Friday, August 10, 2012

Healthcare: A Uniquely American Solution.

       After much thinking, and more discussion, (yes, that was intentional) I have arrived at a solution, agreeable to both sides, for the problem with America's healthcare system.  Again, this is why it is important to think before you act.  (ahem, Congress, Mr. President)  I hope that whichever person wins the Presidency, and the new Congress, will see this and at least think it over.
       First, let's discuss what the problems are.  Insurance costs too much.  Many people are denied it because of this.  Insurance is allowed to deny coverage for any reason they want, leaving the consumer to argue for coverage they already have, and have already paid for.  And finally, any discussion on fixing the issue results in claims of socialism.  (pass a law that states insurance companies can't run at a profit, socialized medicine etc.)
       We all know it needs to be fixed.  We all know that the cost of insurance is driven by the uninsured, not the insured. Hospitals have to charge those who can pay, more; to cover those who can't, because government is asleep at the wheel.  Lawyers only serve to drive the prices higher with lawsuits that are largely without merit.  I could go on...
       The fix is simple.  Treat insurance like any other contract business.  That's it.  Every problem we have is because they are allowed to operate under a different set of rules than the rest of the business world.  If insurance was merely a coverage contract and was denied the power to deny coverage, like any other contract business, it would fix almost everything.
       This would not require you to have coverage if you didn't want it.  (making the wealthy happy)  It would not demand that an American company operate without profit.  Free trade is the cornerstone of the American way of life.  That is the problem currently, there is nothing in the insurance industry that is the same as any other industry.  The safety net preventing abuse by doctors and the insured, would be co-pays and delectables, which would be regulated like utilities, to prevent abuses by the insurers.
       Insurance companies would cover anything ordered by a doctor, that was performed on a patient.  (cosmetic surgery would be denied, unless required to restore appearance after a surgery or other treatment.)  Any issues about necessity would be handled in court, after payment was made, just like any other contract dispute.  (keeping the lawyers employed)  That is to say the burden of proof would be shifted to the accuser, not the defendants.  If that standard seems oddly familiar, there is a reason for that.  This would have the side affect of lowering the profitability of insurance companies, since they would be unable to randomly deny coverage.  (making the middle class happy)
       Doctors and hospitals would no longer need to employ an army of people to work in the offices, just to untangle the individual policy quirks.  Claims sent to the insurance company would be paid.  End of story.  The cost of doing business in medicine would drop overnight.  To a point where more people could afford it. 
       If you have noticed that I make no mention of coverage for the uninsured, there is another fix for that.  We need to further reduce costs by limiting a physician's, and a hospital's liability.  Then apply that standard evenly in all states.  Right now Illinois has a shortage of certain specialties, because they are relocating to states with liability caps.
       This would reduce costs further.  Then, we need to make insurance a part of employment.  If you have a job, part of your wages are insurance coverage.  (making the "working poor" happy)  While there are those who see this as punishing small business, some quick math would show that , if government were honest, (see end of paragraph) taxes would go down an amount nearly equal to the cost of providing insurance; due to the savings realized, and the number of people who would no longer need public aid.  (Governmental honesty is the only real problem with this plan)
       Remember there is a large part of our workforce who have jobs, but no insurance.  What happens when they go in to the hospital?  Either they don't pay, or they get public aid.  Either way serves to either increase taxes, or increase medical charges to those with insurance, in order to cover it.
       With these fixes in place, the current public aid system would cease being overburdened, thus enabling government to pay their bills.  (pleasing the unemployed, doctors and hospitals)
       As always, I welcome responses.  (clean and well thought out)(I promise not to moderate you out based on opinion)

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Keep it clean and well thought out.