I recently wrote a piece criticizing Obamacare and the inevitable creation of “death panels.” Most of the responses were along the lines of “OK, big shot, what would you do?” (I love when people ask me for my opinion), fair enough.
First, a brief, 1 sentence review of Obamacare:
Healthcare we are forced to purchase and fined if we don’t which covers somewhere between 15-30 million people without adding 1 more MD or hospital bed but needs 16 thousand more IRS agents written by a committee whose chairman says he doesn’t understand it passed by a Congress and signed by a President who didn’t read it but exempted themselves from it administered by a gov’t that has already bankrupted SS and Medicare and financed by a country with an $18 trillion (and counting) debt. Hmmmmm.
In the interest of full disclosure, I am no fan of insurance companies. I fight with them every day. I am also a free market, personal responsibility, small gov’t, capitalist. The last thing this country needs is another massive, unfunded, gov’t -created entitlement. The solution lies with less gov’t and more individual control. That has been the formula for success for the last 240 years. One more thing before the fix. I often hear reformers shout “people have an intrinsic ethical right to healthcare!” Hmmmmm, really? Announcement: We are a nation of laws, not intrinsic ethical rights! When did the American dream become the American promise? Show me in the Constitution where it says we have such a right. I’ll save you the time—- it doesn’t!
That’s not as cold and heartless as it sounds. Mandated health insurance that allows gov’t bureaucrats to interfere with the MD/patient relationship, dictates what meds and treatments that will be paid for (“death panels”), and guarantees rationing and low quality of care—— now that’s heartless!! I could go on. But, what to do, what to do?
1- Repeal it. Start over. Sorry, it can’t be fixed. Include MDs, hospital administrators, and insurance experts in drafting a new law.
2- No more gov’t mandates regarding what insurance companies must cover. That should be determined by individuals, not lobbyists. Create high-deductible plans coordinated with health savings accounts (HSAs). Some formula for employer matching could be implanted. Then, each individual is protected against catastrophic illness but could spend his own money on routine care. Money not spent in any calendar year is rolled over to the next. If you are spending your own money, you might not accept the $25 hospital aspirin so easily. You may even want an explanation of your entire bill. No more “Hell, I don’t care what it costs. I’m insured.”
3- Equalize the tax laws. Employer-paid insurance is deductible. Individual-paid insurance is not. Besides being just plain unfair, it would incentivize people to get coverage.
4- Allow insurance companies to compete across state lines (nothing like free market competition to lower costs).
5- Enact tort reform. In highly litigious areas malpractice premiums increase. This forces MDs to leave, creating shortages. Those MDs that stay merely pass the increased costs on to their patients. Judgments should be limited to 100% of actual costs and a cap on punitive damages.
6- Make costs transparent. How many of us actually know what we pay for? Enact a law that forces MDs and hospitals to itemize costs. Remember, under this system, you, not Uncle Sam, pay the bill. Shop around, if you like. (can’t help it—– love free market competition)
7- Medicare reform. Yuk! Let’s face it. Fixing it is painful and politically unattractive. But it has to be done. It’s going bankrupt. First, increase the age of eligibility to 67 or even 70. Next, implement some form of flexible coverage proportionate to net worth. Finally, fix the fraud. I know, easier said than done. Special prosecutor, FBI, Gestapo. I don’t care. Fix it.
8- Increase reimbursements for prevention. A good way to lower health costs is to keep people healthy. It’s cheaper to keep people healthy than to heal them after they’re sick. The best way to do that is to make it profitable for MDs to keep their patients healthy.
I’m sure I left something out—- suggestions welcome. Obamacare started with the noble idea of insuring the uninsured. Noble, but misguided. The health insurance being mandated comes with such low reimbursements, few providers will accept it. More insured, yes. More access to health care, NO! Waiting lines go up while quality of care goes down. Everybody loses.
Instead of increasing gov’t spending and control, every American needs to be in charge of his own health care choices. Whatever reforms are finally enacted, they must include freedom to choose our own MDs and services— free to make lifestyle choices while realizing there are consequences for our decisions. We are responsible for our own health care and our own lives.
