Better health care at no additional cost

Published: Tuesday, September 17, 2013 at 4:30 a.m.
Last Modified: Monday, September 16, 2013 at 4:58 p.m.

What if we get rid of Obamacare? How will the people who have problems with health care get along? Here are some ideas that do not call for a single additional cent of government money but would solve the real problems in U.S. health care, one by one:

Problem: Current employer-owned group insurance policies are not portable, and if a person changes jobs, the next employer’s insurance excludes existing conditions.

Solution I: Instead of giving an employer a tax break for purchasing health insurance for its employees, give it a tax break for donating to an employee’s pre-tax health savings account. The employee could then use the money in his account to buy his own policy as part of a company-wide purchasing group. Since the individual would own the policy, it would move with him and thus prevent the pre-existing conditions problem.

Solution II: Encourage self-employed individuals and those whose employers do not contribute to their health care to set up pre-tax health savings accounts and use the money to buy health insurance. Encourage them to join together into large groups that anyone can join and to buy health insurance at the same discounted rates that large companies receive.

Problem: Health care insurance costs too much.

Solution 1: Encourage folks to join health care insurance buying unions. Like financial credit unions, health care buying unions would be staffed by elected member/managers. Of course, the elected insurance managers and the clerks needed to process claims and payments would be paid, and overhead would be a cost, but the price of the insurance would still be cheaper because the buying union would not need to produce a profit for its stockholders; it would not be a company. The cost would automatically drop by as much as the current insurance companies make in profits.

Solution II: Allow insurance to be bought across state lines so that individuals can buy the insurance policy that best fits their age and family situation. Competition will work its magic to keep prices down.

Problem: Some folks are living on the edge of poverty but don’t qualify for Medicaid. They go to emergency rooms for primary care.

Solution: Hospitals are already charging a significant amount over and above the cost of actual care to those who are able to pay or have golden insurance policies. Instead of using this money to cover ER primary care treatment, open up a primary care clinic right next to every ER. Such a needs-based clinic would be much cheaper than treating the folks who can’t afford insurance in the ER. Doctors are good guys/gals and many of them would volunteer a few hours a week at the clinic making care even cheaper. Using physician assistants for routine problems would also keep costs down.

Problem: Some solvent young people refuse to buy insurance because they think they are invincible.

Solution I: Allow insurance companies to market “term” health insurance policies. Like a term life insurance policy, these policies would start out with low premiums if you start buying them as soon as you get out in the workforce. Everyone would know it would cost more per month if you wait until you are older to start buying insurance.

Solution II: Expect that solvent young people who refuse to buy insurance will pay “unexpected” medical costs after the incident, perhaps on the installment plan, or go bankrupt. That is what they would do if their uninsured car or house were totaled and they had no “rainy day” savings put aside to make repairs or replacements. Bankruptcy is there to help folks who have made unfortunate financial decisions such as not buying insurance. Perhaps a simple personal economics course could be required for graduation from high school. (My husband, George, and I were caught without hospital insurance when our second child was born. We paid for her at the rate of $25 per month until she was in grade school.)

Problem: Some folks are born with health challenges and are “uninsurable.”

Solution: This is the only case in which I can see that the American people might be asked to cough up some more tax dollars. Most folks would be willing to subsidize a needs-based “high risk pool.” Or perhaps we could find some money floating around in the Medicaid system that is set up all wrong so that there are no incentives to prevent fraud and thoughtless spending.

Danz is a Flat Rock resident and a former columnist with the Radford, Va. News Journal


▲ Return to Top