Friday, August 27, 2010

Health Care simplified (maybe)?

Why does the government always look to solve a problem by starting with the most complicated and controlling approach first (and often never moves on from there)? And that is assuming (a very big and IMHO false assumption) that it can accurately determine whether or not there actually is a problem.

Indulge me by joining in another look at Health care in America. The whole conversation is about two areas: costs and availability of coverage, right? For the sake of argument, supposing we separate the two for purposes of discussion.

Cost. Right now, the individual states control the cost of policies sold in their states...or, at least they have the power to control those rates. So...the federal plan that is going to cost us who knows how many trillion dollars does not really address or improve that factor, does it? Do we really think that federal bureaucrats will do a better job than state bureaucrats? I don't either. But...can we change the factors in a way that might (and I emphasize, might) improve costs? How about allowing cross-state-line sales of different health care insurance products? Instead of mandating a specific model of coverage, as states do now, why not mandate that different policies can be marketed with different scopes and levels of coverage and the consumer can select whatever suits his or her desires? Further, if you thought it would be helpful, research and find out what the profit margin is for Health Insurance Companies, come up with an average and mandate that all Health care Insurance Companies may not set rates that result in exceeding that margin. Adjust that number by inflation, provide for public auditing of compliance. Require that promotional and explanatory literature on the different Insurance policies highlight in bold print and plain English just what the differences are between policies, with emphasis on scope (types of things and illnesses covered AND NOT COVERED) and Coverage (amount of money available by type of service and lifetime of policy).

I think all of this, done at the STATE level, would result in lowest possible (knowing that this does not necessarily lead to an actual reduction in bills, just that the charges are not inflated) costs and allow a family to chose at least some coverage at a cost that they can afford.

Availability of Coverage. Again, let us presume that we want to extend coverage to all citizens. Why not just provide for reimbursement of costs of medical care to citizens who do not have coverage. All Doctors, Hospitals and Medical Laboratories have to do is document the person receiving coverage, why they were not covered by a policy (pre-existing condition, financially unable to afford coverage, etc.) verify that they were a citizen or a legal resident, and the government would cover the costs. There would be no reimbursement for treatment for illegal aliens or non-citizens. Also, these forms would also be required to be audited to prevent fraud.

This would, within a couple or 5 years provide us with a baseline for the costs of covering those who do not have any insurance. If the experience seemed to support it, perhaps a follow-up step would be to replace the reimbursement program for the Health care Industry with a subsidy for lower income families to enable them to buy an insurance policy, leaving the government directly responsible only for those with pre-existing conditions.

Such an approach would provide both more alternatives and more power of choice to the American citizen and family, keeping government control at a minimum while mandating government verification of industry, provider and end user truthfulness, as well as minimizing taxpayer costs.

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