I am fixing this post based on insight from a Huffington Post poster who goes by ‘Stephen S’….
I’ve written about this before, but I’m caught in a great gust of hot air on one of the forums I frequent, so I’ll restate my position on healthcare. It costs too much, and it needs to be fixed. We are the only ones who can fix it, nobody can fix it for us.
Healthcare costs too much because Americans don’t have to pay the bill directly, and they don’t have to make cost/benefit judgments about their own healthcare. This is similar to a “Tragedy of the Commons” situation, where there’s no downside for any individual grabbing as much as they can at everyone else’s expense. When nearly everyone is doing that, you end up with the healthcare costs we have.
Fixing this is simple: present the bill to the consumer. That is also impossible without some very substantial preparations beforehand. I don’t have the entire 200 page bill written, your Congressperson has the staff to do that. Here is the logical outline (a line diagram, if you will).
1. Forbid third party payers, except (eliminate “perhaps”) for military personnel delivering healthcare to military servicemembers. No person not a direct and close blood relative may pay anyone else’s medical bills. This is necessary to achieve the objective of having Americans shop as thoughtfully and diligently for health care as they do for running shoes.
2. Provide tax exempt and subsidized health care savings accounts. Set a reasonable amount (obviously, somewhat less than the average health insurance premium is today) and insure that all Americans have that much set aside each year. The wealthy get little gov’t help, perhaps a tax break, and then on a sliding scale the less well off get more and more help. Until those at the bottom get a direct subsidy to insure their account is funded.
This account can only be used for healthcare, at the citizen’s discretion. Families (based on Stephen S’s input, expand this to any concerned citizen, and provide for tax exempt, tax advantaged fund raisers when needed) can pool/share accounts as necessary. Residual funds can be bequeathed (passed on) to heirs. Any facility accepting payment from these accounts must meet certain standards, including a published list of representative fees.
3. A national catastrophic/chronic insurance program to cover those expenses for individuals afflicted with these conditions. This is true “insurance”, like auto liability or term life, where everyone pays in a small amount, but only those who are affected draw benefits. No refusal for pre-existing conditions. A panel of widely respected industry, government, and academic experts to develop the definition of these conditions and how insurance referrals would work.
Conclusion – and that’s it, that’s all it takes (unless there’s something I’m missing, but so far no one has pointed anything out [obviously Stephen S has contributed, my thanks to him]). These measures, taken together, will provide a human, equitable, high quality, and affordable health care system for America. A true single payer system that leverages comparison shopping and human judgment at the most granular level.
G’night all, and may God continue to bless America!