Health Care: A Compromise
Over the last few weeks, I've seen my friends and acquaintances express a wide range of opinion on how to reform health care in this country, from completely leaving the current system alone, to scraping everything and handing it carte blanch to the federal government. I find myself somewhere between those two extremes. While I completely believe the current system is broken, I don't think it is beyond salvaging.
I do have two fundamental beliefs about health care--that it be available in an affordable way to everyone in this country, and that doctors and patients, not bureaucrats, be in charge of determining treatment.
I have worked out a system that I think might work. There is some government involvement, which I know is an abomination to some of you. At the same time, I think this is far cheaper to the average taxpayer than straight-up single payer. And everyone who wants health care will be able to get it.
The first part of my plan is to make sure anyone who wants coverage can get it. Right now, insurance companies have wide leeway to deny coverage to anyone they want to, for nearly any reason. Under my idea, that will end. Insurance companies will be required to offer full and complete coverage to anyone who applies, with no exceptions. Once insured, the company can only drop them for failure to pay premiums. However, the companies will, within reason, be able to set their own premiums for each individual policy. Obviously, that will mean some people will be facing much higher premiums than others. And that is when the government will come in.
I envision an agency, probably within the Department of Health and Human Services, that is charged with figuring out how to get insurance for everyone who wants it. Consumers will come to them if they are unable to find a reasonably-priced plan. This agency will have numerous options available. They can negotiate with companies to see if they can get a lower premium. They will have other options and other companies available that the consumer perhaps wasn't aware of or hadn't considered. They can examine the monthly household budget of a consumer and his family and suggest ways to economize in order to be able to afford the monthly premium. If none of those options work, then, and only then, would the government offer partial or (in rare cases) total reimbursement. This is not a government insurance plan--this is government paying for a private plan, but only as a last resort.
Meanwhile, if an individual chooses not to get insurance, that's perfectly all right. However, should they incur any medical bills; they will be 100% responsible for them.
That's the first part, to get everyone in the system that wants to be in the system. The second part is to make sure that doctors who actually see the patient get to pick the proper course of treatment.
There are legions of patients who did not get the treatment their doctors recommended because an insurance bureaucrat who had never even met the patient nor spoke with the doctor demanded that a cheaper treatment be used instead. That is simply wrong. However, I'm also sympathetic to the idea that insurance companies are not made of money, and forcing them to pay for any and every prescribed treatment, no matter how outlandish or unnecessary, would be a good way to drive them into bankruptcy.
If a company refuses to pay for the treatment prescribed by the patient's doctor, and recommends an alternative treatment, the patient has the right to further opinions. The insurance company will pay for him/her to visit two other doctors, only one of which can be required by the company. The two other doctors will examine the patient, review the medical records, and consult with the original doctor about what is best for the patient. If one or both of the second opinion doctors agrees with the original doctor about the course of treatment, the insurance company will be required to pay for it. If the both disagree and say the alternative treatment is a proper substitute, then the company can demand that they go with their recommendation. Either way, the decision will be made by doctors who have actually seen the patient.
I will admit that my plan is not perfect. I realize there are flaws, but there are flaws in pretty much any proposal. This, I think, is a workable compromise. It's a shame that I'm just an ordinary private citizen, and have no way of getting my ideas to anyone who might actually be able to do something about it.
I do have two fundamental beliefs about health care--that it be available in an affordable way to everyone in this country, and that doctors and patients, not bureaucrats, be in charge of determining treatment.
I have worked out a system that I think might work. There is some government involvement, which I know is an abomination to some of you. At the same time, I think this is far cheaper to the average taxpayer than straight-up single payer. And everyone who wants health care will be able to get it.
The first part of my plan is to make sure anyone who wants coverage can get it. Right now, insurance companies have wide leeway to deny coverage to anyone they want to, for nearly any reason. Under my idea, that will end. Insurance companies will be required to offer full and complete coverage to anyone who applies, with no exceptions. Once insured, the company can only drop them for failure to pay premiums. However, the companies will, within reason, be able to set their own premiums for each individual policy. Obviously, that will mean some people will be facing much higher premiums than others. And that is when the government will come in.
I envision an agency, probably within the Department of Health and Human Services, that is charged with figuring out how to get insurance for everyone who wants it. Consumers will come to them if they are unable to find a reasonably-priced plan. This agency will have numerous options available. They can negotiate with companies to see if they can get a lower premium. They will have other options and other companies available that the consumer perhaps wasn't aware of or hadn't considered. They can examine the monthly household budget of a consumer and his family and suggest ways to economize in order to be able to afford the monthly premium. If none of those options work, then, and only then, would the government offer partial or (in rare cases) total reimbursement. This is not a government insurance plan--this is government paying for a private plan, but only as a last resort.
Meanwhile, if an individual chooses not to get insurance, that's perfectly all right. However, should they incur any medical bills; they will be 100% responsible for them.
That's the first part, to get everyone in the system that wants to be in the system. The second part is to make sure that doctors who actually see the patient get to pick the proper course of treatment.
There are legions of patients who did not get the treatment their doctors recommended because an insurance bureaucrat who had never even met the patient nor spoke with the doctor demanded that a cheaper treatment be used instead. That is simply wrong. However, I'm also sympathetic to the idea that insurance companies are not made of money, and forcing them to pay for any and every prescribed treatment, no matter how outlandish or unnecessary, would be a good way to drive them into bankruptcy.
If a company refuses to pay for the treatment prescribed by the patient's doctor, and recommends an alternative treatment, the patient has the right to further opinions. The insurance company will pay for him/her to visit two other doctors, only one of which can be required by the company. The two other doctors will examine the patient, review the medical records, and consult with the original doctor about what is best for the patient. If one or both of the second opinion doctors agrees with the original doctor about the course of treatment, the insurance company will be required to pay for it. If the both disagree and say the alternative treatment is a proper substitute, then the company can demand that they go with their recommendation. Either way, the decision will be made by doctors who have actually seen the patient.
I will admit that my plan is not perfect. I realize there are flaws, but there are flaws in pretty much any proposal. This, I think, is a workable compromise. It's a shame that I'm just an ordinary private citizen, and have no way of getting my ideas to anyone who might actually be able to do something about it.