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.
Saturday, December 22, 2007
Tuesday, December 18, 2007
Rebuttal To My Brother
My brother Mark recently posted an article, Convenient Targets on his blog http://www.unsolicitedopinion.blogspot.com/ For my perspective read an earlier post of mine, Mexican Standoff. I visit Mark's site regularly because he writes well, posts often, and I respect his political savy. Even though sharing the same genes we don't think alike on many issues, but you can tell we're brothers. This article is a good illustration of our similarities and differences.
Mark expresses the opinion that corporations seek to lower costs and maximize profit without regard to social progress. I believe in a free market where every individual seeks to get the maxium return for their effort (wages) and spend the least amount possible for goods and services. When it comes down to illegal immigrants it's not corporations (big business) that hires these folks--it's the lettuce growers in Yuma who can't find an American willing to pick crops combined with other Americans who won't pay for Americans to pick lettuce when someone else will do it for a fraction of the harvest cost. It's the contractor re-roofing a house where the homeowner gets 4 bids ranging from $1,500 to $6,000. I could go one but you get the point--and certainly other factors (insurance, taxes, etc) influence this.
Mark has a valid point about the balance between profit and social progress. The issue I have is the dependency on government to measure, monitor, and deliver. I trust government about as much as Mark trusts corporations. There are lots of wealthy corporate officers (Greenburg, Welch) who have profited at others' expense, but there are plenty of politicians (Clintons, Bush) who have done the same thing in a different arena. I live in Atlanta and have watched the 40+ year neglect over our sewer system now being addressed with torn up streets and massive amounts of money changing hands under government tables. It's big business AND government seeking their self interests, and I dont trust either one. The best way to fix something like this is for citizens to become much more concerned about their local and state goverments instead of worrying so much about national politics, but I'm getting off the subject here.
Many Mexicans see more opportunity here in America. How do we change that? Mark's post doesn't offer a concrete solution. The simple answer is we annex Mexico and make it the 51st state. Save a lot of money on border security--perhaps set up toll booths and generate even more revenue. Of course Mexican politicians and corporations may not like this, but I don't care--invading and annexing Mexico is a lot less expensive than all the "social progress" we're paying for in Iraq--probably even less loss of life than when Pancho Villa tried to annex Texas. And it's a damn site closer to home.
Mark points that migration has been a key to opportunity throughout history. I agree and in a perfect world there shouldn't be any lines or barriers. One problem is there are people on this planet who want to terrorize and kill others just because. I would rather see the United States spend less resources on "illegal immigrants" and devote them to reducing the risks presented by those who want to harm us either here or from abroad.
Like Mark, I don't have a concrete answer yet. But the sooner we as a nation recognize we can't solve all the planet's issues the closer we may get to prioritizing and dealing with our own. And isn't that how a free market system is suppose to work?
Mark expresses the opinion that corporations seek to lower costs and maximize profit without regard to social progress. I believe in a free market where every individual seeks to get the maxium return for their effort (wages) and spend the least amount possible for goods and services. When it comes down to illegal immigrants it's not corporations (big business) that hires these folks--it's the lettuce growers in Yuma who can't find an American willing to pick crops combined with other Americans who won't pay for Americans to pick lettuce when someone else will do it for a fraction of the harvest cost. It's the contractor re-roofing a house where the homeowner gets 4 bids ranging from $1,500 to $6,000. I could go one but you get the point--and certainly other factors (insurance, taxes, etc) influence this.
Mark has a valid point about the balance between profit and social progress. The issue I have is the dependency on government to measure, monitor, and deliver. I trust government about as much as Mark trusts corporations. There are lots of wealthy corporate officers (Greenburg, Welch) who have profited at others' expense, but there are plenty of politicians (Clintons, Bush) who have done the same thing in a different arena. I live in Atlanta and have watched the 40+ year neglect over our sewer system now being addressed with torn up streets and massive amounts of money changing hands under government tables. It's big business AND government seeking their self interests, and I dont trust either one. The best way to fix something like this is for citizens to become much more concerned about their local and state goverments instead of worrying so much about national politics, but I'm getting off the subject here.
Many Mexicans see more opportunity here in America. How do we change that? Mark's post doesn't offer a concrete solution. The simple answer is we annex Mexico and make it the 51st state. Save a lot of money on border security--perhaps set up toll booths and generate even more revenue. Of course Mexican politicians and corporations may not like this, but I don't care--invading and annexing Mexico is a lot less expensive than all the "social progress" we're paying for in Iraq--probably even less loss of life than when Pancho Villa tried to annex Texas. And it's a damn site closer to home.
Mark points that migration has been a key to opportunity throughout history. I agree and in a perfect world there shouldn't be any lines or barriers. One problem is there are people on this planet who want to terrorize and kill others just because. I would rather see the United States spend less resources on "illegal immigrants" and devote them to reducing the risks presented by those who want to harm us either here or from abroad.
Like Mark, I don't have a concrete answer yet. But the sooner we as a nation recognize we can't solve all the planet's issues the closer we may get to prioritizing and dealing with our own. And isn't that how a free market system is suppose to work?
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