Phil Hauck's TEC Blog

Monday, April 12, 2010

Reaction to Health Reform ... not positive!

Okay, so why can't we get enthusiastic about the new health care "reform" legislation ... supposedly the biggest reform since Medicare in 1965?

Well, because it was done irresponsibly. No "family", no "business", no one who has responsibility for their own money would ever do it this way.

Even if you agree that universal coverage is important, which I do, this has NO substantive cost control. (Too, it was not engineered in a way that would create the "true reform" of a "broken system" that was needed ... but that's another topic.)

And it wouldn't have been that hard.

Here's what should have been included ... without even beginning to reform the "broken system."

1. Expand/Incent use of individual Health Savings Accounts coupled with High Deductible plans. It would put more of a person's money "at risk," incenting more careful spending. Says economist Gary Becker, "In the U.S., we spend 17% of GDP on health care, but out-of-pocket expenses make up only about 12% of total health care spending (businesses pay the rest). In Switzerland, the out-of-pocket is 31% of the spend, controlling the total cost at 11% of GDP (still one of the highest in the world)." Our third party reimbursement system is a total disaster.

2. Extend tax deductibility to all individuals, not just those covered by businesses. This puts everyone on the same footing and sends the message that health care is of national importance.

3. Transparency: Require some form of disclosure to patients/users of the approximate cost before they are exposed to the service. Forbid the non-disclosure/confidentiality clauses in the pricing agreement contracts between providers and insurors.

4. Medical Liability: Control it at a low level, such as non-economic damages caps of $250,000. To be sure, medical liability premiums aren't much (just $2 billion, although they are astronomic for such specialties as gynecology), but estimates are that they drive extra, un-needed tests to the tune of $210 billion ... almost 10% of our $2.4 trillion spend.

5. And finally, the quid pro quo: If we're going to subsidize the cost of health insurance, then there must be a "health/wellness/fitness" requirement of each person. They must be doing prescribed things that can be third-party verified to reduce the likelihood they will need the sick care system, and certainly the more expensive parts of it. Many businesses are requiring this of their employees; extend it. What are they: Diet/nutrition and exercise that controls such costly disease-causing factors as glucose, cholesterol, and triglycerides that can be analyzed by blood draws. Forbid smoking. Let's finally establish and enforce national standards, since parents and other adults aren't doing it.

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