You are 100% correct. That is why THE health care changes I believe need to be made are in a book that is NOT getting attention probably because NO special interest COULD make money if the changes were implemented. It creates a true free market--and you correctly pointed out what happens when that occurs.
The author has a LOT of good, documented info on health care, and has changes that could easily be implemented NOW with the BS system we have and improve it.
However, her real strength is her proposal for a new way to do things. She states that the federal government does NOT have the jurisdiction to offer things like Medicare, BUT being a logical woman, recognizes that what is, is and is not going to change overnight. So she has a proposal that could be used either as a transition (she figures about 30 years) from government to private industry OR at least a self-supporting government system.
Because of a recent news article showing the current system is impotent against large insurers (http://www.newsmax.com/medicine_men/medical_insurance/2008/01/03/61543.html) which are robbing us blind, I took the time this morning to sit down to right some politicians AGAIN about this plan and I'm just going to paste down some of what I shared with them because I'm tired of typing, but SOMEONE has to try to do something:
To summarize the sensible plan again, which should be reviewed here (and it is the PDF, NOT the blurb): http://www.booklocker.com/books/3068.html
It offers ALL Americans a catastrophic health care package for an AFFORDABLE price.
Key points:
ALL Americans are eligible (and yes, there would be the traditional breakdowns into categories by age, sex, medical condition so that accurate premiums could be offered).
It is a CHOICE, not mandated with scare tactics and punishment—right now the UNINSURABLE are screwed again with things like “Must have insurance or we’ll fine you.” How about making a legit plan available to all before dumping on the victim again?
Catastrophic health care package is ALL that ANYONE NEEDS. The actual purpose of insurance is to share risk so you avoid bankruptcy. This is NOT done at all these days. First, over half of all bankruptcies are for medical bills and most of those folks were insured. Thus the current system clearly does NOT work. Second, this stupid “if you’ve got a nice policy and a sniffle, stop by the doc’s and others will pay for it” runs up medical costs for NO good reason at all. Resources are wasted every day. IF people had to pay for their tendency towards hypochondria or refusal to follow basic sensible provisions, they’d be more likely to change their behavior.
AFFORDABLE is key. Insurance is NOT now affordable and the UHC story helps shed light on why that is. This plan would use a sliding-scale for the premium AND the co-pays so that those who really are not making much money (be they students or folks just starting out in the work force or the retired or disabled) would not pay more than they can afford. There would be a REAL limit on out-of-pocket NECESSARY medical expenditures as well.
Other key plan points:
There would be one physical with follow-up visit per year as well as one ER visit IF NEEDED (how to prevent ER abuse is covered) for reasonable co-pays.
The point here:
Prevention is ALWAYS cheaper than waiting for a problem to develop. It is also the moral approach to medical care. By getting folks in annually we’d be able to save a lot of lives and improve peoples’ productivity. We could also review meds (or if they’re needed), keep people immunized appropriately, answer questions about nutrition and more, and have a baseline of info should the person be in an accident or fall ill. Again, with a reasonable co-pay, there is now NO good reason for folks not to see the doctor. The follow-up makes sense for anyone who HAS a medical issue. If someone came through with flying colors, he would not even need to use that follow-up. Not everyone needs the ER, but it would be sensible IF needed to not leave people SOL. This logical plan would address ALL the legitimate needs of probably 80% of the population.
Another key plan point:
Necessary medications are covered as well as NO caps on necessary medical treatments.
Right now, we have BS like the “donut hole” of Medicare. This would be eliminated as would all fertility treatments, ED med coverage, and anything else which is not NECESSARY. This does not prevent people from receiving treatment for such things—let them find an insurance plan (this plan doesn’t stop others from being offered) or pay for it themselves, but there is no justification to make the taxpayer help someone have kids or sex. There is a reasonable reason for people on insurance to help those with cancer, strokes, heart disease, diabetes, etc. as this is far beyond a quality of life issue and goes to the heart of life and death. This is the same rationale for ending caps on legitimate procedures, like bone marrow transplants, which are quite expensive. Too often now a plan lies and claims something is covered, but by shunting off $25-250K on the patient to pay, that’s NOT a covered item in a rational person’s book.
Funding then becomes the issue and we’re taken care of here. First, we eliminate all these bogus government offered plans—from Medicare to SCHIP to Medicaid. (IHS is a separate issue and if folks want to keep it, they can. Ditto VA which is also a special deal considering the substantial number of vets who have medical issues the civilian population is NOT used to seeing or dealing with. Funding for both of the programs should be increased and, of course, every Indian and vet who wants this program is more than welcome to be covered by it as well. We’re not going to exclude folks, but two groups get an option for another program.) All the rest of the existing program funds go into the pool. Then every single “charity” designation for every hospital is removed and the taxes those providers now pay will be divided up so that the local taxes go into the local tax pool (got to keep 911 up and running and roads people can get to the hospital on). The state taxes will go into the state’s med pool account and the fed taxes will go into the med pool that helps re-allocate funds to the states, just as they receive things like Medicare block funds now. IF there is a shortfall (and if the other suggestions in the large chapter on health care are followed, there should NOT be), then some funds from the general taxes will have to supplement it because the taxpayer will STILL be better off. How? We’re reducing the number of bankruptcies, which costs the public funds. We’re reducing welfare rolls as people should be more productive when they’re healthier. We should reduce the number of folks on disability as if you can get proper med treatment your whole life you will reduce the number of people who can’t work. We end the issue of free care to illegals (that’s in the immigration chapter of the book). That is NOT a legitimate medical expense to be born under this plan (and how to reduce illegal immigration is dealt with as well as stopping “compassionate entry” at the state taxpayer’s expense. That’s a federal choice and that should come out of FOREIGN AID if people are going to continue to support that stupid policy.) People are paying premiums and co-pays. We are now being logical and negotiating prescription med prices. We are ending the illegal subsidies and protections for the large insurers (they can offer policies, but they’re going to have to start delivering the goods in a cost-effective manner instead of screwing the public, patients, and doctors and skimming off multi-millions for their fat cat lifestyles by abusing contract law principles, not paying their fair share in taxes (see Meidinger’s testimony), and being unfairly gifted with the bogus ERISA shield (see Jamie Cort’s book “HMOs: Making a Killing.”) When people are paid fairly and on-time and paperwork is reduced and a lot of BS regulations are dispensed with, costs will drop.