Health Care Reform: The Good, The Bad, and The Ugly

The Pediatric Insider

© 2009 Roy Benaroch, MD

We can all agree that the current “system” needs a-fixin, and there is no shortage of good ideas that could be implemented quickly and fairly, and could dramatically improve access and costs. But there is also no shortage of truly bad ideas, and unfortunately, there is one Huge Ugly Problem that guarantees to muck up the whole process if left unchecked.

The Good

Allow people to shop for health insurance across state lines. Current laws allow a small number of huge plans to flourish in each state, stifling competition and choice. One tiny law with 15 words could immediately allow consumers access to hundreds of different plans.

Stop discriminating against individual plans. Currently, if your employer buys your health insurance, you don’t pay taxes on the premiums—but if you want to buy your own policy, you lose thousands of dollars back to Uncle Sam in increased taxes. That’s stupid, and unfair, and unreasonable. Stop it. Allow a personal income tax deduction to people who choose to buy individual plans.

Make it less easy to exclude pre-existing conditions. Current HIPAA laws forbid health insurance companies from excluding pre-existing conditions—but ONLY if you’re only covered by a group plan, and switch to a different group plan. If you’ve got individual insurance, the group plan or individual plan you’re considering switching to can exclude anything. Again, stupid; a loophole like this can be closed by legislation like *that* (that was me snapping my fingers).

Permit businesses to pool their employees and seek discounts for group insurance plans. Can you believe this is currently forbidden? Again, *snap*, the cost of group insurance for employers can drop dramatically if competition and group purchasing power is allowed.

Encourage the use of health savings accounts, so people can set aside money for health costs. Not those stupid “medical savings accounts” that are confusing, and allow money to disappear at the end of the year if you don’t use it—but real HSAs, controlled by individuals, where money can be used for any health reason, or rolled over from year to year.

Reform the medical malpractice litigation. There are many creative ideas here—“loser pays” or caps on punitive damages would be an excellent start. At the same time, make it easier for people who are genuinely harmed by medical errors to get quick compensation that doesn’t end up in lawyers’ hands. The goal of med-mal should be reducing errors and compensating the harmed—NOT to create a bonanza for lawyers, a nightmare for doctors, and an atmosphere where errors are hidden instead of studied.

The Bad

Creating a new federal “right” to health care. Sorry, health care isn’t like “freedom” or “the pursuit of happiness.” Health care has costs, and someone has to bear the costs. Remember elementary school civics? Your “rights” are only a “right” if they don’t interfere with my “rights”—and if I don’t want to pay for your health care, yet you’ve got a “right” to it, now the government has to take my money away from me. So much for my “rights.” You can’t pull a “right to health care” out of the air any more than you can invent a “right” to food or a “right” to housing or a “right” to high-speed internet access. A civilized society ought to have a mechanism in place for health care for all, as it should also provide for the infirm and the elderly and the meek. That doesn’t mean that all government social services are a “right.”

Pushing all costs into the future. Good Lord, we’re considering saddling our children with debt unimaginable, far far larger than even the made-up numbers in the newspapers. Do we want to be a generation that leaves a country entirely bankrupt for our children? We need to be honest about the costs of things, and we need to be honest about who will pay the bills and when. Our representatives in Washington, from both parties, have been profligate to the point of insanity.

Micromanagement of mandates. Health insurance should always cover certain basic services that could be outlined on a single sheet of paper. Beyond that, consumers should be allowed (but not mandated) to pick further coverage as they see fit. You want chiropractic coverage? You want prescription medications? How about brand-names? Do you want to be able to choose from a list of 100 participating hospitals, or is 3 enough? The law should stipulate that insurance plan information should be honest and easy-to-understand, so that what is and isn’t covered is clear. Beyond that, let the consumer decide if they want plain-vanilla, no-frills coverage, or if they want to pay extra for more-comprehensive coverage. States that have long lists of mandates end up with very expensive premiums that no one can afford—so few people actually benefit from the expanded coverage anyway. Who really thinks government bureaucrats  are in the best position to decide that A must be covered, but not B, for everyone?

The Ugly

President Obama says that health care legislation must be passed this summer, by August. Remember the Stimulus Bill, the one that was pushed through in the wee hours, the one that no congressman could possibly have read in its entirety? At least that was a one-time deal. Reforming health care is much bigger, and could shape the American economy for years to come. Let’s think about this, think about the ideas, allow time for congress to listen to their constituents, and come up with a plan that has been well-researched and well-discussed. The current rush-em’-through system benefits the Washington insiders, the lobbyists, and the cronies at your expense. Let’s take a breath and think this thing through, or we’ll end up with a huge ugly mess.

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4 Comments on “Health Care Reform: The Good, The Bad, and The Ugly”

  1. Shannon Says:

    I sure hope that you’ve written to our federal representatives here in our state! You tell ’em!


  2. Dr. Roy Says:

    Reported today: Senate Majority Leader Harry Reid, D-Nev., delivered the official pronouncement on what had been expected for weeks, saying, “It’s better to have a product based on quality and thoughtfulness rather than try to jam something through.”

    Couldn’t say it better myself!


  3. Becky Says:

    Your comments were very well written and express my feelings exactly too. There is a lot we could do to fix the current system without loading up our national debt!!!


  4. Dr. Roy Says:

    For those of you eager to have the government take charge of your health care, let’s see how they handled this recent project:

    And that’s just cars, and (just!) a 3 billion dollar program!


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