Thoughts on U.S. Health Care

I’m coming out of the closet regarding health care. I’m not an expert in health care, other than being a consumer who pays attention. However, I feel some crucial common-sense issues are being ignored.

1. Taking single-payer off the table. Whether you like the concept of single-payer or not, the redesign of a system should not begin by removing potential solutions from the discussion table before debating their benefits & drawbacks. It is certainly true that a massive replacement of our health care / health insurance system would have vast implications. However, whether or not you like single-payer, removal of potential solutions before analysis is simply a poor way to start a redesign process. It seems they have a result in mind before starting the analysis process. Besides, the entrenchment of such an existing system leads to a culture of entitlement.

2. Culture of entitlement. Yes! This phrase is more commonly used to derogatorily describe the personal welfare system. However, to claim that a company, or an industry, must continue to exist regardless of market conditions is to create a culture of entitlement. No company or industry has the inherent right to exist; they must succeed on their own merits. If the market for health insurance vanishes, then health insurance companies must find another way to provide value to their customers. If you think that long-established markets should remain relatively static and reliable, consider the fate of the U.S. manufacturing industry.

McCain urged them he would fight for health care reform but reiterated his opposition to President Barack Obama‘s plan to create a government option to compete with private insurers, arguing that it would be the eventual end of private insurers in the U.S. (http://news.yahoo.com/s/ap/20090827/ap_on_go_co/us_health_care_mccain, Par. 7.)

I disagree with Senator McCain on the premise that private insurers have an innate right to exist. They have the right to fight for their existence in the market. And they might face a new competitor in a government-controlled public option.

3. The government cannot do as well as private industry. Now, I’m not saying the government would do a great job, but this claim has paradoxical implications. If people are convinced the government will do a horrible job, why are people concerned that private industry will not be able to compete effectively? After all, private industry has shown remarkable adaptability. If the government system proves to be inept, private alternatives will arise in the free market.

4. Free Market. I have often heard we should let the free market decide the most effective way to provide health care. I disagree. The existing “free” market is broken and deeply flawed, and is distorted by well-funded lobbyists. It is erroneous to say that success in the market as it currently exists can decide anything, since any result would be as distorted as the market. The market as it stands is not free.

5. Flaws of an Employer-based system. Regardless of the current or future health care system, an employer-based health care system has inherent flaws. The most obvious flaw is the impact of job loss. When the loss of insurance accompanies the loss of a job, the newly jobless must find not only a new job, but also obtain health care during their job search, and they must also be concerned with avoiding the creation of new “pre-existing conditions” that can interfere with future attempts to obtain health care. And this is not even considering the impact upon employers.

Each employer must individually negotiate terms with the insurance carriers, and bear the associated overhead. This puts our employers at a disadvantage against businesses from other countries. Since the rates are negotiable, it also puts small business with a small pool of participants at a disadvantage against large businesses. Further, it gives businesses the ability to price their insurance artificially high, thus becoming a de-facto exclusion of employees from the company insurance plan.

Additionally, employer-based health insurance is tax-free while privately-obtained health insurance is taxed. I don’t know whether I should call this annoying, frustrating, or just ridiculous. As someone who carries private health insurance, I just can’t understand how this policy exists. Perhaps I don’t understand tax law (who does, really?) but I’m puzzled over this. If a person relinquishes their company’s health care subsidy to seek different care, why should that person’s payments, coming out of the same paycheck, become taxed?

6. Health care has already failed. It is irrelevant how people feel about the socialized systems of other countries. The U.S. pays insanely more per person than any other nation, and the last I heard we’re around 37th in  the UN’s health care quality rankings, and 50th in longevity. US citizens are receiving horribly inefficient care. So, I must ask: why be so concerned about weaknesses of other systems when our current system is so shockingly broken? We have 50 states, each of which could independently try out various health care systems & concepts. Let’s find a model that works for the U.S., and commit to it!

I’ve heard- I believe from Glenn Beck- I the argument that our health care system is the best in the world; so great, in fact, that the Prime Minister of Australia comes here for care. Well, that’s fine, but it’s a red herring. The purpose of the US health care system is to provide health care to US citizens. If a non-citizen wants to take advantage of our system, that’s cool but irrelevant. I’ll touch on resident aliens later.

7. Insurance is not health care. Insurance pays for health care, among other things. Having insurance is not the same as having health care. My family has expensive insurance that provides poor health care, so we must treat it as catastrophic health care insurance. I heard an interesting analogy to car insurance. You don’t use your car insurance when you get an oil change, so why do you use your health insurance when you get a checkup? It seems to me that the insurance companies are getting quite a good deal out of the current system.

Further, addressing the areas of (1) Health care and (2) Health insurance does not go far enough to solve the problem. Some commonly related areas must also be addressed.  Some of these areas are (3) Pharmaceutical interests, (4) Lawsuit settlements for ridiculous amounts, and (5) Malpractice insurance of similarly ridiculous amounts.

A basic problem exists if the government focuses on health insurance as a solution. I don’t need health insurance for my family. I need health care. If I have a guarantee that my family’s health care needs will be met, then I do not need health insurance at all. For example, anyone on Medicare can reasonably survive without health insurance– although Medicare has troubles of its own.

8. Medicare has long-term structural problems. (This thought ties into social security, the other U.S. retirement “safety net”- which is similarly broken.) While I value the benefit of Medicare, it is well-known to be a system that is becoming increasingly broken as the U.S. population ages. Fixes to Medicare don’t come easy. To avoid losing popularity and votes, politicians cringe from making alterations to the Medicare system.

The time has come to take some political risks. When I was a boy, retirement age was 65. Period. Now, we are forcing our younger workers to retire later. Well, come on now, how fair is it to ask the young to bear more of our burden, especially when they’ll be forced to bear it during their later years? I call Shenanigans! Just because I am X years old, why should I be required to work for years longer than someone X+30 years old? I’d agree, it’s a grim thought  to ask today’s 65-year-olds to delay their retirement. But I’ll tell you what- when I’m 65 and facing another 3, or 5, or even 10 more years of work before retirement, I’ll be just as old as today’s 65-year-olds. You know them, they’re the ones we wouldn’t dream of asking to work a few more years. But we’re asking the young to do just that.

Besides, the extension of retirement ages is a short-term patch, not a fix. Since the Great Recession already eliminated everyone’s savings and adjusted their retirement plans, maybe we could just raise the retirement age now and let everyone contribute several years of extra productivity before retirement. Not to mention the benefit from the related additional income for their Great Nest Eggs, and even retaining their non-Medicare health insurance.

There remains one more point I must make before bringing this to a close. I said I would discuss the issue of resident aliens. And what I really mean is, illegal immigrants. The legal resident aliens should be entitled to care identical to that of a US citizen, whether they are actually planning to immigrate or simply living in the US temporarily. Illegal immigrants, and also people with no insurance, take advantage of our mandate that Emergency Rooms must care for anyone upon arrival. Such care is insanely expensive and wasteful, and the costs must be paid by other (legitimate) users of the system. This policy shifts and hides the true operating costs of Emergency Rooms and unfairly burdens other payers.

How could this problem be addressed without eliminating emergency-level or around-the-clock admittance? The basic assumptions can be changed. My favorite proposal is to expand our existing structure of specialist facilities by providing new admittance points, allowing for non-emergency care to be handled at non-emergency costs. The new admittance points would supplement our existing emergency rooms, and would mirror the current hospital transfer system. It is common practice to transfer patients from one hospital to another when the admitting hospital cannot provide the necessary care. Similarly, we could open multi-tier care systems to handle initial admittance and triage. If a patient needs antibiotics or a bandage, they can be handled on the spot. If they need emergency care, their case can be escalated and they can be transferred to an appropriate facility. Restructuring the concept of Emergency Rooms can help to resolve the problem. (Note that this concept does not necessitate the construction of new facilities. Existing buildings could be used, particularly clinics or sections of hospitals that normally close at 5:00 p.m.)

There. Now I’m out of the closet on health care. I have little faith that a solid system can be produced via the huge amounts of lobbyist money and the ridiculous political grandstanding from both sides of the aisle. I can’t wait to see the mess which comes out of Washington, but I am still hopeful for improvement.This is near silent focussing and 1:1magnificant as cialis 5 mg close as 19cm which makes it robust lens perfect for high-resolution closeups of the natural world, but its strong imaging potential is excellent wherever you shoot. Buy Extenze Male Enhancement Glucolo herbal pills for controlling diabetes have become quite popular in recent years robertrobb.com cheap cialis because of its effective results. Consequently, the man will be able to attain strong erection of their penile region & thus, this is the main cause for the problems of erectile dysfunction. levitra from canada has been a main ingredient of levitra and is essentially used to treat male impotence or erectile dysfunction is not only frustrating your sexual partner but also to increase sexual libido in men and women. During the primary stage, the condition can be relieved through medication and treatment methods that relieve the painful symptoms. generic levitra robertrobb.com