The month of July is over, and the various other shoes have not yet dropped. No vote, yet, on health care reform in Washington. The bloviators have started telling us family docs that we're going to make more, and the big bad specialists are going to make less. Translation: We'll make less, and they'll make a lot less.
Our various medical societies are signing onto reform with the illusion that they can help shape the legislation by helping to pass it. If history is a faithful guide, then the politicians will use that support until it is too late to reverse the votes, and will then slice those who help them into tiny bits. We never seem to learn.
I have a reform idea in four parts:
1) Make group insurance illegal. The whole concept of employer-based insurance skews the risk in insurance such that it cannot make sense for the whole populace.
2) Use community pricing. By setting fees and prices for insurance locally, there will be local control and local factors that cannot be managed efficiently from Washington.
3) No refusal for pre-existing conditions. This must be done in order to cover the whole public, but it must be combined with:
4) Mandatory purchase. Everyone must buy insurance, no matter what their situation or reasons for not wanting to do so. This spreads the risk over the whole public, not just those who are healthy enough to buy private insurance.
If my program were adopted, it would require no new government programs, other than using part of the IRS to monitor insurance purchase, and possibly a system to help those who really, really can't afford the insurance. Maybe their 'earned income credit' could go to insurers instead of to the individual, to buy a catastrophic coverage insurance at low cost.
Anyhow, I don't have any illusions that reasonable change will occur. Such is my faith in the United States Congress.
Be well, and stay cool....
Friday, July 31, 2009
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