Monday, August 5, 2013

US Health Care in the 21st Century

As the United States slowly recovers from recession, the European Union struggles and Britain continues to decouple it's economy from the EU it's hard to believe that over forty years ago President Nixon repeatedly lobbied Congress to pass comprehensive health care reform:

http://www.presidency.ucsb.edu/ws/?pid=3311

Nixon's arguments for heath care reform make sense today and it's possible that our current national health care anxiety is part of the reason the United States' recovery has been so anemic and Europe's recovery, with it's expansive social programs, has repeatedly stalled.

Today, we are still dealing with health care reform as the house again votes (40 times now) to repeal Obama care while the administration determines sections of the legislation need to be rewritten, delayed or just not enforced such as congressional staffers.  All of this results in uncertainty for business, which again further exasperates our economic recovery.

The Affordable Health Care Act addressed many needed reforms but does it take us down the path of a European based socialized health care?  Regardless, many Americans absolutely want a European single payer system while others see this as North versus South... Korea.

I propose a completely different approach to health care, not modeled on the European single payer system but one that incorporates the popular & positive changes of the Affordable Health Care Act while turning on the competitive switch we see in other forms of insurance such as auto and home.  The crux of my argument is that insurance is just insurance.  I've been selling it for over 20 years and it boggles my mind how people try to make it into something it's not.  Life insurance isn't a savings vehicle and health insurance isn't too complicated to be sold individually.  If group health plans didn't exist, it's likely individual health plan premiums would come down.

Consider this... Would it makes sense for federal employees or Home Depot employees to get their auto insurance from their employer?  That is silly... So why are we so committed to employers provided health care?

Fourth-Five million Americans don't have health insurance for two reasons.  They don't think they need it or it costs to much.  This insurance gap is an incredible drain on our economy and puts American companies at a significant disadvantage when they try to compete globally. 

What can be done?

Forty-eight states require car insurance, lenders require home insurance and the Affordable Health Care Act will soon requires health insurance.  OK... So for starters make health insurance mandatory for those ages 26 to 65 without exception.  Get the federal and state governments out of providing insurance for employees and find ways to prohibit employers from providing health insurance to their employees.  Employers should not be incentivized, via the tax code, to offer any insurance.  If offered, the policies should cover everyone and cost the employee nothing.  Furthermore, the CEO's plan should be no different to that of the mail clerk.

With reform all cost associated with health care should be fully deductible to the individual (recovered for the poor via the earned income credit) and it should save money if 100% of preventive medicine was paid for by a combination of local, state and federal government.

In addition:

The current Medicare drug cost "doughnut hole" should be filled so that Medicare covers the cost of drugs after a certain amount which is now $2,970 for 2013.

Insurance companies can't screen for or maintain databases of those with pre-existing conditions.

Insurers can only base rates on age, NOT sex or past treatment.

Upon birth children are automatically added to parents health insurance and covered up to the age of 26.

Insurance payouts are not capped.

Health coverage reports are standardized so consumers can accurately compare health insurance plans.

The cost of procedures are pre-disclosed and not based on who is paying.

At 65 Medicare kicks in for everybody.

An expansion of the private insurance premium base with healthy individuals while ensuring those with existing medical issues can get coverage will be a net plus.  The private medical system continues intact and it's my hope that standardize health care cost benefit reports and upfront cost transparency will allow market forces to do what they have done so well in other areas of our economy.

Lastly, I look forward to one day having Flo (Progressive car insurance) help me bundle my car, home and health insurance.