adding another person.
Health care needs to be reformed, not just tweaked. It's clear we're not getting a system like Canada's (or France's, which no Republicans mention because it's apparently awesome) but maybe there are enough Democrats with the political will to fix some things like insurance companies dropping people when they have the nerve to get sick, or denying coverage to people with pre-existing conditions.
The problem comes down to costs that are too high, and the reason for that is the lost link between he who gets the treatment and he who pays for it. There is no shopping around, except for things like LASIK and breast implants, which are dropping in price. Obama's plan further severs this link, which can only lead to government-directed rationing. My proposal addresses costs on several fronts (legal, medical, insurance) from a market perspective.
ReplyDeleteMy plan won't help 100% of people, that's true, but it would help a good majority of them. The scenario you mention about bankruptcy would be ameliorated by catastrophic plans, which would be low-cost because they are only used for emergencies. Democratic plans take us in the opposite direction, by eliminating these plans and using insurance to pay for more and more procedures.
The Democratic plans would help a minority of the population while relegating a much larger proportion to a lower quality of care.
I'm in a business group plan, and having stated that, CraigCare SCARES me!
ReplyDeleteThanks for the harassing comment, I had to return the favor. How's Texas?