My Healthcare Reform Ideas

Read THIS ARTICLE from the NYT’s Nicholas Kristof.

Many features of healthcare should function as a “public” service…like fire protection or police. Few would argue that trauma care or truly emergent care, like a heart attack or stroke, should be denied to anyone, regardless of ability to pay. So, why not fund it publicly and organize it publicly alongside “traditional” American medical care. Why must we pursue an “all or nothing” approach? Some of healthcare should be thought of as a public good, but some of it should be thought of as a consumer good. But, do it at the most local level possible, not Federal, like we do police and fire.

However, if you want your own private policeman, then you should pay for it. Few would argue this point, but why do we think that everyone is entitled AS A PUBLIC GOOD to their own personal physician. We all want our own docs and we should pay for this as a consumer good. If you pay your PCP monthly and directly, say $30-$40 a month (which your Internist would LOVE to get), then you can have your own personal policeman of sorts. Almost nobody in America would be unable to pay that. Hell, a pack of cigarettes a day or a cellphone is more than that.

Get rid of the bizarre tax code treatment of medical costs–rewarding your employer for paying it but not the individual who takes the initiative to cover their own costs…strange policy. Its just a holdover from special treatment during WWII when the govt forced wage and price freezes on employers.

Also, few of us would argue the value of pooling the risks of catastrophic costs in medicine. We do this without a thought in other areas. Travel to the Gulf Coast and rent a beach condo…this is hurricane country folks. The insurance on these condos has a cap for the commercial insurers. If losses exceed the cap (a disaster) then the government steps in to fund the catastrophic costs. Few people argue the value of this. Without this arrangement, then very few of us could afford the rent in these areas, so very few of us (except the extremely wealthy) could enjoy a sunset over the Gulf.

Why not do the same for healthcare? Have State governments set up statewide risk pools for catastrophic costs…say above $200k per year for any person…above which your Blue Cross insurance would seek reimbursement.

With these common sense “reforms”, the premium for your health care would more resemble your car insurance premium as opposed to your mortgage payment.

Just some thoughts.