Tag Archives: alternatives

how about behavior reform?

When I started this blog, I wanted to keep personal details out of it. Mostly so if random people happened to find it, they wouldn’t discount my opinions because of my background or experiences. But, let’s be honest: who we are shapes our opinions, world views, understanding and expectations. Right? So, if readers choose to discount my perspective because of any personal details I happen to share, I didn’t want them here anyway!

In 2007 I was working, my husband was in school, and our insurance was provided through my employer. Then I had a baby and chose not to return to work. But because we needed insurance for some medical issues, we chose to pay COBRA for the next 6 or 8 months. COBRA cost us around $850/month, as much as the rent on our apartment.

During that time, I needed to have a small procedure done. It came up just as we were considering ending our COBRA coverage, so we figured we’d see which was the more economical option: pay the $850 for another month of coverage or pay for the procedure in cash. I asked my doctor what the procedure would cost. She had no idea. I asked the front desk people what it would cost, they had no idea. I asked the billing people and all they could tell me was, “Oh honey, it’d cost a few thousand dollars at best.” No one could give me an exact figure. So, we paid for another month of COBRA.

But it’s hit me lately that, as consumers, it’s almost impossible for us to operate within the healthcare market the same way we operate within other markets. My husband, for example, is a huge deal hunter. He researches, he studies, he shops around, he gets the best deal he can find. I don’t think we pay full price for much of anything, and it’s great to be able to choose how we spend our money on the items we want or need.

With our healthcare, however, we don’t even question the cost. Why? Because “our insurance covers it.” Someone else is paying for it. We’ve even adopted the attitude that, “Well, I probably could just wait out this cold, but shoot, it’s only $5 to see the doctor, I might as well go in.” What does that doctor visit really cost? Who knows? $100? $10? If the healthcare market actually functioned like every other market in this country, I’d call around and see which doctor had the best rates (combined with the best quality of service) before going in and spending my money on a visit.

Before we blow trillions of dollars on sweeping healthcare reform, why don’t we focus on behavior reform? If consumers could understand comparison shopping and financial accountability, they’d force the market to become competitive, all without government involvement or mandates. How to achieve this, I have no idea, but letting the credit market crash would’ve been a good start.

This video demonstrates my point exactly! And I appreciate how he clarifies that insurance initially existed to cover huge expenses like cancer treatment, catastrophic emergencies, etc., not routine, day-to-day care. Can’t we get back to that way of thinking?


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Alternate ideas

Like I mentioned earlier, I’m not opposed to changing the healthcare system, I’m just opposed to the kind of change that results in government-run options and the step-by-step destruction of the American marketplace.

This article presents some great alternatives to the sweeping, competing bills being presented in the House. In short:

  • Remove the legal obstacles that slow the creation of high-deductible health insurance plans and health savings accounts (HSAs).
  • Equalize the tax laws so that employer-provided health insurance and individually owned health insurance have the same tax benefits.
  • Repeal all state laws which prevent insurance companies from competing across state lines.
  • Repeal government mandates regarding what insurance companies must cover.
  • Enact tort reform to end the ruinous lawsuits that force doctors to pay insurance costs of hundreds of thousands of dollars per year. [FYI: Doctors MUST pursue payment from their patients. If they don’t, the IRS comes after them. Lawyers, coincidentally, not only have the option to take on pro bono work but they can deduct it from their taxes based on what they would have charged! So sure, your malpractice attorney “won’t get paid if you don’t get paid” but he’ll still deduct it from his taxes; and your doctor’s malpractice insurance just doubled. Thanks, Justice.]
  • Make costs transparent so that consumers understand what health-care treatments cost.
  • Enact Medicare reform.
  • Finally, revise tax forms to make it easier for individuals to make a voluntary, tax-deductible donation to help the millions of people who have no insurance and aren’t covered by Medicare, Medicaid or the State Children’s Health Insurance Program.

Just because people don’t agree with ObamaCare doesn’t mean they’re totally happy with the status quo. But lawmakers don’t seem to even step back from a government option in favor of true reform to the system–reform ideas like those presented above. Instead, they want to initiate a plan that will ultimately evolve into a single-payer system (no matter what Obama says, take a look at the math) and put the government in charge of your health.

Let’s look at options that take the existing system and improve it instead of throwing it out the window and putting a different, broken system in place.

I, personally, don’t even think this debate is that critical. (Gasp.) Sure, Congress and the media and the President keep throwing around that infamous number of uninsured Americans that need coverage now! What’s it up to today, 50 million? I’ve been digging around to find a breakdown of those 50 million people and the reasons they’re uninsured. I mean, hello, they’re the reason for this whole mess right? (Well, and a power-hungry administration, but that’s another post.) The most concise information I could find breaks it down as follows:

According to the US Census Bureau, 17 million of those without health insurance live in households having over $50,000 in annual income. That’s 38% of the uninsured in America.(2)

In fact, 9 million – 20% of the uninsured – reside in households pulling down more than $75K a year. (3)

And then there are the young invincibles. Over 18 million of the uninsured are people between the ages of 18 and 34. (4) They spend more than four times as much on alcohol, tobacco, entertainment and dining out as they do for out-of-pocket spending on health care.(5) They represent 40% of the uninsured in America.

14 million people without health insurance are eligible for government health care programs like Medicaid and S-CHIP but choose not to enroll. (7) They represent %31 – nearly one third – of the uninsured in America.

The U.S. has 12 million illegal immigrants who don’t buy health insurance but still get health care.

So, how many are truly uninsured? Around eight million. Just 18% of the 45 million that we hear about so often.

This data is based on 2007 Census info and other sources, but 8 million Americans equals out to about 3% of the population. Is it worth destroying our economic infrastructure to provide coverage to 3% of the population? Or is it worth it to examine alternate improvements to the existing system to provide that access?


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