Re: Health Care Reform?
I agree that our industry is a mess, and see little hope that the current discussions regarding "reform" will be of any value.
From my libertarian viewpoint, I think the best solution would be the following:
- Eliminate government involvement in the healthcare marketplace (getting rid of Medicaid and Medicare, which serve as the constructs upon which most private insurers base their reimbursements). This would serve to reestablish free market economics in healthcare, which would tend to reduce the costs of many services (especially hospitalizations and invasive procedures), and likely also improve reimbursement for primary care providers.
- Encourage a shift from the current model of medical insurance (which, to some degree or another, ignoring co-pays and deductibles, cover most physician visits, hospitalizations, procedures, diagnostic testing, medications, etc.) and toward a combination of catastrophic medical insurance (for truly unexpected illness and injuries) and health savings accounts to which contributions and withdrawals are directed by the patient. This would encourage individuals to use their healthcare dollars wisely, and to be more accountable for their own health, such as by adopting a healthier lifestyle. To use automobile insurance in comparison, we purchase said insurance to cover auto accidents and the like, but not to cover routine maintenance such as fuel, oil changes, tune-ups, etc.
Such changes would foster personal responsibility for one’s health, encourage competition, and therefore reduced costs, among healthcare providers, and promote greater awareness of the costs of healthcare among both patients and providers. In a fully socialized system, rationing of healthcare is inevitable, as resources finite and costs are seemingly infinite. In a patient-directed, free market system, such decisions would be made by the involved patients and their healthcare providers, not by bureaucrats at the state and/or federal level.
By the way, this is essentially how medical care was financed until early in the last century. For those unable to pay for care to treat a life-threatening condition, hospitals and doctors provided care for free, or at drastically reduced costs, and/or families and communities helped support those of their members who were less fortunate. Government then intervened, in the form of "safety nets" like Medicare and Medicaid, and of regulations imposed on small business to provide medical insurance for their employers, and we eventually ended up with the system we have now. Along with a sense of entitlement to healthcare, loss of personal responsibility, an undermined sense of valuation of our families and communities, and skyrocketing costs. We need to turn this clock way back!