Stubborn Facts has an interesting post analyzing Hillary Clinton's health care reform proposals as well as others, and gives this insight:
I have said many times that the real problem with health care right now is that previous government "solutions" have distorted the market forces and led to an inefficient, byzantine system. For example, government subsidy (via tax deduction) of employer-provided insurance but not individually-purchased insurance has marginalized the market for individuals to buy their own insurance and forced millions of Americans to stay in jobs they don't like simply because they need the health care benefits.
It's a good thought. There are far too many people who stay with an employer just because of the benefits, and there are many other people who try desperately to work for employers who have such benefits, regardless of one's interest in the company. But I found this section curiously naive:
Finally, and I can't find where I've said this previously, though I certainly have, I want to hear more from the politicians about what they think the real causes of the increased health care costs are. I believe that there are several components to the increased costs, each of which may need a different solution.
For example, large sums of money are spent on health care for individuals in the last years of their lives. Perhaps new health insurance products could be created which would work similarly to life insurance, where after the older folks have paid in a certain amount of premiums, their policy is "paid up" and they will then be provided coverage of, say, up to $1 million in health care costs. If the individual started paying premiums on that policy when they were 20 or 25, the premiums needn't be that large.
Another large chunk of health care spending is for individuals with certain chronic diseases, like diabetes. Imagine parents being able to purchase, at a low cost, insurance which would provide coverage if their children were diagnosed with diabetes or cystic fibrosis or some other chronic condition. Since the proportion of such illnesses is relatively low, the cost of such insurance should also be low, so long as enough people purchase it. The company selling the policy would also have an interest in encouraging the mother to have regular prenatal check-ups and take other appropriate steps to reduce the risk that the baby would be born with such conditions.
This really shows how unfamiliar the author must be with insurance and how it works. Insurance is designed specifically to eliminate people who might need the coverage. Even people who can get coverage will find they pay higher premiums (as I found out for myself). The idea that a company would offer insurance for those predisposed to diabetes is almost comical. How does a company make money having to pay out for treatment of an illness? The fact is, it doesn't. Insurance companies make their money by denying coverage to anyone likely to need medical care and pushing insurance on those least likely to use it (specifically healthy 20-somethings).
Pat offers some quick and easy improvements to American health care woes at this post.
I agree with these fixes, but the interesting part of Hillary's plan for my family is the fact that pre-existing conditions cannot disqualify one for insurance. This is a huge problem, bigger than I hear people discuss. There's an attitude out there (and I used to be this way, too) that everyone who wants insurance can get it. But the truth is, if one loses one's high-paying, good insurance-providing job, it's likely that the next employer's insurance program is going to exclude you because your health problem is now a pre-existing condition.
It's one thing to argue that one's personal behavior can prevent various health problems like obesity and lung cancer. But what about genetic predispositions to conditions like high cholesterol, diabetes, or--as in our case--thyroid cancer?
I'm waiting for someone to explain why eliminating thousands, perhaps millions, of Americans from the system is the best answer for controlling health care costs.
|