Category: politics

Sep 08 2009

Solution for America’s Healthcare concerns

I do not intend to blog much personal opinion here and to mostly avoid political discussions. I do that at another location on the web (heretofore undisclosed anonymous blog.) But I couldn't resist blogging this. By this I mean THIS. Or copy and paste... http://www.theatlantic.com/doc/200909/health-care The article linked above, published last week in the Atlantic and written by David Goldhill, is a fantastic analysis of the problems with America's Healthcare system and proposes a realistic solution. But you can't know that unless you read it ...so go ahead ... read it ... I'll wait right here............................................................................................................................................................. .................................................................................................................................................................... .................................................................................................................................................................... OK...it IS a little long. But the problem's with our system are pretty complex and the article explains them amazingly well. I believe one of the evidences of the "truthiness" of his proposals are that no one is going to be perfectly happy with them. If you are a progressive you are not going to be happy with a proposal that is not a big government solution...one that acknowledges that the free market should be playing a much larger role than it currently is in keeping down costs. But you will like that it provides medical insurance and a means of payment for EVERY AMERICAN and scraps the current 3rd Party Payer (ie INSURANCE) system. If you are a conservative you are not going to be happy with a proposal which has mandatory payroll deductions for Health Savings Accounts and Catastrophic Insurance Premiums. But you will like that it does prevents a big-government takeover of our health-system and introduces heretofore missing free market principles for controlling costs and increasing price visibility. But that's the rub. This is a plan that both conservatives and progressives can get behind. Both sides make compromises in this proposal and both sides win which seriously ramps up its chance of success. I think to thoroughly read the linked article will take about an hour of your time. And I HIGHLY recommend you do that. But if you just don't have time now or will promise to do it later (you promised...I heard you) then let me sum up the recommended solution. These proposals make more sense in light of the whole article so if you think you don't understand a point or you don't understand a proposal...you'll just have to dig in and read the whole thing. Here is the proposal...
  1. Everyone is required to buy a catastrophic insurance plan. Payroll deduction. Single national pool. Fixed premiums based solely on age. No underwriting for specific risk factors. "But the real key would be to restrict the coverage to true catastrophes—if this approach is to work, only a minority of us should ever be beneficiaries."
  2. Most of our health care costs would be paid out of our income and savings. Every American will be required to have and maintain a post-tax HSA that has both a floor and cap in total contributions. Eventually all non-catastrophic care would be funded out of HSAs. "But account-holders should be allowed to withdraw money or any purpose, without penalty, once the funds exceed a ceiling established for each age, and at death any remaining money should be disbursed through inheritance."
  3. Major expenses that exceed someone's HSA balance but is not considered catastrophic would be paid by borrowing against your FUTURE HSA spending. This could be done by the government or provide guidelines for private lending.
  4. "Catastrophic coverage should apply with no deductible for young people, but as people age and save, they should pay a steadily increasing deductible from their HSA, unless the HSA has been exhausted. As a result, much end-of-life care would be paid through savings."
  5. "For lower-income Americans who can’t fund all of their catastrophic premiums or minimum HSA contributions, the government should fill the gap—in some cases, providing all the funding..."
  6. "The government could provide vouchers to all Americans for a free checkup every two years."
That's it in a nutshell.  I think the one question that it will raise for nearly everyone who read that is "how can I afford to pay most of my health costs out of pocket"?  Fair question.  And for the best answer read the article.  But here is how Mr. Goldhill answers that question...
"How am I supposed to be able to afford health care in this system? Well, what if I gave you $1.77 million? Recall, that’s how much an insured 22-year-old at my company could expect to pay—and to have paid on his and his family’s behalf—over his lifetime, assuming health-care costs are tamed. Sure, most of that money doesn’t pass through your hands now. It’s hidden in company payments for premiums, or in Medicare taxes and premiums. But think about it: If you had access to those funds over your lifetime, wouldn’t you be able to afford your own care? And wouldn’t you consume health care differently if you and your family didn’t have to spend that money only on care?"
Please take the time to read this.  And if you like it as much as I did pass it on to your friends. Seth B Spearman