The System Is Broke, What to do?

Sorry for this digression from paramotoring—every now and then I feel the need to vent.

Regardless of your health care leaning, there are some things that  most people will probably agree on with a little thought.

For starters, too many people get health care and don’t pay anything, most commonly through the emergency room. These same people frequently have reasonable jobs, cable TV, a car, eat out occasionally and enjoy other benefits of modern life. Yet they bristle at paying for health care or buying insurance. Why is that? In some cases they take good health for granted and live on hope that it will continue. But some feel that they are entitled to free benefits, that somebody else should pay for it. Some simply want to save the money and take advantage of the fact that ER’s have to treat everybody. That’s hardly fair to the rest of us.

Here are some points that seem to be good ideas for any health care reform.

1. Anybody who is able to pay should pay something every time they go to a doctor. If they can’t pay right away, then a penalty should be applied and the amount added to their yearly tax burden. Paying something will limit superfluous visits.

2. Government has an abysmal record for efficiency. Any system should be structured to allow financial incentives for being efficient. Appropriate regulation of the private sector may be better than a government run system. If a government run system is chosen, then guaranteeing its efficiency, with appropriate incentives, should be of primary import.

3. Tort reform is a must. There has to be a balance struck between responsibility and turning medical mistakes into the lawsuit lottery. Incompetence should have a consequence, for sure, but without blowing out the system.

4. It’s utterly and completely unfair how our elected representatives won’t have to use the same health care system that they’re crafting.  Congressman Fleming of Louisiana, to his credit, has started a petition that proposes putting all congressmen under whatever system they enact. That makes so much sense. So much that it spurred me to write this piece. Here’s the petition.

In December, 2009, the Senate health committee voted 12-11 in favor of a two-page amendment, introduced by Congressman John Fleming of Louisiana, that would require all Members and their staffs to enroll in any new government-run health plan. They are currently exempt and have a separate government health care plan.

His petition is here and his hope (besides generating publicity and getting re-elected) is to have the voice of the people. It’s an effort that seems to have merit.

5. Not everyone is going to get the same health care nor do I think that’s appropriate. Extra insurance that adds to what’s covered by a national plan should be available to those who can afford it. Such folks will likely receive the ground-breaking, expensive care that eventually trickles down to the rest of us.

6. Poor people who truly can’t afford more than basic housing and food should have a way to get basic health care. They’ll do so anyway, through emergency rooms, which is terribly inefficient. Realize that medical care is provided already. Calls to 911 already get a person to the hospital regardless of ability to pay. It would likely be no more expensive to provide treatment before their ailments get to that point.

7. “Big pharma” is a business that must make money in the same way everybody else does. Profit is is the linchpin of motivation to make good products. It’s why you work. It’s why your business operates and its why research goes on to improve a medical system that has been enormously successful. That’s how capitalism works. Provide us a good product, that works with reasonable (not perfect) safety, that we’re willing to pay for, and we’ll pay for it. If the product doesn’t work, or is too expensive, we won’t pay for it. Doesn’t that sound like every other product?

The system must not become another colossal government bureaucracy and it must operate with the budget given. As an aside, wouldn’t it be nice if government operated on a pie-based income system. All government budgets are doled out as a percentage of the total revenue, not a fixed amount. That way, when a new program or change is introduced, it must either come with its own funding or have its share of the pie taken from some existing program’s slice. That forces an efficiency and a realization that sometimes there won’t be enough income to cover expenses.

I would love to see a health care system that essentially everybody pays into, and everybody benefits from. Where an accident or illness doesn’t bankrupt an individual, and where hospitals don’t bear the brunt of running an emergency room. Such a system could be designed to accomplish these goals if we have the wherewithal. If the premium comes out of taxes, so be it. And why not? If everybody is paying into it there should be an increase in total premiums paid while individuals don’t pay any more in taxes.

Health care reform is a great opportunity to improve our lot, lets do our part to get it done right.