Monday, August 17. 2009
Quoting (somewhat) out of context from President Obama's inaugural address:
"What is required of us now is a new era of responsibility -- a recognition on the part of every American that we have duties to ourselves...."
The duties to ourselves include taking responsibility for our health. That includes our eating, personal habits, exercise -- and personally paying for our medical needs. Rather than the medical community and the health insurance industry deciding on individual health care, the individual takes responsibility for those decisions.
When the health insurance premiums are paid by the employer or subsidized through Medicare, there is no relationship to the service received from the medical community. Doesn't matter what tests are done. It doesn't cost the individual anything. No questions asked – run the tests. Prescribe the drugs.
The vast majority of people (including those over 65) are very healthy and have little need for medical care. For the healthy, a visit to the doctor every other year would be a small amount of money that could be readily handled by most any budget. What is really needed is coverage for those accidents and medical events that escalate into the thousands of dollars. Purchase of a major medical policy with deductibles based upon personal capability would be the correct solution.
Liken this to your home owners insurance. The home owner does the house maintenance and upkeep to the home. The owners insurance is for the major loss of the actual home.
That is the same approach that should be used for health care. Insure for the major medical items. Be self responsible for the small medical issues.
Positives and negatives of the approach:
Positive.... Considerably less cost the government. If the government wants to hand out money there are plenty of poor and elderly who can't afford the medical -- let alone the major medical policy. That would be a whole lot less expensive than the plans currently under discussion.
Positive or negative depending on view.... The insurance lobbyists would be all over this proposal spinning how bad it would be. Why is it bad for insurance companies. The premiums for major medical would be much less than all the "laundered" money that goes through their hands from purchaser (employers or single purchaser) to medical provider. With reduced income the insurance company execs will get smaller bonuses and the share holder profits would be less.
Positive....Employers give all their employees a small raise once they no longer have to pay the insurance companies for employee health plans. The employee is now responsible for his health and purchase of a major medical policy.
Positive....Once there are no employer health insurance plans, everyone will pay the same rate for a medical service. Today there are contracts between insurers (including Medicare) and the medical provider about the cost of each medical service. A recipient of care without medical insurance pays the highest rate to the medical provider. There is no discount for that joker who isn't employed with a company providing health insurance.
Positive.... My approach would go from cradle to grave. The end of Medicare. The amount that is currently taken out of my social security could be used to purchase a major medical policy.
Positive.... The employer would no longer shop for the cheapest provider of health insurance. Instead of the benefit of health insurance, they could pay for a major medical policy. It would be a lot easier and less costly to administer.
Negative.... There may be no way to ensure that people will buy a major medical policy. However, that is no different than the requirement for auto insurance. There are some who do not have the auto insurance, but yet they drive.
Granted, my personal health is excellent and have had few reasons to visit the medical providers. Perhaps that affects my approach and my proposal, but I DO believe in personal responsibility. Watching what I eat and moderate amounts of exercise are my approach to avoiding visits to the medical providers.
The current health reform proposals being considered are receiving lots of media (print and air wave) attention. Most of it negative. How about a real alternative to that public (government) plan and give health responsibility back to the people.
There doesn't seem to be any support for my proposal, but in the meantime check out Consumer Reports Health Reform Guide.
With all the spin that comes from all sides on the debate, Fact Check does a great job in sorting through all those negative one liners.
Tuesday, June 16. 2009
As a person of over 65 and with a great group policy (although subsidized) called Medicare, my interest in the subject is less than what it was just a few years ago.
That said, a national health system would be great. However, getting that through the legislative bodies and the corporate world that influences much of congressional action becomes a major issue.
Where is the real issue with health care. Most people can afford the daily medical stuff. With a national health care system without any cost to a patient, the trips to the doctor are not even thought about. That is already the situation for those who have health insurance through their employer. There is no monetary amount tied to the service rendered by the medical community. Putting a price tag on it makes people think twice when there may only be a sniffing and cough involved.
The issue for medical care is when those costs rise into the tens of thousands for an individual. As the medical bills accumulate with no possibility to ever pay them off, the individual will file bankruptcy. In that case the medical provider gets nothing.
Rather than a single payer system for US health insurance, how about keeping the current health care system in place with the choices that are available in a free market. However, in addition, individuals can purchase "national major medical coverage" to cover those medical expenses that exceed what the individual or family can afford.
None of this matters for the very wealthy. For those in poverty, nothing changes. They are unable to afford health care today. They will continue to use the emergency services at hospitals.
For the remainder of the population, a national major medical program would be available. The purchaser would decide what level of health coverage is affordable, then purchase major medical insurance for anything over that amount – be that 2000, 5000 or 10000. Obviously, the premiums will reflect those "deductibles".
There are already major medical policies available today. However, they are not inexpensive. There are not enough individuals paying into that pool to bring the premiums down. With a national program with most of the population in the pool, individual premium costs will be much less.
The additional advantage of this solution is that many of those who have no medical coverage are small businesses and self employed individuals. To them this solution would be quite welcome. The costs would be tolerable.
There is no perfect national health care system anywhere in the world. Those facts have been aired for several years and at this time with the health care discussions before congress, more media time will be devoted to this issue.
This proposed solution will have flaws as well and not address all the issues. However, the greater majority of people are very healthy. Time to address those who have the real issues. That would be a better solution. Here's a chance to do something different and address the real problem – the high costs of medical care for single individuals. The health care issues would be much better addressed with a national major medical program.
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