Monday, August 26, 2013

The future of health care

So, then there were two.

I drove my daughter to college over the weekend which has now resulted in our version of the empty nest.  Of course, I miss her, just as I miss seeing my son, but I am also happy that our children are progressing towards independent lives without "parental" oversight.  As I have said to my wife, while we might miss the kids, we (and especially my wife) did a great job raising them and it is time to let them fly on their own with the knowledge that they can return if they need to.  Let's just hope they don't!!

As for writing, I must say I have been uninspired.  My interest in politics is wavering, my interest in debating issues is flailing, my interest in time in front of my computer is slight.  Still...

As the Affordable Care Act begins to kick in, and despite the obsession that the Republican Party has exhibited to repeal and/or defund it rather than addressing its weaknesses and proposing alternatives, I am hopeful that the American people will realize its benefits outweigh its negatives.

Ultimately, it seems apparent to me that we need to sever the link between employment and health care insurance.  Everyone needs to become more involved in the cost of their health care, and as long as we allow our employers to act as intermediaries, and allow the health care industry to dictate coverage, benefits, and choices through the filter of their profit, rising premiums and costs will remain the norm.

From what I am hearing, the exchanges that are being set up in some of the states that are ahead of the curve on this issue, are providing much more attractive premiums than have been traditionally available to individuals and small businesses in the past.  If we are not ready for a single payer option (due to the wrongheaded notion that this smacks of socialism) then we need to make sure that every state in America embraces the goal of providing the means for each of its citizens to have access to affordable health care insurance. 

I often ask my friends and family what contribution their employer pays toward their health care premiums and many don't know.  They certainly know what is deducted from their pay, but they don't know the extent of the subsidy that they are receiving from their employer.  Perhaps if that subsidy was paid to the employee, and each employee was required to purchase their own health insurance, we would be more cognizant of its cost and shop for the policy that bests suits our needs.  My experience has been that most employers offer a single rate and a family rate, and perhaps a married with no kids rate.  But families with one kid might find a more suitable (and less costly) policy assuming that the family rate is based on an insurance company configuration that most likely assumes 2 or 2.5 kids per family.  And, perhaps a single, healthy person might find a single rate on their own with a high deductible that would better suit their situation.

During my years of employment in the private sector, and in discussions with small business owners today, health insurance costs is a big part of their overhead, a pain to have to negotiate every year, a distraction from their actual business, and an impediment to hiring new employees. 

Of course, all that assumes that the health insurance industry is forced to offer group rates to all Americans, regardless of the size of their employer or group affiliation.  Yes, forced.  And, it assumes that all people must participate; yes I am in favor of the "Romney" care individual mandate.  Or, as Hilary Clinton might say, the 1990's Republican alternative to her universal healthcare proposals.  And, it assumes that employers will increase the pay of their employees in lieu of the their current health care insurance subsidy. 

You see, I believe in the market place to establish supply and demand for most products and services.  But, as there are exceptions to every rule, health care insurance is the exception to this rule.  If you want to buy a car, you purchase the car that you can afford. But if you are really sick, you need the health care services that will make you well, despite your ability to pay.  Everyone deserves an insurance plan that provides basic health care services with a catastrophic option that prevents bankruptcy, or worse, the necessity of choosing between health and death.  But personal involvement in the coverage, benefits and costs of our own health care and health care insurance may be the only way to break the vicious cycle of escalating health care costs.


1 comment:

  1. In future health care is a transparent meritocracy amongst doctors
    Patients choose their doctor by either through referral, or online consumer reviews of a doctor’s bedside manner, waiting room decor, or office staff’s disposition — not by the quality of care they provide.

    William Martin

    PPI Claims Made Simple