8 Ways To Reform Health Care WITHOUT A Government Takeover

by Ron Haynes

—Note

No, I’m not a doctor, and I don’t play one on TV either. I’m not a lawyer, or a politician, but I AM an American voter and I want my voice heard … and I want my “representatives” to listen without discounting everything I say simply because I don’t agree with them 100 percent of the time.

I realize I’m probably walking into a gunfight but after speaking with someone about the state of American health care, I was blown away. By what? By the refusal to accept personal responsibility and the claim that certain things “just aren’t fair.” Who gets to decide if something is “fair?”

When Dan lost his job, he went three months without insurance and that just wasn’t fair. It wasn’t HIS fault the company folded.

Can you imagine saying this about any other benefit? As part of my compensation package, I have a company car. If I lost my job, how much sense would it make if I demanded that things weren’t “fair” because I no longer had a vehicle? Is it fair to demand that someone else (the US taxpayer) pay for my vehicle?

Some would argue that health care is far more important than a car, and I’ll grant that argument. But do I then demand that someone drive me to the doctor? Whatever happened to personal responsibility? “We’re dealing with LIVES!” I don’t believe it is. I think it’s more about controling LIVELIHOODS.

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After digesting arguments from both sides about health care in the USA, I’ve stumbled on a few myths and facts:

Myth: There are 46 million uninsured American citizens.

Fact: The Census Bureau puts the number of uninsured at 45,657,000 people, but nearly 10 million (9.7) of the 45.7 million uninsured are classified as “not a citizen.” Claims of uninsured Americans higher than 35.9 million are wrong.

Myth: The 40 million to 50 million uninsured cannot afford health insurance.

Fact: Twenty percent of the uninsured have family incomes of greater than $75,000 per year, according to the Census Bureau. More than 17 million of the uninsured make at least $50,000 per year with a median household income of $50,233 – 8.4 million make $50,000 to $74,999 per year and 9.1 million make $75,000 or higher. Two economists working at the National Bureau of Economic Research concluded that 25 to 75 percent of those who do not purchase health insurance coverage “could afford to do so.”

Myth: The 40 million to 50 million uninsured do not get ANY health care.

Fact: The National Center for Policy Analysis estimates the average uninsured family of four gets about $6,000 in free health care per year. An Urban Institute study found that 25 percent of the uninsured already qualify for government health insurance programs. According to The National Institute for Health Care Management Foundation, 26 percent of the uninsured are eligible for some form of public coverage but do not make use of it.

Myth: People will remain uninsured without government assistance.

Fact: The Congressional Budget Office says that 45 percent of the uninsured will be insured again within four months. Former CBO Director Douglas Holtz-Eakin also said that the frequent claim of 40+ million Americans lacking insurance is an “incomplete and potentially misleading picture of the uninsured population.” Yet another CBO analysis found that 36 million people would remain uninsured even if the Senate’s $1.6 trillion health care plan is passed.

Even the liberal non-profit Kaiser Family Foundation put the number of uninsured Americans who do not qualify for government programs and make less than $50,000 a year between 8.2 million and 13.9 million. Splitting the difference means there are probably about 11.05 million without health insurance (not without health care – there’s a big difference). That’s 11.05 million out of 304 million or just 3.6 percent of the population.

What SHOULD we do to solve this “crisis?”

1. Classify any premiums spent on health insurance a tax credit and retain the deductibility of health care costs.

2. Lower the adjusted gross income requirement for the deductibility of medical expense from 7.5 percent to 3 percent or less.

3. Permit people to purchase health insurance from any state and make it portable from job to job.

4. Cut down the barriers that prevent/limit insurance companies from offering high-deductible insurance.

5. Repeal state mandates requiring a minimum level of health care coverage. Some states have established minimums so high that the cost of health insurance is unconscionable. The irony here is that government regulation sent the cost of health insurance soaring, but politicians claim that they alone know how to lower health insurance costs. It’s like the Black Knight from Monty Python and the Holy Grail telling you how to fight (’tis but a flesh wound).

6. Educate the public on health care costs. People know how much a gallon of gas costs but have no idea what an office visit to their doctor costs. They know the cost of a new Prius but couldn’t get close to telling you how much an MRI costs. An educated public will demand competition and market prices – they do in almost every other aspect of their lives! Everything being relatively equal, would YOU go to a movie theater that charged $30 for a ticket and $20 for a small popcorn? Competition drives down prices.

7. First reform Medicare. According to a Council of Economic Advisers Report,

“nearly 30 percent of Medicare’s costs could be saved without adverse health consequences.”

Medicare is a bureaucratic, bloated, huge, single-payer, government-run program so it should provide the perfect opportunity for a government run health care experiment, shouldn’t it? If more efficient government management can slash health care costs by addressing problems like high cost, low-value treatments, too little effective and high value care, variation in the quality of care provided to patients, medical errors that lead to worse outcomes and higher costs, and too much defensive medical treatments — why not start with Medicare? Let’s see what “better management” looks like applied to Medicare before we force it on the rest of the country.

Is there anything in your life you think would be better if it were run by government bureaucrats? For most of us, the answer is a laughable “No.” Yet oddly, there is sympathy for turning over our most private, personal decisions, not to mention one sixth of our economy, to the same unresponsive, anti-entrepreneurial culture that gave us the response to Hurricane Katrina.– Newt Gingrich

8. Place a cap on malpractice awards. Not only do the tremendous costs of lawsuits require doctors to pay massive premiums to get malpractice insurance (costs then passed on to consumers), but these costs encourage many doctors to engage in defensive medicine to avoid these lawsuits. They prescribe useless tests and exams that are expensive and have more to do with protecting themselves in court than with a patient’s health. A study in 2000, for example, estimated the cost of defensive medicine to be 70 billion dollars a year. A simple $2 million cap on malpractice awards would reduce insurer’s risk and lower malpractice premiums while still providing an incentive for doctors to practice good medicine.

We can have better, more available, less expensive health care in this country but it won’t be because the government got involved, it will be because the government got out of the way and allowed competition and choice to rule. Competition will make certain that more Americans are covered without destroying the impressive quality of our current system. We can’t put overbearing bureaucrats or green lampshade accountants in charge and expect that health care costs will go down and quality and availability will go up. We need to empower Americans with more choice and competition, not with a huge single payer system that will be just Medicare for all.

About the author

Ron Haynes has written 1000 articles on The Wisdom Journal.


The founder and editor of The Wisdom Journal in 2007, Ron has worked in banking, distribution, retail, and upper management for companies ranging in size from small startups to multi-billion dollar corporations. He graduated Suma Cum Laude from a top MBA program and currently is a Human Resources and Management consultant, helping companies know how employees will behave in varying situations and what motivates them to action, assisting firms in identifying top talent, and coaching managers and employees on how to better communicate and make the workplace MUCH more enjoyable. If you'd like help in these areas, contact Ron using the contact form at the top of this page or at 870-761-7881.


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{ 12 comments }

tom

Thank you, Ron.

You’re the voice of reason in a screaming match.

jon

Don’t see you addressing our biggest health care failings; the rejections for pre-existing conditions, rescissions, and the whole underwriting process. Maybe you think portability and out of state policies address these problems, but I would disagree.

I think you underestimate the insurance companies profit motives, and their expertise at manipulating the regulatory system for their gain.

All-in-all, I think we are worst-of-breed in health care compared to the rest of the civilized world.

Ron

I understand your concerns, but I think that the situations you mention are red herrings. When someone has a lapse in coverage, it’s generally because they’ve changed jobs. Portability would help alleviate that issue without forcing a bloated, bureaucratic nightmare on the other 300 million of us.

And right now, the insurance companies are already manipulating the regulations. Why do you think they’re all in favor of government mandated health insurance? — because it will increase the monies sent to their treasuries.

And I’ll choose American health care with all it’s failings over any other country’s system. Have you seen the survival rates of various cancers in countries with socialized medicine?

Thanks for keeping the debate civil Jon. I appreciate your concerns and hope that whatever happens, they’re addressed in a way that allows you and me to choose our doctors and have a voice in our own medical care. Most other countries with socialized medicine don’t do that.

Health Insurance Providers

@Jon

The Federal HIPAA laws already protect people with pre-existing conditions. The HIPAA laws ensure that people that have done the responsible thing and maintained continuous health insurance coverage but due to no fault of their own have lost their health insurance coverage and cannot get another plan because of pre-existing conditions will be guaranteed approval for a health insurance plan from a private insurance company that covers all pre existing conditions immediately.

What can only be thought of as ridiculous is the extreme things that many talk about and maybe you are alluding to when it comes to pre-existing conditions that would force all insurance companies to accept people with pre-existing conditions even if they have not tried to maintain continuous coverage. That would be like someone totaling their car without car insurance and then after the car is totaled calling up an auto insurance company and trying to get comprehensive car insurance coverage that would pay for the totaled vehicle after the fact.

Of course, if insurance companies are forced to accept everyone regardless of pre-existing conditions even when people have not done the responsible thing and obtained and kept coverage beforehand then why would anyone buy insurance when they could just wait until they develop a major illness? Why would anyone in their right mind want to pay premiums when they know the insurance company would have to accept them even if they had just developed cancer or some other expensive illness? All that this would mean is that EVERYONE’S premiums would wildly increase – even the responsible people that buy health insurance BEFORE they need it. In America the HIPAA laws already protect the responsible people that buy and keep health insurance – those who are irresponsible do not get the same protections (and rightly so).

Ron

Thanks — I couldn’t have said it better!

Credit Girl

All great points here. However, my personal favorite would be educating the public about health care costs. I’m sure that many of us who receive health care do not look into the medical billings– we tend to just look at the final price. It’s smart to know how much one medical exam may cost in order to effectively reason with our providers.

Erin

I loved everything about this post. As to Jon’s comment that we are “worst-of-breed”, I must disagree…we live in a border state between the US and Canada and our local hospitals are filled with Canadians who just drive over to get better care. Yes, socialized medicine is terrific for stuff that can wait – check-ups, vaccinations, etc., but waiting two weeks to be seen by an orthopedist after you break an arm? Um, no thank you. As to comments by “Health Insurance Provider”, it is disingenuous to deny the profit motive of the insurance companies as it plays into the decision making regarding coverage for preexisting conditions. When insurers will go back 15 years to see if they can find a hint that condition A might have had an unnoticed warning sign to negate coverage, I’d say that there is a problem. Obviously things are out of balance, but I don’t think the government will do a better job. The only thing that will fix this is consumers who make their money talk.

Health Insurance Providers

Of course the profit motive comes into play and that is exactly one of the reasons why the HIPAA regulations were signed into law many years ago. There is nothing disingenuous about me mentioning the very laws that were established to protect people who are trying to do the responsible thing. If anything it would be exactly the opposite of disingenuous (whatever that is :) ).

Financial Samurai

Sorry but a complete government take over is inevitable. Open up your wallets and pay folks. Even those who make under $200,000 are gonna pay out the wazoo! :)

Dennis

I agree completely with number 8, we need tort reform to lower malpractice insurance rates physicians must pay. I would also add that to increase competition, that insurance companies be able to sell their products across state lines. With increased competition the price of monthly premiums will drop.

The lowest premium are those with health savings accounts, which I feel is the best reform there is, personal accountability for your health.

bear market strategies

All great points here. I agree completely with number 8, we need tort reform to lower malpractice insurance rates physicians must pay.

Christopher Holdheide

A lot of great points but I have one to add. I run a manufaturing business and in order for a us get a job we have to bid on the job and estimate what it would cost to do the job and in the end we can not go over the estimate or it comes out of my pocket.
Why couldn’t doctors do the same. I’m not talking about doctor visits or emergency medical incedents but rather is you needed a knee or hip replacement. Doing this would allow people to compare prices and features instead of just racking the insurance companies. This would also make the medical feild more competetive and push prices down.
Any thoughts I would love to hear them.

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