The biggest issue I have with Mr. Obama's speech last night is this line:
"If Americans can't find affordable coverage, we will provide you with a choice."
Why is this entire debate about this abstract and amorphous thing called "coverage"? Shouldn't it be about health care? The fact is, this is not about health care and never has been. It's about how to make money with insurance "coverage" which the record will show has been the source of all our problems since we started paying them to pay our medical care. We have been hoodwinked and they will continue to rob us if this fundamental issue does not change. Yes, this might sound a bit different than previous language I have used. That language has focused primarily on the GOP stupid stick from which masochistic Americans seem to get their politio-erotic thrills.
I am done with trying to "fix" the very center of the problem. It's not that insurance is broken, it that it exists.
- Dislodge health insurance from businesses altogether to save business a lot of cash. Premiums are so high because they can be. A market is only as big as it's total sum of available cash. Squeeze the available cash, the market has to adjust.
- Everyone stop paying insurance premiums and start paying direct costs to physicians who perform the services. Those who fail, stop getting your business. Again, the market will adjust because you can use your common sense to dictate who is giving you the care you want. This will also reduce litigation because bad doctors will have to improve service or go out of business. Malpractice insurance for good doctors can now go down.
- Vote out all of your incumbent politicians and vote third party. They have all been bought by some corporate entity somewhere at sometime and no longer represent you, the consumer, and represent big third party companies and organizations who have inflated costs – again without any of your ability to control the flow of money into the system.
- Rebuild health care so that the poorest among us, those with the most debilitating illnesses, and the aging get tax incentives and subsidies that puts money in their hands to help float costs. If they don't use that money to pay for health bills and use if for a vacation or a car, you lose the benefit; just like insurance fraud, without the costly legislation and without insurance calling the shots. Use something like a good driver discount that auto insurers use, but for healthy people. The healthier you are, (e.g. the more preventative care you can substantiate like checking your testicles, mammograms, pap-smears, regular dental check-ups, blood tests, etc.) you get a tax break.
- Offer very low insurance for catastrophic care and set premiums not unlike auto insurers do. This is an "in case of emergency" safety net and nothing more. It's like a bank account really. For those who do not opt in, how about interest free loans to help defray costs? Many ways to help out here.
Think about this sort of free market system. Charities would have it so much easier to help people with health costs since right now they cannot possibly keep up with inflation and regulations. Doctors would be able to reduce costs in biotechnology and pharm by collaborating to reduce overhead. If they and the biotech industry do not cut costs and someone can get cheaper goods, they will get more business. Most importantly, bad behavior would not get rewarded. If someone is failing in their job as a physician, you better believe that someone else is going to get better business – just like auto repair.
As an aside, can you imagine if auto insurance, which is needed since car values depreciate exponentially, worked like health insurance? Not paying your favorite mechanic because he is "out of network" or paying him more because you are going "out of network"? Waiting six months to get your alternator replaced with a re-furbished unit because it is "experimental"?
The issue is that we are not deathly afraid of our cars breaking down, but we are deathly afraid of our own bodies. A tumor is more than an "inconvenience". Fear is what is killing us, not health care. Insurance and government are working hand in hand to perpetuate this fear that without "coverage" we will die. No, without care we will be sick and many more will die. How did we get to a point where someone else is dictating the level and cost of care? Isn't it time to put our health into our own hands again?
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I totally agree that health insurance is the problem. The very idea of "insuring" health is absurd.
That being said your proposal, while certainly better than our current situation, is just too libertarian for my socialist heart. I want the NHS. I've lived in Britain (had my first child there) and the care is excellent.
This overlooks a simple fact: diseases are infectious. They spread from person to person. To protect your own health, it is imperitave that other people receive prompt, competant treatment of their disease. Which is why there must be universal health care available to all on demand. Universal health care is self defense.
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i agree with universal health care. what i don't agree with is universal "coverage" as if that resolves anything. i would be more comfortable with the japanese model of total government control, primarily through cost regulation, than the hodge-podge that seems to be developing which really only seems to serve the insurance industry in the end.
Drew, I don't think I have ever read anything, on any blog, with which I agree more. The tell here is that Big Insurance and Big Pharma back the Demoblicans' plan.
the depressing bit is that when i pitch this people will say, yeah but that's not the way the world works. is does not imply ought. pretty amazing how we have sold our souls to the devil of corporatism this way. 1973 – the year we made that sale and got sickness and debt in return. pretty easy to locate the cause of the problem and that cause is not worth fixing in my opinion.
and yes, this fits the "scorched earth" position eh?
NPR did a great piece a few weeks ago about the Japanese system. To be a Dr. in Japan you've really got to be in it to help people. They don't make the big bucks there. It was the same in Germany: they pay their teachers better than their physicians. That says something about them–and us.
[...] shares some ideas for fixing healthcare and a video from Ron [...]
I love this blog! Will come again next time for sure,
I love this blog! Will come again next time for sure,