Health Care – Is there a solution? Part 3 of 3
The first move to make in health insurance reform is forcing consumers to make medical decisions based upon market forces. During the wage and price freezes of WWII America, companies were forced to offer benefits in order to attract workers since they could not offer more money. Once this became an employment “entitlement”, the provision of health services was taken out of the market-sensitive environment. Rather than deciding whether to use services based upon need and price, consumers with insurance neither purchase services nor are treated by providers of services on that basis. “Do whatever you need to do for whatever price you charge. It doesn’t matter to me. I have insurance”.
This has been clearly seen in the provision of laser eye surgery. With insurance providers refusing to cover this procedure, market forces have driven the cost down to a level where more consumers could afford it. Even with medically necessary services, consumers would be more discriminating in choosing where they receive those services. Insurance plans should be crafted to give consumers a benefit in making some medical decisions based upon market forces. Higher deductibles, Medical Savings Accounts, and Catastrophic coverage accomplish this.
The following points outline the changes I recommend that we immediately put into action here in America.
As is the case with Major League Baseball, Health Insurance companies enjoy an exclusion from market competition. Does anyone remember how fast phone bills went down with the AT&T breakup in 1984? Same thing here. We must remove this exclusion. When we allow insurance companies to sell to customers in other states, rates will go down and quality of services will go up. Then, perhaps, health insurance companies can focus on serving customers and improving the level of care. Without this reform and the resulting lack of competition, there are few incentives for insurance providers to improve their services.
Stop providing health care to people who are not citizens unless they have health insurance. Perhaps they will find their way back home to their native countries to receive care there. Taxpayers are not required to care for the world without their consent. Recently Danny Williams, the Newfoundland Premier, opted to come to the United States to pay for an operation he could have received for free under Canada’s national healthcare plan. He chose to forego those services (and the resulting wait that is commonplace in that system) and come here to have his procedure.
Pass meaningful tort reform to slow the growth of defensive medicine. Recent polling of physicians suggests that they use an additional 26% of resources to prepare for potential lawsuit opportunities. That amounts to a lot of co-pays paid by the patient/consumer.
Stop talking about fraud, waste and abuse in the system and start prosecuting people to the fullest extent of the law who intentionally misuse Taxpayer money. This applies to Medicare/Medicaid and all state-run healthcare program.
Encourage Health Savings Accounts (better known as HSA’s) to encourage better market price sensitivity. These accounts encourage consumers to purchase services on a more market-sensitive basis. This also encourages planning for medical expenses.
Allow individuals within a company plan to own their own policies so that loss of job does not mean loss of coverage. Allow them to take that coverage to a new company and continue to be a part of the corporate risk benefit.
Allow individuals to join larger constituency groups (NFIB, etc) to reap savings in plan costs. These organizations are currently unable to create large risk pools.
Stop requiring hospitals to spend huge sums of money caring for irresponsible people. It is unfair to allow individuals to ignore health coverage while requiring hospitals and physicians to lose millions caring for these same irresponsible people. If one is free to avoid health insurance, providers should be free to refuse care. It sounds heartless, but we do not require farmers to feed people who refuse to work or display other responsible behaviors. Accountability has a benefit to holding down unnecessary costs to the taxpayer. There may be an attendant drop in demand for cell phones, cable TV, luxury purchase, and other unnecessary expenses, but such is the nature of life.
This is an interesting side-note. One of the constituency groups that got a pass in the recent health reform legislation were the Amish. In the Amish community, young men are not allowed to marry until they can demonstrate to the community that they have the financial resources to care for a woman and they are not allowed to have children until they have the cash available to pay the hospital and physician for the services, without benefit of insurance. How do they manage to survive without health insurance? On the contrary, they not only survive, they are thriving.
Each one of these reforms can be accomplished without one additional penny in cost to the taxpayer. The main reason they are not attractive to the Progressives on the left is that the power rests with the people, and not leftists. They assume that Americans in general cannot make these tough decisions. When we truly analyze the situation, the reality is brutally clear: government power is what this discussion is all about.