PROBLEM: We are told by the World Health Organization that American health care is about number 40 in the world.
They base this largely on the fact that 39 or so countries provide “free” care. So Cuba has better health care than the U.S.A.?
Actually everyone in America has the best health care in the world. The problem is that some people don’t have health insurance. If you get sick and present yourself at a health care facility and you don’t have insurance or money you will still get the best health care in the world.
If you can’t afford your treatment, they will put you on Medicaid and the state taxpayers will pay for you.
SOLUTION: I have collaborated on the following solution to our “health care problem” with John Mackey the co-founder and CEO of Whole Foods Market Inc. and an avowed leftist.
The United States has the best health care on Earth. People come from all over the world for treatment here. There are problems but we do not need a two trillion dollar-a-year government take-over of one fifth of our economy.
The fact that 50 million Americans are without health insurance is used to justify the need for this massive government take over. You can buy a good health insurance plan for $1,200 to $2,000 per year. Two thousand times 50 million is $100 billion so we can insure all of the alleged uninsured for considerably less than the $2 trillion Obamacare is estimated to cost.
But the Census Bureau report “Income, Poverty, and Health Insurance Coverage in the United States: 2005,” puts the initial number of uninsured people living in the country at 46.577 million.
A closer look at that report reveals the Census data include 9.487 million people who are “not a citizen.”
Subtracting the 10 million non-Americans, the number of uninsured Americans falls to roughly 37 million.
But according to the same Census report, there are 8.3 million uninsured people who make between $50,000 and $74,999 per year and 8.74 million who make more than $75,000 a year. That’s roughly 17 million people who ought to be able to “afford” health insurance because they make substantially more than the median household income of about $50,000.
Subtracting non-citizens and those who can afford their own insurance but choose not to purchase it, about 20 million people are left – less than 7 percent of the population.
“Many Americans are uninsured by choice,” wrote Dr. David Gratzer in his book The Cure: How Capitalism Can Save American Health Care. Gratzer cited a study of the “nonpoor uninsured” from the California Healthcare Foundation. “Why the lack of insurance [among people who own homes and computers]? One clue is that 60 percent reported being in excellent health or very good health,” explained Gratzer.
We all have air-head friends who say they would rather pay for their motorcycles, mountain climbing and snow boarding trips. They know that if they break their neck, you and I will pay for their health care.
So what is the true extent of the uninsured “crisis?” The Kaiser Family Foundation, a liberal non-profit foundation frequently quoted by the media, puts the number of uninsured Americans who do not qualify for current government programs and make less than $50,000 a year between 13.9 million and 8.2 million. That is a much smaller figure than the media report. If we bought 14 million people $2000 health insurance policies it would only cost $28 billion.
It is worth noting, that, the Congressional Budget Office points out that “45 percent of the uninsured are going to have insurance within four months” because many are transitioning between jobs and most people get health insurance through their employers.
So now that we have reduced our crisis to between 4 and 7 million what shall we do?
Remember, these are people who have no health insurance not people who have no health care. Everyone in America has health care. Any medical doctor will attest that the best care is provided to those who have no health insurance!
To solve our health insurance ‘crisis” here is what we need to do:
1. Enact tort reform to end the ruinous lawsuits that force doctors to pay insurance costs of hundreds of thousands of dollars per year. These costs are passed back to us through much higher prices for health care. Establish a “loser pays” legal system. If you sue someone asking for $100 million and win, you get $100 million. If you lose, you pay $100 million. If you can’t pay, your lawyer has to pay. This will stop frivolous law suits brought by attorneys who expect to be paid on a contingency basis. They never settle for less than that required to pay their generous fees.
2. Remove the legal obstacles that slow the creation of high-deductible health insurance plans and health savings accounts.
3. Require individuals to be responsible for their health expenses. Require them to purchase health insurance. This is unconstitutional so amend the constitution. Pass an Individual Responsibility Amendment that says “Everyone in America is Responsible for providing for himself and his minor children. The combination of high-deductible health insurance and HSAs is one solution that could solve many of our health-care problems. For example, require an individual to put $1,200 per year in tax credit dollars and up to $15,000 more in tax deductible dollars into an HSA to spend as he chooses on his own health and wellness. The $1200 would be used to pay for mandatory critical care insurance so if a person breaks his neck skiing he is covered. When he dies anything that is in his H.S.A. goes to his heirs. If the individual is unwilling or unable to pay for his health insurance, his carrier would report it to the government and the government would lend him the money to pay for it. This would be a debt to the government. The government can withhold any tax refunds or other payments owed to the individual by the government to pay for this required basic plan. It can even use its extremely powerful and unique collection powers to collect this money. If you have never had the government come after money it thinks you owe it, ask someone who has. At some point most people get so tired of the government’s pit bull collectors and super-legal collection powers that they just give up and let the government have the money. Money in your H.S.A. not spent in one year rolls over to the next and grows over time. As money accrues in the account, your insurance deductible increases and your insurance premiums go down. The individual, therefore, spends his own health-care dollars until the annual deductible is covered and the insurance plan kicks in. This creates incentives to spend from your H.S.A. more carefully. The parents pay for their child until he is an adult then he pays for it himself. No one would ever have to shop for insurance. He can if he wants to but he shouldn’t cancel his current policy until his new policy is fully operational. Have a one-time open enrollment period in which an individual can pick a plan without regard to pre-existing conditions. There are no limits to coverage. All of a woman’s children are automatically enrolled in her plan for life. Make it illegal for an insurance company to drop a client. No matter what illness insured develops, if he has purchased the appropriate treatment the insurance company cannot drop him or refuse to pay.
4. Equalize the tax laws so that employer-provided health insurance and individually owned health insurance have the same tax benefits. Now employer health insurance benefits are fully tax deductible, but individual health insurance is not. Better yet get the employer out of health insurance altogether. Make health insurance, like auto insurance -- mandatory but shopped for by the insured. If an employer wants to offer a health care benefit he can fund the employee’s health savings account.
5. Health insurance should be portable. Repeal all state laws which prevent insurance companies from competing across state lines. We should all have the legal right to purchase health insurance from any insurance company in any state and we should be able to use that insurance wherever we want. Better yet use the “commerce clause” to forbid states from regulating insurance companies. The best regulator is a free market.
6. Repeal government mandates regarding what insurance companies must cover. These mandates have increased the cost of health insurance by billions of dollars. What is insured and what is not insured should be determined by individual customer preferences and not through special-interest lobbying. These last two changes will allow insurance companies to offer high deductible critical care, major medical care and accident insurance. Insurance that does not include routine doctor visits, treatment for minor illness, holistic medicine, alternative medicine, herbal medicine, acupuncture, spiritual healing, etc.
7. Make costs transparent so that consumers understand what health-care treatments cost. How many people know the total cost of their last doctor's visit and how that total breaks down? What other goods or services do we buy without knowing how much they will cost us?
8. Enact Medicare reform. We need to face up to the actuarial fact that Medicare is heading towards bankruptcy and enact reforms that create greater patient empowerment, choice and responsibility. With the combination of H.S.A.s and the insurance reforms we are discussing here our generation could be the last on Medicare.
Promoters of federal health-care takeover believe that people have an intrinsic right to health care — to equal access to doctors, medicines and hospitals. While we all empathize with those who are sick, how can we say that all people have more of an intrinsic right to health care than they have to food or shelter?
Health care is a service that we all need, but just like food and shelter, it is best provided through voluntary and mutually beneficial market exchanges. A careful reading of both the Declaration of Independence and the Constitution will not reveal any intrinsic right to health care, food or shelter. That's because there isn't any. This "right" has never existed.
Even in countries like Canada and the U.K., there is no intrinsic right to health care. Rather, citizens in these countries are told by government bureaucrats what health-care treatments they are eligible to receive and when they can receive them. All countries with socialized medicine ration health care by forcing their citizens to wait in lines to receive scarce treatments. Although Canada has a population smaller than California, 830,000 Canadians are currently waiting to be admitted to a hospital or to get treatment, according to a report in Investor's Business Daily. In England, the waiting list is 1.8 million.
With the changes above we can require every legal resident to purchase basic health insurance and allow people to choose the benefits they want to pay for.
Rather than increase government spending and control, we need to address the root causes of poor health. This begins with the realization that every American adult is responsible for his own health and the health of his children.
Many of our health-care problems are self-inflicted. Two-thirds of Americans are now overweight and one-third are obese. Most of the diseases that kill us and account for about 70% of all health-care spending — heart disease, cancer, stroke, diabetes and obesity—are mostly preventable through proper diet, exercise, not smoking, minimal alcohol consumption and other healthy lifestyle choices.
Actuarially people who practice these lifestyle choices should be required to pay higher premiums. Because of the high expense in medical care in the last two years of a geezer’s life, fatties, couch potatoes, smokers and drunks actually consume less health care money than those of us who are healthy.
Health-care reform is very important. Whatever reforms are enacted it is essential that they be based on individual responsibility, and that we have the freedom to choose doctors and the health-care services that best suit our own unique set of lifestyle choices. We are all responsible for our own lives and our own health. We should take that responsibility very seriously and use our freedom to make wise lifestyle choices that will protect our health. Doing so will enrich our lives and will help create a vibrant and sustainable American society.