Unorthodox Thinking on Health Care Delivery

Providing affordable, cost effective health insurance appears to be a national debacle. "Socialized" medicine, in which the government pays everyone's health care, would present an uncomfortable tax burden upon most Americans, which is the same burden that currently exists under employer plans. The young and those who do not utilize medical services subsidize the rest of society. Other than those who are blessed with governmental employers who eat most, if not all, health insurance costs, employees face a health deduction from their pay check which they have virtually no control over. They cannot opt for a high deductible plan and a large self-paid self insured retention which would afford cover only for the most severe conditions and expensive tests. Indeed, the current system as it stands represents "socialized medicine" since consumer choice is severely limited.

The experience of Massachusettes, which presents with the highest rise in the rate of insurance this decade according to the Boston Globe, is illustrative of how restaints on market forces and competition create higher costs. It appears that Governor Patrick is attempting to further interfere in a health care market place subject to fee schedule price controls and dictate the level of premium as well as the terms and conditions of the insurance policies.

http://www.boston.com/news/local/massachusetts/articles/2009/01/06/patrick_intensifies_states_push_to_curb_soaring_health_premiums/?page=2

Health insurance in the United States has its roots in the nineteenth-century sickness funds offered by industrial employers, fraternal organizations, and labor unions as well as the rise of not for profit groups plans as Blue Cross and Blue Shield in the mid-twentieth century. The health insurance contract is therefore not rooted in a need to defend and indemnify against litigation risk, as is your automobile insurance policy or your homeowner's plicy, claims which would be rooted in the common law of tort. This insurance arose out of the need for those interested in the labor market to provide a benefit for working people and their families, with medicare based plans as acting as the insurer of the retirees and medicaid as the insurer of last resort for the poor and disabled who cannot work.

Ultimately, insurance costs in the United States are increased by the mind numbing layers of federal and state regulation placed upon the medical and the insurance industry. What is needed is a depature from the traditional regulation of an insurance contract by the individual states, and a system of federalized insurance policies. Physicians, insurers, and the public should have to look at only one uniform system. In addition, this national system should allow for greater choice, such as medical savings accounts and high deductible policies which allow the consumer to pay $75 - $125 for an office visit, but also permits them place the money which would normally go to pay health care premiums which are not portable into a private tax deductible bank account. The consumer should also be free to shop for PPOs and other discount fee plans to pay for routine care.

If a patient only requires or only chooses to require minimal health care intervention - which is her right - then she should not have to go broke for paying for everyone else's care, but she should have the right to protect herself by saving for a rainy day, and only utilizing insurance to pay for those things which would otherwise leave her financially devestated.

Our current system of financing health care is morally bankrupt and woefully ineffective. It creates artificial markets and vast opportunities for waste and fraud. Huge amounts of money is pumped into healthcare from a variety of private and public sources, with little or no oversight other than fee scheduled which act as price controls. Indeed, one sees the rise in "unnecessary" testing as a means to act as an additional profit center for patient visits, particularly in areas involving automobile no fault insurance coverage, where a doctor may be paid only $115.00 to do make a patient perform a range of motion examaintion free standing in his office, but if he hooks his patient up to a machine, can charge several thousand dollars to the same insurance company.

The health care crisis is one which is not being resolved by through our current political system. The Democrat wants to socialize medicine to satify supporters with free health care, and to take care of various special interest groups. The Republican will cling to notions of federalism without acknowledging that the many innovative health care products which can be created through private sector means are frustrated by multiple levels of state and federal regulation.

Indeed, President Elect Obama has in the past been accused of borrowing speeches from Mr. Patrick. Lets hope that he does not borrow Mr. Patrick or Mrs. Clinton's views on healthcare.