So what SHOULD we be asking our Reps for?

I have asked repeatedly for anyone reading this blog to call their representatives and tell them that we DON’T want this massive government overhaul of the healthcare system, but I have been very limited in chiming in on what we SHOULD be requesting. Our healthcare system works for a majority of the people right now. But it isn’t perfect and it probably never will be. Any system encompassing one sixth of the US economy and affecting the lives of every single citizen is going to have some flaws here and there and some things to complain about. There are some very easy, straight forward, and extremely effective things that we can do to improve the system and drive down the cost for EVERYBODY.

The first thing is competition. Competition is our friend and a huge, untapped gold mine in driving down healthcare costs. Right now federal and state laws limit competition in the insurance market. They do this in a number of ways, primarily by limiting the players in the game. Break open the gates and allow every market in the country to be open to any insurance company willing to compete in it. When you have more companies competing for business you have lower costs and you get improved service because companies try and set themselves apart from their competitors. With a more competitive market companies are forced to control their costs more and they become more efficient as a matter of necessity. It’s a beautiful thing.

The next step is to kill mandates. Mandates are required coverage on any insurance plan. They sound really good; like requiring insurance companies to cover mammograms for all of their clients. The problem is that half of their clients will never need a mammogram. Why should plans that only cover men have mammogram coverage? Leave certain things as an option that people can add to their plans for certain members.

Another one is cost limits, which are also included in HR3200. This means that insurance for someone that is going to use it extensively can only cost ‘x’ (usually x = 2) times as much as someone who will need very little coverage. For instance you have a college that is near a retirement community. There are laws in some areas that say that the cost for the college student, who may never even use his insurance, has to cost no less than half the price of the insurance for the person in the retirement community who may use their insurance every week. This may drive down the price of insurance in the retirement community (to a very small degree), but it sends the cost of insurance for college students through the roof.

Change the tax laws to disconnect health insurance from the employer. This is a HUGE one, because it allows people to be directly responsible for their healthcare choices and allows them to choose the plan that is best going to suit their family. This is also huge in opening up the market and encouraging companies to offer more reasonable packages for different situations.

Start early. Young people should be able to start early with healthcare savings accounts, which are like ultra low risk investment accounts; small yield, no principle risk, completely portable, and need to be federally insured. The money going in should be tax free and employers should get a tax break for contributing to it. Hand in hand with this is catastrophic coverage, which only covers that scenario. You go to the doctor, you pay directly from your HSA. Most doctors will give a discounted rate for people who pay immediately and directly without having to file insurance claims - lower cost. Plus, because you are managing it yourself you are only going to go to the doctor for things that are significant. You think you have strep, you go to the doctor and pay for it out of your HSA. You fall and brake your arm - it comes out of your HSA. You are diagnosed with lymphoma - your catastrophic coverage kicks in. For younger, healthy people, this is really the best type of care; lowest cost, you get to use whatever doctor you want, you are covered for the unexpected, and you have control over your healthcare.

True mutual plans. Mutual plans are basically insurance companies owned by the members of the plan. These are NOT the government subsidized, government regulated plans that some congress members are talking about. They are truly independent bodies of people that all get together and share healthcare costs like any type of traditional co-op.

Pooling plans. This could be a great option for small businesses who can pool with other small businesses to get the best deal on insurance plans for their employees. The more people covered, the best deal possible. It gives small businesses the same leverage that big businesses have.

For me these are the best options going. Some of these things are available in some markets and some are not. They need to be available EVERYWHERE. When we open up competition, extend the number of options for patients, and get government regulations and bureaucracies OUT of the way, costs go down and coverage improves.

The next thing to tackle after these changes is tort reform. None of the bills proposed so far even touch this issue because too many congressman receive too much backing from ambulance chasing trial lawyers (sorry, I was doing so good at not ranting in this post too..). Quite frankly both parties, but primarily the Democratic party receives HUGE donations from tort lawyers NOT to fix the system. This has to be addressed to deal with costs.

Medicare and Medicaid HAVE to be reformed. I’ve mentioned it before but I’ll say it again, because they limit fees to the doctors, that are BELOW costs in some cases, they drive up the costs for the rest of us. These are CRUSHING plans. The good thing is that if we make the changes I’ve already suggested then the overall cost of insurance coverage will go down and you will have fewer people on either Medicare or Medicaid. Just imagine a couple who have not had to deal with significant health problems in their family, but they and their employers have been contributing to an HSA for thirty or forty years- that’s huge. If they pass away without using up the funds, let them pass that on to their children tax free.

These are the things that we need to be pushing for. They don’t all have to go into one MASSIVE, unreadable bill. They can be individual and they can be over months or even a couple of years. Don’t crush the system and reform it, just make improvements that are REALLY going to make a difference in the positive direction for EVERYBODY.