It's been nearly two weeks since I blogged on this site. The health care debate rages on in Congress. I would like to first speak on the idea of requiring people to purchase health insurance. It is very different than the auto insurance requirement. Here is why:
1. I do not really have to purchase auto insurance! Really? Yes, the law requires that you have auto insurance...if you have a car. You do not have to purchase a car or obtain a driver's license. If you operate a car, you agree to carry auto insurance, but you do not have to operate a car...therefore auto insurance is optional.
2. Auto insurance is about YOUR liability. It is to protect YOU against the financial losses when YOU make a mistake. SOME medical issues are preventable, but not all of them. Some are hereditary, some are environmental or involve other factors beyond your control. Why should YOU be responsible for something YOU can not control?
Now for the 8th point. In review, here are the other 7:
1. Catastrophic-only insurance. Government as a last-resort safety-net. Pay out of pocket for simple and common doctor visits and meds. He who has the gold makes the rules. When you run a business that relies on third parties to pay your services, you should not be surprised when those third parties attempt to control the process. The more the money comes directly from the patient, the more control the patient will have over the process.
2. Diffuse the risk. Bring low-risk populations that are not currently covered into insurance plans. These populations include immigrants, college students and younger workers. Reward those who take steps to lower their personal risk by joining gyms, loosing weight, etc. Lower risk means lower costs. It would also lower risks to focus on preventative measures.
3. Tort reform to end unneeded CYA-type tests. End medical testing that doctors order simply because they are afraid of being sued. Sure, there is negligence and the duty to care or at least do no harm, but testing simply because one is fearful of a lawsuit is a different thing entirely. It increases demand for medical services which drives costs.
4. Realistic end-of-life care that focuses on extending a quality of life instead of simply delaying death. This would include proper grief counseling for those who loved ones are near the end. It is hard to let someone go, but there comes a time to do so.
5. Train more providers of all types. Introduce more competition into the system by ending the shortage of doctors, nurses, physician assistants and pharmacists. I'm certain that everyone knows someone who would have been a great doctor if he could only get into medical school.
6. End the use of the Emergency Room when an unplanned medical problem arises. Have more insta-care type facilities including co-located facilities that people can use for such situation. If someone shows up in the ER who can wait, have them wait or pay through the nose. This will leave the ER people available for real life or death problems.
7. Alternative payment methods. Patients who can not pay for their medical bills should work them off through community service in lieu of forcing them into bankruptcy. No one gets a free ride. End the practice of just writing-off unpaid bills. End the expectation of a free ride. Use arbitration instead of threatening bill collection.
8. Aggressively prosecute medical fraud. Recovering from criminal losses adds to everyone's costs in one way or another.
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