Impeding changes to our Health Care system

[classicman]

Please note that I believe that the goal of many of those that support the current plans in Congress is to ultimately get to single payer universal coverage provided by the government – because I have read many comments from supporters stating that this is what they support. I am against that. I don’t believe that government run health insurance will help anyone in the long run. I do, however, believe that the health care status quo is unacceptable and unsustainable. I want major changes.

1) I want to encourage competition based on price and customer satisfaction. Customer satisfaction should be driven by overall treatment and outcome. Not all that different from any other service.

2) I would like to see all healthcare related tax payments and exemptions removed. Employers should not receive any special tax treatment for providing healthcare to employees, but at the same time I should not be penalized for buying my healthcare on my own. This would enable insurance portability because I would buy my policy. My employer would not buy that policy. It would also change the competitive nature of insurance because insurers today work to meet the needs of the human resources departments within businesses, not the needs of the individuals on their plans. Yes, there is a difference.

Income taxes on health care workers should be removed. From the doctor to the janitor, the entire industry should be exempt. WAIT: Before you scream at me, think about this statement. If we can achieve real competition in health care, then by removing taxes we create room for prices to go down. For example, if a doctor wishes to take home $200k per year, that doctor needs to bill far more – varying by tax situation – to actually take home that $200k. The doctor also needs to pay staff, rent, equipment, etc, all of which are laden with taxes from income taxes to sales taxes. Keep in mind that even if the drugs the doctor injects you with were purchased tax free, the costs of those drugs included all the income taxes and other taxes the drug company and the company employees had to pay.

That we tax a patient, directly or indirectly, for trying to regain their health should be disturbing to every decent person. I would like to see Congress dedicate a committee to the removal of all health care related taxes.

3) No, I am not totally anti-government. I believe that government has some very important roles in health care. The first of those roles is to act as judge in disputes over complaints that insurers or the insured are failing to live up to their contracts. The ability to act as unbiased judge is huge and it is a role that is vital to protecting patients. It is a role that the government can not effectively play if the government also controls the health care industry. There is simply too much opportunity for influence and pressure. Think of it this way; how fair is it that if your health insurer denies coverage your appeal starts and ends with that health insurer? Why would it be different if that insurer is government? There are still budgets and careers and egos at play. Profits are gone but expenses still will need to be met by the government. However, when the insurer is private and the judge is government you increase the chance of a fair judgment.

4) The federal government should establish itself as the head of the standards body for the development of a nationwide healthcare information technology infrastructure – the computer network that will manage health records and billing, etc.

Those of you that have been part of an IT standards body, for example a standards body responsible for insuring that your PC can get your WiFi signal, know that this is an extremely complex undertaking. Standards bodies are complex organizations. Government as a whole, and individuals in government careers, can be very qualified to lead these bodies. Leadership involves constant politicking, compromise, deliberation, and deal making – the art of a operating a Constitutionally based representative government.

And, I bet Constitutional lawyers would find government’s involvement here very acceptable because it would absolutely involve interstate commerce.

5) When I first started writing on health care I opposed forcing individuals to buy health insurance, though I strongly believe that the economics in this country involves increasing the number of people that are actually paying into the system. I still hate the idea of forcing people to buy insurance, but I am coming around to the belief that we either need to insist that everyone that can possibly afford catastrophic coverage get that coverage or we need place some sort of payment requirement on those that visit emergency rooms or use some other means to get health care without paying. Maybe to avoid paying you have to prove you don’t own any luxury items or purchase alcohol or cigarettes. This sounds heartless on the surface, and maybe it is. But I would like to know that the part of my insurance and tax payments that go to pay for the health care of the uninsured is going to the truly needy. I believe that a portion of what we spend is to help those truly in need, but I also believe a portion goes to people that work the system and people that make bad decisions that I have to pay for.

6) Health care reform must include tax reform. I do not understand how we can burden the producers in this nation with complex, high taxes when we so desperately need to pump more money into health care, infrastructure, job creation, and a long list of other activities. Nothing would help ease the burden of health care costs and all the other above mentioned needs like an economic boom that benefited all segments of our economy. Simple as that. Tax simplification and reduction helps everyone at ALL income levels. I believe it helps those with low incomes but big ambitions the most. Naive?

7) Along with tax reform, we need to focus on cultural reform. See my many posts including yesterday’s post on encouraging President and Mrs. Obama to focus their efforts, first and foremost, on encouraging educational excellence, accomplishment, and self-reliance on the many people that they can reach in our society that no one else seems to reach – at least no one else that can act as positive role models.

8 . Health insurance today acts very much like a health care savings account in that almost everything that is a part of health care is paid for by health insurance. I believe that we should break out the health care savings account from the catastrophic, true insurance piece. Let the patient be the consumer for non-catastrophic care, making the best deal by using their health care savings account. I believe that insurers should offer rewards and penalties tied to insurance pricing based on patients following a course of routine health maintenance.

9) There are more than 1,000 health insurance providers in the U.S. We need to encourage competition among them. If that means opening up sales across state lines, fine. If not, then is there a better option?

10) My big concession to those that support strong government involvement. I believe that we need to restructure the insurance market – yes, forcibly through government action, so that the outcome is competitive and thus meets consumer needs, and can generate profits and incentives. I think that the best way to get to this environment may be by requiring this outcome.

So that it is folks. Have at it. The President meets with Republicans on February 25. I know, based on the readership of this blog, that our debate can impact that meeting.

Oh….One final thought. Whatever the health care outcome All government employees including Congress take part. No special privileges for the political class.

From Here