The Healthcare Post

The President asked for ideas that might help solve the healthcare problem. I didn't just fall off the turnip truck, so I know any ideas I would present would be the last ever to be considered by someone of his leftist and power-mad bent.

All the same, I have a lot of insight on the topic. My business is closely tied to consulting with companies on their employee benefit programs, so I know a lot about how most people get health insurance. I am a small independent businessman, so I know a lot about the difficulties involved in obtaining healthcare for anything close to a reasonable cost.

So, based on my own life and business experience, here's how I think the healthcare problem might be solved.

1. Break health insurance away from employer plans and transfer it to each individual or family. I think employers in general would be happy to get the monkey off their back, allowing their employees to simply purchase their own health plans on the open market. If employers want to subsidize health insurance and/or help collect premiums through payroll deductions, fine. But make health insurance work for everyone the same way as auto or life or homeowner's insurance. Everybody just goes out and buys their own. Employers would then naturally increase employee salaries by the amount they're saving by getting employees off their insurance rolls.
2. Let insurance companies compete for the business. They can bundle the health insurance with auto, home, and life. They can sell products like healthcare savings accounts or combine healthcare and life insurance into new blended plans. What they can't do is turn down anyone. The only rule for purchasing health insurance is that someone can be denied a new policy with another company if they're currently in treatment for a major disease that's covered under their current policy.
3. Health insurance for the majority of people would likely be focused on a Major Medical plan. In other words, routine exams, treatment for common conditions, and routine prescription drugs would be paid out-of-pocket unless the individual chooses a plan that covers those expenses. Full coverage of such expenses would be available, probably with choices to blend medical savings accounts and insurance.
4. Insurance filing by medical providers will use a standardized electronic form. The insurance industry will be asked to form a standards board to define the electronic standard, which is provided by any of a wide choice of commercially-available software packages used by the providers.
5. For low-income individuals and families, a revamped MedicAid program administered by the states can be accessed. Application can be made to the program for assistance with medical bills and insurance premiums. A low-interest loan program will also be available for anyone faced with a budget-busting medical bill, that can be paid off when the borrower is more financially able.
6. Tort Reform, specifically MalPractice Reform, would generally work as follows: Medical Review Boards would be formed in each state, charged with a review of the facts surrounding a possible malpractice case. If the board, made up of an impartial group of professionals and non-professionals, finds the case has merit, it can be referred to civil litigation, or the parties involved can utilize mediation with the review board before moving into court.
7. All medical costs, including fee-for-service, prescription drugs, and insurance premiums, are fully tax deductible for all individuals and families. The 10% threshold will be eliminated. Medical Savings Accounts can be funded with pre-tax earnings, and are not taxed when used for medical expenses. Tax on earnings from medical savings investment accounts is only assessed on money taken out of the accounts for non-medical use.
8. The government has a very limited role in this proposal. They will make sure insurance companies agree on an electronic standard, enforce rules around universal eligibility, administer the Medicare and Medicaid programs and the Medicaid Loan program, and provide regulatory oversight to make sure insurers treat their clients fairly.

I think this framework will result in lower costs, better accessibility, and a healthier population. Rather than allowing insurers to punish clients for bad health habits, they would be permitted to offer rebates or prizes to their clients for things like losing weight, stopping smoking and drinking, lowering blood pressure, controlling diabetes, etc.

If the onerous burdens on providers are reduced, specifically malpractice lawsuit threats, 20 different insurance filing forms, having to constantly negotiate rates with every insurance provider, having to treat one-third of patients without collecting any fees, etc., the cost of treatments will go down.

If an office visit costs $30 to $40 instead of $60 to $80, most people will be able to pay out of pocket. If diagnostic testing costs less than $100 instead of hundreds or even thousands of dollars, again more people will be able to pay.

Providers have much less paperwork and get to collect most of their fees immediately, while patients know what things cost, can afford them, and will ask better questions and be able to work with their physicians to avoid unnecessary and defensive diagnostic testing.

Finally, everyone will have at least a Major Medical plan, that pays for all hospitalization, trauma treatments, cancer treatments, rehabilitation, and any costs related to a critical disease or injury. Spreading the risk across the entire population lowers the cost for everyone, and protects the providers from today's high percentage of uninsured who pay little or no part of the cost.

I'm absolutely against the idea that the government needs to take over, building a bureaucracy to decide what treatments people can and cannot have, adding a layer of cost without addressing root causes of already out-of-control costs, and trying to build punitive taxes on the "rich" to pay for free healthcare for everybody else.