Medical Care & Health Insurance

I should the last person to criticize the current state of medical care and health insurance. I've had 10 orthopedic surgeries over the past 40 years and they've all been taken care of with very little out of pocket expense on my part. I've been fortunate to have been covered by some type of insurance at a reasonable cost. For the past 8 years my health insurance premium has been paid for by my employer.

But something is very wrong with the overall system: I see a couple of issues

LOTS OF PEOPLE UNINSURED
Estimates vary but there are probably about 40 million people in America who have no medical insurance. Some of them are young folks no longer covered under their parents, others are unemployed between jobs, some are those with a serious medical problem which emerged while they were uninsured, etc. While some of these folks go without coverage for a short time, some of them remain uninsured for a long time. Unfortunately illness and accidents strike enough of this group to put a strain on the overall system and/or let people do without.

RELYING ON EMPLOYERS TO OBTAIN INSURANCE
Many Americans are covered by group plans through companies. This works for those employed by companies who offer(and sometimes subsidize plans). Insurance can become real expensive for the self employed and employees who change or leave jobs. It may not be possible to continue when a person changes jobs with a medical condition--of course no one ever changes jobs or has a medical condition--right!

RELYING ON GOVERNMENT TO SOLVE A FREE MARKET ISSUE
I believe this would be disastrous. Except for the Constitution and the interstate highway system I can't think of anything the government has done more efficiently than the free market system. Think I'm wrong--audit the post office and social security for starters. The only role government should play is offering tax incentives and designing transportation systems that provide alternatives that promote wellness, i.e. sidewalks, room for bikes on roads, etc.

MEDICAL CARE IS A PAPER, SCISSORS, STONE, GAME
Insured patients don't shop for medical services because they don't pay directly. Doctors, hospitals and other providers inflate charges because they know insurance companies with large groups will beat them down. Insurance companies have large numbers and money. Each group seems to work on their own to win without regard to other components. Uninsured patients either go without treatment and/or pass their costs onto society.


WHAT DO I RECOMMEND?
1. Create Individual Health Savings Accounts. All funds deposited are tax deductible for contributor. No limits--if an individual sets aside $1,000,000 that's fine--if they set aside $100 that's OK too. Contributions can come from anywhere, i.e. individual, friend, family, company whatever. HSAs can be established for anyone, anytime and funds can only be used for medical/health care costs. Funds in an individual account can be transferred to a designated beneficiary upon death.

2. Let existing insurance plans continue that work for groups and/or individuals.

3. Eliminate expiration date for Cobra. If someone leaves employer sponsored program they can continue coverage as long as they pay premium.

4. Push for incentives that benefit individuals, doctors, hospitals, and insurance companies. This topic warrants a separate post--stay tuned.