Saturday, May 6, 2017
Life, Liberty and Healthcare
Well here we are again. Trying to figure out how to provide healthcare for 325 million Americans and who’s going to pay for it. The healthcare problem is challenging, but it’s not all that complicated. It comes down to five basic questions:
_1 Are all Americans entitled to healthcare?
_2 If all Americans are entitled to healthcare, what level of healthcare are they entitled to?
_3 Are all American’s entitled to the same level of healthcare?
_4 How do we control the costs of healthcare and still provide timely, high-quality service?
_5 How do we pay for it?
What we have now is not sustainable? I have the opportunity to review benefit plans as part of the compensation negotiation between employers and candidates. Over the past 5 or 6 years health insurance benefits have changed significantly. Premiums have increased big-time for employers and employees. Some of the premium increases are being offset by increased deductibles and more HMO offerings. In other words, the more “affordable” insurance options now carry high deductibles and are often part of an HMO network (as opposed to PPO networks.)
And if you are already confused, you’re not alone. That’s part of the magic show health insurance has become. Give them Gold, Silver, Bronze options and whatever other metal you can think of; and just maybe no one will figure out what’s really going on. The truth is most people figure it out eventually when the bills come in. They realize they are paying more for less. Or they figure it out when they realize that the HMO option they selected forces them to change doctors, have fewer doctors to choose from and go through a tedious process of referrals and approvals before treatment.
We are where we are, as they say. And it’s time to answer those five questions.
Are all Americans entitled to healthcare? I say yes. It’s just unacceptable that someone would suffer and/or die when there is a medical solution to their condition.
What level of healthcare are they entitled to? Again the standard is if someone is sick, in pain or their life is at risk; they should have access to treatment.
Are all American’s entitled to the same level of healthcare? The key word here is “entitled”. If by entitled we mean “at least” the same level of healthcare and not “only” the same level, then I would say yes. This is not a free country, but we do have freedoms. If someone wants better or more healthcare than they are “entitled” to, and they can pay for it, that option needs to be available.
How do we control the costs? As Shakespeare wrote, “first we kill all the lawyers”. Just kidding, sort of.
But we do have to reduce litigation risks and get physicians away from practicing defensive medicine. Secondly, we need to streamline the “process”. The administrative side of the healthcare industry is way too expensive and inefficient. Third, more emphasis on healthy living. If we are all going to pay for each other’s medical care, we have the right to demand healthier food choices, higher taxes on tobacco and alcohol and maybe a few other things that will really make Libertarians mad. Fourth, open up markets to more insurance providers. No brainer. Lastly, we need to figure out how to fund research and development of new drugs and treatments other than by charging an arm and a leg when they are finally offered to the public. And as part of that, new drugs and treatments should get to the market sooner. The government bureaucrats are unnecessarily driving up costs and delaying drugs and treatments that could benefit thousands of people.
So how do we pay for it? We’re already paying for it. And we’re not getting what we pay for. There will be taxes. Some of us who make more will have to pay more. Some who can’t pay now, will have to pay later. I see us with a “basic” entitlement healthcare program and everyone will have to participate. All physicians will have to take a certain number of “basic” coverage patients at the prescribed rates in what is essentially a managed care system. Then for those who can afford supplemental or umbrella coverage, they get to use the “express lane”. More options, more services, more timely, self-managed and expensive.
This is fixable. Those at the top of the pyramid are going to take a haircut. No way around it. Physicians, hospitals, insurance companies, big pharma, medical equipment and supply companies will get dinged. High income individuals will get dinged. Basic healthcare is a right, not a privilege and we need to make sure that it is there for all of us. And, you’re getting this from a conservative. What is this world coming to?
Leave all the afternoon for exercise and recreation, which are as necessary as reading. I will rather say more necessary because health is worth more than learning.- Thomas Jefferson