Why does Health Care Reform need to be so hard and so complex? And why is it that the best the Democratic leadership can come up with is to overlay a government-run solution on top of our current, flawed health care system?
There are several areas of our health care system that are not functioning properly as you’ve noted in your speeches, press conferences and town hall meetings.
Choice. Our current health insurance system does not give individual Americans true choice. Many of us with employer-based health insurance are lucky to have more than one option through our employer. So the plan you support offers us a second choice, but not really, because the choice will still rest with our employers. Why not free up the market by allowing individuals to have real choice?
- Change the tax laws to remove the benefit employers have of providing health insurance to employees and instead let the tax benefit go to the individual.
- Allow for more competition by removing the barriers an individual has to buying a policy across state lines.
Affordability. For many Americans health insurance is not affordable.
- The change in tax law I mentioned earlier could go a long way to solve the problem. Make the tax benefit a tax credit, and everyone will have money to put toward a health insurance plan.
- Provide direct subsidies to the poor to purchase health insurance in lieu of tax credits.
- Expand group insurance to include associations, so more people have access to insurance at lower group rates.
- Remove coverage mandates, so insurance companies can develop less comprehensive and less expensive policies.
- Provide money to the states to help create and fund high risk pools for those who are priced out of the health insurance market due to pre-existing conditions.
- Expand Health Savings Accounts by increasing the cap an individual can save in a year.
Portability. The entrepreneurial spirit of Americans and the free flow of labor are often crushed by the weight of health insurance premiums. Losing a job means the loss of health insurance for many.
- Changing the tax law to focus on the individual would help solve the problem of portability as the individual would not lose the tax benefit to become an entrepreneur.
- Allowing associations to offer group policies would allow individuals to switch jobs without the concern of losing their health benefit.
Access. The ability to find a doctor is especially problematic for Medicaid patients and rural and inner-city residents. Encourage local governments to find solutions to these problems at the local level
- Perhaps the establishment of city or charity-sponsored health clinics.
- Provide tax benefits or education subsidies for health care professionals to provide services to these areas.
Cost. Not only is health insurance becoming less and less affordable, but as more people are unable to afford health insurance, the cost of care is rising. Tort reform is essential to lowering the cost of health care.
- Something as simple as removing or reducing the lure of punitive damages from medical malpractice suits would do the trick.
- If punishment of malicious behavior is the goal, let the states give their licensing boards more authority to fine the malevolent provider.
Health Education and Nutrition. You have often said that education about healthy lifestyles will reduce costs over time. There are a number of ways to encourage healthy behaviors. The legislation being considered has both punitive and positive measures. I’ve come up with two ideas that are not included in the legislation. I am certain in the vast wealth of talent our citizens possess, there are many more ways to accomplish this goal, and with better and quicker results than what I am suggesting.
- Support efforts at the local and state level to educate people about healthy behaviors and healthy choices.
- Make healthy nutritional options more affordable by removing agricultural subsidies, encouraging farmers and ranchers to diversify into other food crops and livestock, resulting in more and more affordable options for the consumer.
I haven’t submitted these ideas to the Congressional Budget Office to determine the impact to the federal budget, but I would guess the impact is either revenue neutral or perhaps even adds revenue to the coffers. As a nation we seem to be caught up in the weeds of this debate. Now more than ever we need leadership to address the six issues outlined above. As I read the bills coming out of the House Committees, the only one of these areas being addressed adequately is sufficiently is portability. Perhaps we should step back just a moment, as a nation, and assess whether the health care reform legislation is truly reformative.
Thank you for all your work to make our nation a better place.