When it comes to a big, long term, government run health programs, the ultimate question is: would you trust YOUR health to President Obama? He would be the ultimate guy in charge, at least according our Constitution. Lots of people say yes. Then I ask: would you trust your health to George Bush or Sarah Palin? I just get laughs… “That will never happen. Why would I?” Well, I explain, you don’t know who is coming after Obama, it might even be Sarah Palin herself.
The problem with the current health bill is that everyone who is pushing it really wants a single payer system. Single payer won’t sell now, so they came up with a 1200 page bill that nobody understands and claim it is nothing like a single payer system. Would you believe them? These proponents are being disingenuous, and most people understand that Obama will implement the bill as though it is a single payer system, eventually. In a single payer system all of your health decisions are controlled by a single payer, and guess what, YOU are not that payer.
Whether Congress passes a health bill with death panels or rationed care or free care for illegals or value based decision making really makes no difference. Whatever bill is passed now is just a another step down the path of thinking that the our government knows better than we do. The national health insurance system currently assumes that our employer makes better decisions than we do. Our employer decides our benefits, our deductibles, our drug plans, our co-pay our medical groups, and in many cases our employer even has to approve specific medical procedures. For most people it is not a stretch to change employer to government, in both cases someone else is making our most basic decisions for us.
To say that there is no choice in medical insurance plans is just wrong. There are lots of choices, it is just you aren’t allowed to make them. When my company wanted to offer medical insurance we asked a broker to come up with a list of possible plans. I expected a handful of plans and got literally hundreds, more than we wanted to read or understand. I’m an engineer, not a insurance specialist. We ended up offering our 5 employees a choice of just two plans, one HMO one PPO. Four years later we have more than 40 employess and have added a third choice: Kaiser. This is the way medical insurance is decided for 80% or more of Americans. By the way, employers make the same decisions for 401K retirement plans. I had to pick one of those too.
The health bill I would propose would be very short and contain just two key and simple elements: employers or other groups are not allowed to offer insurance, only individuals and families can purchase insurance; insurance rates or availability may not depend on individual or family genetics or health history but may depend on the number of years they are uninsured (this would have to be phased in) and other general characteristics. This would provided a basis for universal coverage in that all people could be covered if they could pay an average rate. If someone decided not to have insurance, that is OK, but if they get sick they would have to pay up, maybe 2 times, maybe 100 times the going rate before they get coverage. The value of having insurance would be amplified, and the cost would be controlled by the individual. People wanting only catastrophic insurance to reduce their health insurance costs could. If you want complete coverage it is your choice, not your employer’s and not your President’s.
If Congress wants to pass a law to pay for the insurance of people who do not want to, or cannot pay for insurance Congress can, but that would be a different bill with its own issues. Any such law would have to define a minimum acceptable insurance plan (MAP) which would be a source of great debate. It is the same question that each of us would have to answer ourselves, which plan is best, only this time it would have to be a plan that would fit everyone. Let’s face it, there is no such plan. I’m sure they can write another 1000 page bill that describes a minimum plan. 1000 pages may be too few though, I mean the tax code is a lot bigger and that.
While we are at it, we should eliminate the 401K retirement program and replace it with personal retirement accounts too. I like giving people their own choices in life, but I guess that is a perverted idea in Democracy today. I learned in high school that Democracy was about letting people vote for the things that make a difference in their lives. I didn’t realize that meant that my neighbors could vote if I qualify to live. Seventy years ago my father left a country that voted on whether he would live or die. They picked die. Each of us deserves to make our own health insurance decisions, to be the one and only member of our own personal death panel.