Tuesday, August 4, 2009

Dr. Mom's Health Care Plan

I generally don't like to delve into political topics. However, this is one that has affected and will affect so many people's pocket books that I wanted to address this topic with a few ideas. My first job out of college was working in Washington DC when Hillary was tackling the health care issue. I watched all the intensity put forth toward this topic and its eventual failure. The current desire to drastically change health care appears to be following in the footsteps of Hillary's attempt. Is there a way to improve what we have without throwing out our entire system? And not putting our entire health in the hands of the government? Here are my ideas.

You have to start with the problem. From what I see, there are two major problems. First, the people who need health insurance the most can't get it because of pre-existing conditions. Second, health care costs too much (people wouldn't need massive amounts of insurance if it did not cost so much).

How to improve the problem:

1. Make it illegal for insurance companies to question a person about pre-existing conditions or to drop a person from insurance because of pre-existing conditions. It's illegal to ask potential employees about certain things (married, children, etc.), why can't we do the same thing here?

2. Have a top 20 (or 50 or 100) government mandated maximum price list for most used medical services. A medical provider could not charge more than what the government mandates. Insurance companies/doctors would have to compete by lowering their administrative costs which are known to be outrageous compared to other nations. How would you get the service prices? There are two places I would look first. What do the insurance companies pay on average now with their discount and what are the standard prices in other countries' socialized medicine? Somewhere in between there would be my starting point. I think it is a shame that people without insurance have to pay some outrageous price just because they don't have an insurance company negotiating the prices down.

On a side note, I actually hate that I suggested this idea. I am a true believer in competition and its affect on lowering prices. However, with the intervention of insurance companies, competition for health services has all but disappeared. People appear to be more concerned with the cost of health insurance and not with the constant increase in service costs. At the very least, make the cost for a service be the same for the insured vs. the non-insured and a portion of competition will return. For those of you with insurance, think back to your last health visit. Do you know what the total cost of the visit was (not just the co-pay)? We no longer shop for the best/cheapest doctor which is a mechanism of competition. We shop for insurance.

3. What about the service not on the list for the more rare ailment? Provide a large tax incentive for doctors that donate 5 - 10% of their services to people without insurance and are unable to pay. We currently have a tax incentive to make donations, these would be just a different type of donation. The government has historically used tax incentives to influence actions of its population.

This would not fix our system, but it could be a vast improvement without putting our children's future finances on the line to pay for a lumbering government insurance program. It is my desire to see the government be the rule maker not the provider.

Any ideas?


Milk Donor Mama said...

I work in state government as a public health epidemiologist. I hear ya in some ways. In others, well, I'm a healthy, normal weight non smoker. Why should I have to pay extra to cover the obese, smokers, etc? Let them pay according to their risk because in the end, they cost more... but again, I see it from both sides.

Tiffany said...

I agree, my husband and I have very good coverage through his job and I swear doctors run tests and whatnot just because the insurance will pay for it. They wanted to run a slew of unnecessary tests on my son and after calling around I realized it was only because it would be covered. I quickly changed docs but I imagine so many places do it.

Renee Camacho said...

I agree, knowing first hand what being without insurance can do. My husband (a Type 1 Diabetic from teenage years - NOT his fault due to poor health, obesity, or other problems) lost his job in January. He is fully able to make a living doing consulting work from home; however, we CAN NOT get insurance for him. One bottle of insulin (not including insulin pump supplies that cost $1000 4-6 months) cost him $160.00. INSANITY. That doesn't include required doctor visits just to receive the benefits of having a prescription to GET the insulin...with bloodwork each time running at least $300 or more. We simply, in good conscience, could not afford for him NOT to work for a corporation where group insurance is provided (pre-existing medical conditions do not affect your potential coverage). It's frustrating - and to know that more problems from an already defunct health care system are on their way is just simply unbelievable! I agree with you that reform must happen, but not in the ways outlined by Obama's current proposal.

ND Life said...

I agree with your points but I would also add another which would be tort reform. By no means do I think you should not sue physicians who make errors, misdiagnose, etc. but there has to be a sense of reality on the payout.

Part of my fear is that government hasn't been able to run any program efficiently yet. The cost estimates are astronomical, add the inefficiencies and we are in deep trouble.