Rich
& Others
Public awareness is often critical to this discussion
and is part of the reason insurance companies are so successful in maintaining
the status quo.
This is what I think should be done and would meet
the needs of the 98 % of the
population.
All medical expenses as currently classified as
deductible should be able paid by people out of pocket until they reach the
7.5% which is currently exempted under the tax code. Every individual or
their employer is they elect would pay $1.50 per the age of the person per
month into a public pool of dollars. For a family of four ages 38, 35, 12 and
10 total 95 x $1.50 = $142.50 month or $1,710.00 year. Once the 7.5% is
spent 100% of anything over that it is reimbursed dollar for dollar from the
pool. The 7.5 % applies to those over 65 but the $1.50 is absorbed by
the pool. ALL INSURANCE WOULD BE ELIMINATED. Government price
controls "could be" used or price enforced under the
existing Robinson-Patman law.
I welcome others to run the
numbers
Paul Double
I've
been asked who should pay for health insurance if it's not the employer.
Dwayne and Phil both are convinced it should be a government run single payer
system. Their arguments are convincing to me. I would support such a system.
However, I'm not convinced that you can bring such a system to reality. In my
opinion, Americans (for good or bad) are loath to put the federal government
in charge of aspects of their day to day life. Imagine for a moment, you call
the IRS for a health insurance question. I know it's not a fair analogy, but
it is the way some people think (again, this is my
opinion).
While I'm breaking the rule that says you should never write a letter
like this late at night (I'm never as clever and witty as I think I am) I'm
going to give it a shot.
Assuming Dwayne and Phil are unsuccessful at bringing about a move to a
national health care system I would propose the following:
1)
Think only in terms of the State of Minnesota
2)
Think in terms of making Insurance Companies play by rules that would 'mimic
the rules we would use in a single payer system'.
What
does this mean?
Well, besides the evil profit motive of insurance companies (sarcasm
intended since I'm sensitive to the word profit being equated with evil) there
are a few things that strike me as reasonable reasons that health insurance
premiums vary significantly from person to person or business to
business.
1)
Pools and Cherry Picking: If you're a small employer with one or two employees
with significant health issues, your premiums are going to be different from
employers who have huge numbers of employees and 'on average' aren't as high a
risk factor. Throw in the fact that self-insured people who have little in the
way of 'health issues' are able to get insurance much more easily (or less
expensively) than an individual who is seeking insurance but has a history of
health problems.
2)
Many healthy people are not in the insurance pools. I would suspect this
happens because of two primary reasons.
2a) I'm young and healthy and I have better things to
spend my money on.
-or-
2b) I'm wealthy enough that I don't need
insurance.
How
would I 'regulate' insurance companies to deal with this?
1)
First and foremost, I would eliminate the issue of 'which pool are you in'?.
If I was King for a day and could decree only one absolute law, it would be
that insurance companies had to look at Minnesota as one and only one pool. If
you are a resident of Minnesota, you are a member of that pool. Add to that
the requirement that you could NOT be denied insurance because of a
pre-existing condition. If you live in Minnesota, you can get insurance and it
doesn't matter where you work or what your health history
is.
2)This is going to be the part that will kill my plan but, .... treat
health insurance in the same way we treat auto insurance. If you have an auto,
you are required by law to have insurance. In my opinion, if you have a 'body
and you're alive' you should be required to have health insurance. This will
keep all the people that think they can stay out of the equation while they
are young and healthy (or wealthy enough to avoid insurance) from diluting the
pool of healthy individuals.
Please note that neither of the above points preclude insurance being
provided by your employer. While I'd rather not pretend that it makes
sense for me to be an integral part of the health care system, at least
level the playing field.
Oh,
if it isn't already obvious, the state of Minnesota would have to play a role
in providing the health insurance premiums for those who could not afford
them. And, the state of Minnesota may have to address the 'Minimum Wage Laws'
if we expect people to buy their own insurance. Of coarse, if people would
prefer, we can continue to require businesses to provide this
benefit. I'm expecting then that the day will come where I'll be required
to buy my employees their groceries.
So
much for my late night dissertations. Good night all.
Rich
Pflughoeft
