A NEW NATIONAL HEALTHCARE PLAN
(FIRST WE REPEAL THE EXISTING HEALTHCARE LAW)
We all know where the wrong road was taken and why. But does anyone remember what we REALLY wanted in the first place? I thought it was portable healthcare we could take with us, from job to job. I thought we wanted something that most if not all Americans could be a part of, and at some more affordable rates. Didn't we want to address the skyrocketing costs of healthcare? Didn't we also want see if there was any way we could avoid annual or lifetime monetary limits in cases of a catastrophic health event and maybe also come up with a way to eliminate "pre-existing conditions"? And didn't we want to retain our current healthcare system, since it was the best in the world? Maybe just tweak it a bit, here and there, to freshen it up some and hopefully improve on it a little. Yeah...I thought so, too.
Of course, on the surface it sure sounds like an impossible task, doesn't it. I mean it sounds as though we are asking for the moon in regards to healthcare. Well, if you're honest with yourself, we are doing exactly that! But that's never stopped America before, has it.
It's just going to require a bit of an "attitude adjustment" on our part in terms of the structure of the current healthcare system and what we're getting for the amount of money we're paying out, while having to sidestep the several financial bottomless pits throughout our lives. And moving from that (which is already crumbling beneath our feet) into an entirely new approach to the whole thing.
First though, we have to set the table, and acknowledge a few things that seem to have been forgotten over the years. It has to do with choices we make every day. Choices that begin when we are children, and continue throughout our lives until we die. As kids, those choices usually brought consequences with them and hopefully, after the punishment, our parents gave us guidance into making the right choices and learning how to make good choices. Not only do choices have consequences but they're also linked to personal responsibility. Being responsible for yourself and your actions or choices. At least, these were the lessons taught back when I was growing up. And if you learned your lessons well, when a time came where a choice had to be made, you pretty much already knew inside which ones were the right ones and which ones were the wrong ones. And, many times when we went with the wrong ones, "just to see what would happen", we learned another valuable lesson known as experience. And as everyone can attest to, we also learn through experience. Choices are a part of life, and personal responsibility for those choices and their consequences end up being with us for the rest of our lives. Put another way, all men are created equal from the point of conception, through to delivery and into the world, where the pursuit of happiness then begins. The path you take from there with all the choices, personal responsibility and consequences determines your eventual destiny!
Healthcare is not a right! It's a commodity or a service that is offered. You pay to play.
If you're not feeling well, you can choose to go see a doctor and pay for that visit, or you can stay at home and suffer through it. The choice is yours. You can choose to buy health insurance, just as you do for your auto, your house and your life. Insurance is a necessary evil. When you get right down to it, you're betting the insurance man, your car's going to get totaled, your house is going to burn to the ground, you're going to be hit by a bus or you're going to have a catastrophic health event. You pay your premiums and then hope the insurance man wins the bet, because you don't want your car totaled, you don't want your house to burn down and you certainly don't want to get deathly sick. But more than this morbid game you're playing with your insurance man, you're buying protection against life's unexpected expensive surprises, as few people keep in their back pockets enough money to buy a replacement car or enough to build a new house or to pay that million dollar hospital bill. It's your choice and your responsibility to buy the policy for protection. After that, it's on the insurance man's "dime," In today's expensive world, you can no longer afford to be without insurance. Your house may burn down or it may not, but you can't afford to take that chance. You may consider yourself the best driver on the road, but that won't stop the worst driver on the road from finding you. You just can't take the chance of losing your only ride. And the same holds true with your health. You may feel healthy, appear healthy and actually be healthy, only to stumble in front of a bus. Health insurance like all the rest, is "what-if" insurance. What if I get sick...what if I get into an accident...what if a disease decides to invade my body...what if? Here again, personal responsibility should be thumping you on the head. There's no one else out there that's going to be responsible for your life and your choices, your actions or your medical bills. It's your responsibility to protect yourself and your property. It's common sense. To think you can walk around in life with no health insurance, knowing you can show up at an emergency room and they HAVE to treat you, all the while knowing you won't pay for it is astonishingly stupid, shows a lack of personal responsibility and entirely unfair to the rest of us. As all of those unpaid medical services and emergency treatment ends up raising hospital costs and rates for everyone. If you truly do want a better health system and want to rein in skyrocketing health costs, this is the only way it will work, meaning that attitude adjustment begins here.
Let's list some of those financial bottomless pits-
Catastrophic Health Events
Annual and Lifetime caps on Insurance Pay-Outs
Pre-existing Conditions
System Affordability
Solve these and we're almost home. And while we're at it, let's try and solve it without
any government run, all encompassing, comprehensive load of crap. A little guidance in the beginning just to get the ball rolling, but that's it, as healthcare is really the responsibility
of the states to administer and watch over. All right, let's get started.
As stated elsewhere (Saving Medicare) the first thing is to take care of the common sense things that drive up medical costs. Tort reform is a huge necessary first step. Also removing
all the states' special interest driven prerequisite coverage's that health insurance companies must cover if they are to do business in your state. You know the ones, that involve coverage of elective procedures, surgeries, cosmetics etc, for certain special interest segments of the population. Remove those and you'll immediately find more health insurers that want to do business in your state. Finally, by offering the majority of Americans an affordable health insurance program, it will eliminate the majority of people who show up at hospital emergency rooms demanding free medical treatment and clogging up the waiting rooms with unnecessary and non-emergency ailments, which is one of the extreme causes of run-away health costs in hospitals and medical centers. They may have to treat those that do show up there, but that doesn't mean they can't go after their money by getting a serious lien on the freeloaders' paychecks and IRS refunds. Emergency rooms are the main drain to hospital's bottom lines and when you stop to realize that less than 15% of the patients are admitted to the hospital you begin to see the financial drag. Common sense would seem to tell us that in addition to getting more Americans into a health insurance program, there is also a serious need for more primary care physicians, rather than specialists, and there needs to be more so-called "urgent care" clinics where someone can come and see a doctor right away for all the little things that go wrong that need medical attention, not serious enough for emergency rooms, but which need attention quicker than waiting for an appointment with your primary doctor. One last thing to help keep medical insurance costs competitive would be to adopt a health insurance system, similar to that of Medicare advantage plans, where the insurance companies have open enrollment each year, say from Nov 1 to Dec 31, where the customer can shop around for a better deal on health care services, or find a new provider who would best fit the customer's changing medical conditions. This would keep insurers on their toes in regards to what they are offering their customers and at what prices. It would be envisioned that health care insurers would be able to offer various plans for those same reasons, to hold on to their customers. For example, young people starting out and finding themselves in good health would be opting for a baseline, entry premium in exchange for higher co-pays and percentages of costs on procedures, that they wouldn't be requiring because of their good health. As they get older and things start to surface, they would then probably want to get into a program where the premiums will be higher but the co-pays will be lower since they will be seeing more doctors. Anyway, those are the areas which if dealt with will have a significant impact on overall medical costs. That and one very important other item, that of a significantly larger pool of insurance customers. If you are serious about health insurance that will cover catastrophic health events, remove monetary limits on pay-outs, and you want to remain outside of a government run program (at all costs please) then the only way to achieve those goals is to get everyone on board, thinking the long term. Another point for attitude adjustment.
As far as what's covered is where to begin on the plan itself.
car insurance for the big stuff... not for replacing wipers, brakes and exhaust.
house insurance for the big stuff...not for regular upkeep and garage door openers
health insurance for the big stuff...not for things elective, cosmetic, etc
What's medical peace of mind worth to you? What's the latest in doctor skills, procedures and medical technology worth to you? I think every working American should have access to the world's greatest health care system, and that his insurance will cover the basics in medical treatment while insuring against catastrophic health illnesses and accidents with no monetary cap associated with it. It will include a free annual medical check up, and co-pays
for other doctor appointments and percentages paid on tests and procedures prescribed.
That person also will have options available if he wants additional more elaborate coverage.
I think that employers should no longer be saddled with providing health insurance benefits to their workers. The individual should be responsible for his own health coverage and in doing so, it will become a portable policy for the person, portable to stay with the worker when
he moves from job to job during his lifetime. The employer, instead, will be responsible for
establishing a health account for each employee and make an annual donation into the account which will be drawn upon by the worker to pay for co-pays and percentage costs of
medical coverage. The worker will also be allowed to contribute part of his pay into the account, and this account will be allowed to accrue over calendar years, and in the event the worker changes jobs, the amount in the account will be transferred to the new employees health account at his new job. Meanwhile, the employer will find that the amount of their
donation into the health account could be marketed as a potential hiring tool/benefit.
I think when a child becomes an adult and graduates and moves into the work force, he
should be getting his own health insurance policy, so the transition from the family policy into the individual's policy remains seamless, thereby removing any pre-existing condition problems from health insurance coverage. If all Americans choose this path for healthcare
then it will provide an immediate significant expansion of the health insurance customers
"pool" which will continue over generations, which will necessarily force health insurance costs extremely low. This will allow for all Americans to join into this new healthcare system
for just 5% of their gross paycheck. As pay increases, so does the amount paid to the health insurance company, but the 5% figure stays the same. If two people marry, they're each contributing 5% of their paychecks. If she quits her job the husband pays 10% and that new family plan will also include the first three babies. An additional 5% comes out of the paycheck for additional babies 4, 5,and 6. The insurance companies will then be responsible for balancing out their responsibilities with percentages of higher paid workers with that of lower paid workers. And they WILL be subject to outside audits each year to guarantee a healthy and growing amount in reserves to cover those catastrophic health care needs. Attitude adjustment -theirs ! I also think health insurance companies can become more competitive by working out agreements with pharmaceutical firms to get better prescription prices to offer their customers.
I believe that the choice to join is up to the individual but if you waive that option upon reaching adulthood, you will be responsible for the doctor and medical bills you run up
and outstanding bills will be attached to your paycheck and eventually risk your home.
Furthermore, the prospect of a pre-existing condition once again enters the picture.
And when that day arrives when you really do need to join the program you will first
have to pay a ten thousand dollar penalty fee to the government. The success of this
program really hinges on an almost total compliance to such a program.
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I still consider this to be a "work in progress" that still needs input from others. But its a far cry better than any government run/controlled/rationed program that's out there. And I wanted to get it posted for you to think about before the primary.
