Peder D4

Discussion of politics and other odious things

Wednesday, December 02, 2009

How to Fix Healthcare

In all of the things that I've read about this subject over the past four or five months, this encapsulates well the few easy things that could be done to alter the rising scope of healthcare costs.


Blogger James Colby said...

I'm glad you posted this. It brings up some great points(although, on the left we talk about this stuff all the time)

In the first step about changing the tax code. I see nothing wrong with it, but it seems to do very little to solve the problem. They mentioned the problem of having health coverage linked to employment, and this is a real problem. True universal healthcare would of course, solve this, but I don't see how the tax code changes would do more than make a dent.

In the second step mentioned, you have to note that this change is an awful lot like the "marketplace" Obama is always talking about and Republicans have so vehemently opposed.

And step 3, health savings accounts seem like a good idea, but there is something similar right now, and based on how people save money these days, what is the reasoning that this would work?

And finally, the comparison of Lasik with other medical care seems specious at best. Lasik, cosmetic and other kinds of optional medical services can't be compared to the others. When you have a heart attack or stroke or violent accident, you don't have a lot of time to go shopping for price. And when you're child is diagnosed with pretty much anything serious, none of us should be put in a situation where we are pinching pennies. We all should be able to get the best care around, not just the Walton family.

These ideas aren't all bad, but the fella in the video who said it's just a start was dead on...just a start. If you conservatives want your ideas considered, Democrats are ready to listen, but we do have the majority so if you want your ideas in, you'll have to sign on to some of ours too. And that doesn't seem to be happening.

3:37 PM  
Blogger -Peder said...

James, all good questions, let me take them in order.
1) The tax code change would put the consumer back in the driver seat. Right now the real decisions are being made so far from the money that there is no market signal. Universal health coverage will only make this problem worse. And it has.
2) The public option that Obama has talked about will not provide actual marketplace competition. It will be run more by public outcry than by supply and demand. It will be backstopped by public funds. No matter how badly run, it will never be in danger of going out of business. That isn't marketplace competition.
3) I'm not sure about the buy in for health savings accounts. I know that 401k usage keeps getting higher. And I think that most people feel like they're double dipping with their HSA and their cover-all insurance plan.
4) Lasik doesn't compare with catastrophic situations. However, those are exactly the things that insurance should still be around to cover. If you disconnect the big stuff from the more everyday than insurance premiums will drop. If you put the lower urgency stuff (check-ups, routine natal care, routine medicines, long term sports injuries) on a competitive basis then you drop costs all around. This probably deserves it's own post.

You say that Dems are open to these ideas but I don't see it. There seems to be large agreement among Dems that universal healthcare is a goal in and of itself. Some of this is from a desire to push the profit motive out of the industry (misguided in my mind). Some of it comes from the idea that universal healthcare pushes the cost away, at least one mental step away into the more nebulous category of taxes.
James, you may be open to new ideas but I don't see that as widespread. I get your point about compromise too, but I'd really rather fix the darn thing rather than add in some things that will make it worse.

10:20 AM  
Blogger James Colby said...

I appreciate the answers, but I have to say, the tax code one is still something I've missed. I just don't see what they are trying to do.

The public option, we see differently. It is true competition, just like our local harware store competing with Wal-mart. It may not be fair competition, but the consumer does have a choice, and if the public option is run badly enough, people will choose private insurance.

The 4th topic is one that could be discussed more, see what people think. I don't like it, but that doesn't mean it won't work. Let me tell what I don't like about it... I hate shopping. I shop for electronics, Cable, cell phone plans, my car, my house, a good school for my kids, appliances, insurance of various kinds...I can go on and on, and frankly, I don't want to add medical treatments to that list. That's just me though, I'm sure I'd adjust if America wanted to go that way.

A related thought though, is that whenever changes are made to medical plans the most common concern I hear is "will I be able to see my own doctor?" This system certainly creates a complicated answer to that question.

Still, it's worth exploring.

1:28 PM  

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