There has been much discussion regarding Obama’s Health Insurance proposal lately. I find most of it disturbing in that it seems to be a big power grab by the government instead of a solution. To name a few problems…
- Forcing people to have an insurance policy even though they may be able to self-insure – or pay a 2.5% tax/penalty.
- Forcing companies into having health insurance plans – or pay a 8% payroll tax/penalty.
- Loss of freedom to choose what is in your plan or potentially your doctor.
- Loss of ability to get discounts for a healthy lifestyle.
I don’t believe this plan will do a whole lot to fix the root problem, which is the costs of healthcare. The high costs of health insurance are a symptom of the root problem, not the actual problem.
Some things that could be done to help the problem…
- Reduce rules on the healthcare and insurance industry. The federal and state governments could relax their policies regarding the medical industry. Open up markets for all insurance companies to actively compete (this is a big issue here in Vermont, where we have very few health insurance providers, 2 that I can think of). Make it easier for people to practice medicine and for people to seek care from who they want. Make the heavy licensing of medical practioners and hospitals optional in order to operate.
- Make the FDA approval process optional. Here in the US, we get access to new drugs or medical devices many years after others in the rest of world due to the lengthy bureaucratic process of FDA approval, which can take 10 years to get. Also, the process is so expensive that only the largest companies can afford to participate and only ideas that are very complicated or are expected to have a high retail cost are submitted for approval. Why couldn’t the government make the FDA approval optional and allow other firms to offer their own approval or seal and compete with the FDA. This would allow much cheaper forms of healthcare to be available.
- Promote the benefits of healthy eating and proper exercise. There is strong evidence that most of our health issues are due to bad diets, not enough exercise as well as improper dental hygiene. I have been guilty of this myself and it wasn’t until I lost my health insurance that I began to be concerned about these issues. Since I’ve lost my health insurance, I have done the following…
- Lost about 66 pounds.
- Fixed 18 teeth and began brushing up to 3 times a day and flossing everyday.
- Modified diet dramatically, currently making the main focus on vegetables, fruits, almonds and whole wheat grains.
- Exercise at least 30 minutes a day (on average).
- Reduced risky behaviors – such as less risky bike riding and wearing seat belts more regularly.
- Lost about 66 pounds.
In doing so, I believe I have improved my health dramatically by making these changes which I probably wouldn’t have done if not for the loss of my cheap health insurance. Perhaps that’s part of the problem… if so many people are getting cheap or free health insurance from the government or their employers, what incentive is there to be concerned about your health if you know everything can be fixed for a low cost or nothing in some cases? Wouldn’t it make sense to at least allow discounts for good healthy habits or for scoring well on health tests? Or perhaps allowing them to charge extra for risky behaviors/jobs, such as downhill skiing or logging?
I realize this can be a very emotional and scary issue for most people. Everyone wants good quality care for as little as impossible. No one like to pay for insurance if they are not sure they will need it. At this time, I am currently trying to get on a health insurance plan that is affordable to my wife and I, which can be quite difficult here in Vermont where the choices are so very limited.
The idea or mystic of a very comprehensive healthcare/health insurance program that covers everyone for little cost sounds very attractive, but the reality is that the government running such a program will be very risky and I believe would end up being at least as expensive as our current system and will be far more intrusive. If the government is running the program, what would stop them from placing far more limits on our activities to keep costs down… they probably won’t do that right away, but think 10 or 20 years down the road, when they’ve reached their taxation or premium limitations. Look at anything else the government runs, it’s only a matter of time before the programs go under-funded and need to increase rates or tax rates just to keep up with payments. At this point, the government will be forced to put limits on our behavior, which is already beginning with smoking and trans fat bans. Why wouldn’t this increase with the government taking over healthcare/health insurance? My wife and I are now living a much better lifestyle where we don’t eat much unhealthy food or engage in drinking or smoking or other behaviors considered unhealthy, but that doesn’t mean it’s right for the government to force our lifestyle on others and I certainly would like to be able to get the occasional fatty burger and fries from when I want to.
So, I firmly believe that a government takeover of the healthcare industry will not signifantly reduce the costs in the long run, if at all, will limit our choices and most likely result a huge loss of personal freedoms.
Dave Usher
July 31, 2009 @ 12:00 am
Hi Jeremy,
Yours is a very thoughtful commentary on the health care bill now in Congress and your alternative ideas. I have similar concerns, but as I look down the road with the proposed new system I see rationing as unavoidable:
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Missing in the debate about health care change is the obvious requirement to ration services.
Adding millions more people to a government system without stringent cost control, including rationing, defies common sense and is a prescription for higher deficits or massive tax increases. Other nations with a government-run system implement rationing in one form or another. Yet, on a personal level, denial of service is a tough pill to swallow.
Those who contend that ‘health care is a basic human right’ are obliged to answer the question: how much care and at what cost? Of course, the devil is in the details, but I would favor rationing, if I understand how it will applied.
This mad rush by Congress and the President for massive restructuring is wrong. We deserve a debate that is clear, reasoned and thoughtful. We should understand both the personal and system ramifications of overhauling health care, an industry that accounts for one sixth of our economy, before plunging headlong into it. Clear information for that debate should be coming from our Congressional delegation and the health care industry. But it’s not.
President Obama recently extracted promises from the hospital industry and the drug companies to save $Billions. We deserve to know how those savings will be accomplished. Will hospitals and doctors choose to earn less? Will they ration procedures, gain speculative efficiencies from electronic health records? If the cost savings are real, I want to know how, where and when.
Vermonters should understand how restricting services will be accomplished. We don’t even hear the word rationing used because our political leaders and others are afraid to talk about it. Yet, we obviously cannot afford a system of medical care that treats every person for every condition with all possible means regardless of costs.
Jeremy Ryan
August 2, 2009 @ 12:00 am
Thank you for your comments Dave! Regarding rationing… I think that this is unavoidable, when you are dealing with products/services that someone must make or be paid for to provide. Whether is provided by the government or the private sector healthcare services will be rationed in some way, it’s unavoidable. The question we must ask ourselves as a society is do we want it rationed by one single body or by many?