Monday, November 09, 2009

Health Insurance or Health Care?

The discussion is still about insurance, not health care. Is it the government’s purvey to provide health insurance or provide that government care for the infirm and ill? Traditionally, government did provide for the poor out of humanitarian reasons or out of the need to prevent revolution from the ground up. The funds came from the king and the wealthy. Religious institutions also provided assistance to the poor out of a necessity to prove they practiced what they preached but probably out of a natural human need to care for others.

I am heartened by the Republicans finally coming up with some ideas to reform health care delivery systems. I am disappointed in the Democrats for embracing mandatory insurance as the way to provide better health care for our citizens.

Requiring business to buy health insurance for employees keeps the price jacked up and the whole scheme going. The idea of mandatory insurance for all citizens will also jack the price up. Government price controls are resisted as the public option, which would limit what could be paid for a given medical service, forcing health care providers to rein in costs or services to patients or forcing them to take a pay cut. The debt overload is staggering uphill, so it is suggested commercial debt relief to medical care providers. Exorbitant commercial prices during the boom left medical businesses swamped in building debt in the form of high rents or payments.

These bills our fearless leaders are coming up with contain the idea of mandatory insurance. Our elected leaders deem it necessary to force the people to pay for insurance instead of health care. They also think that insurance companies are better at handling our money than we are.

If this mandatory insurance idea is foisted upon us, I suggest the following be implemented along with mandatory insurance payments:

All health care providers must accept all insurance. No hoity toity, no exclusive treatment salons that do not take Medicare, no ‘private’ clinics that take ‘exclusive’ insurance. If a rich person hires a private doctor for cash payments, that is private enterprise.

All health care providers must accept all insurance because all citizens are required by law to buy insurance. We lose our right to choose, health care providers lose the right to choose who they treat. This means all hospitals, doctors, clinics etc. who accept any insurance have to accept all insurance.

Price fixing between health care providers and insurance companies should be a thing of the past in that prices for procedures will be dictated by the government that requires us to buy insurance. We should not be charged more than what the insurance pays, since so many people with insurance are bankrupted by health care costs. When insurance is mandated, the health care people will earn less since price controls will be instituted.

For the health insurance people, you cannot demand we buy what you are selling without us having some ideas how we want our money managed. Insurance companies must accept controls on pay, number of employees, standards for judging claims, premium price controls and intense oversight. No more golf holidays, spa visits and celebrations of plenty while using premium money to party and gamble.

The domino effect is present here. The strongarm tactic of forcing people to buy insurance creates other hassles. Some of our legislators evidently believe it is easy to force people to buy insurance but in the interests of fairness, the insurance industry and the health care industry will also lose volition. Sure, the insurance companies will have millions more bank accounts to tap into but is it worth the change in our socio-economic structure?

Not one to criticize without offering a solution, here are a few ideas:

The mandatory insurance idea is not free market. Insurance should only be an option, not the only way to achieve affordable health care. Capitalism allows for a variety of approaches, never mandating that one way is the only way. Affordable health care is the real goal, not propping up exorbitant salaries in the insurance and health care arena. As I wrote before, why not use stimulus money to establish low cost clinics in the neighborhoods and to fund nurses in the public schools? Remember, providing health care is the goal.