Thursday, June 25, 2009

Health Care Debate

I watched the President dominate the ABC health care infomercial last night. It was predictable. He took some softball questions, and some that made him struggle to articulate the same answers into the query at hand, but there was no real debate about it. There were also the sob stories, and hypothetical questions that seemed chosen for effect, not to truly debate the issues.

But that is not the point of this post. My point is to ask the questions, and consider things I think real people will be really interested in hearing about. Here they are:

1. What about those who have no health care coverage by choice?
2. What about Tort Reform, in at least two aspects: limiting pain and suffering awards, and "loser pays"?
3. What about illegal aliens and making sure they are not a cost burden?
4. Why does Government intervention have to cost so much?
5. Will the Health care plan work any better than the Stimulus plan, and the natural follow up: why not wait to see how the stimulus plan works first?

That something needs to be done is not really a question. There needs to be some changes, but that does not mean that the program sought by the President and the Democrats is the only way to fix it. We also need to consider our budget as we go. I think that until the budget is balanced, we should not have a government program for health care that costs billions, and certainly not trillions of tax payer dollars. There are some simple things the government can do to dramatically improve the quality of health care, reduce cost, and increase coverage, which would cost relatively little. Before I get into that, however, let me acknowledge the points where the President and I agree. They are few.
1. Portability. We agree that a person's health care plan should be portable, meaning that if an employee leaves their job, they should be able to remain in their health insurance plan. This is something that the Congress can legislate into legality without spending even millions of dollars. With 56% of Americans in employer provided health insurance plans, this would be the single largest step to allowing them to keep their coverage. I have lost mine a few times after leaving an employer, and it was painful.
2. Pre-existing conditions: no exclusions for them. People will in many cases have pre-existing conditions, and that should not be a discriminator against allowing a person who joins a business or other pool to join a health care insurance plan.
3. Health care IT. To stream line storage and retrieval of records would greatly improve health care provided, though I think it would be good for the government to do studies on it, and give tax breaks for the transition to it, rather than for the government to run it. Other countries are using this type of system already, and if the results of their practical experience could be studied with government grant money, an optimal system for our country could be recommended and supported.

Here's what we could probably get passed this year with bi-partisan agreement, and with little cost to the government:
1. Tort reform to limit awards for "pain & suffering", at some reasonable level, such as $1 million. This is not to be confused with allowing suits to recover lost income, medical costs, and other impacts related to medical malpractice. Those types of awards will help keep doctors honest.
2. Tort reform to make the loser pay. In simple terms, this means if a frivolous lawsuit is brought, the loser pays the legal fees of the team that had to fight it (as well as their own). This would reduce lawsuits to those that have basis in fact.
3. Change the law to allow people to keep their health insurance when they leave their job.
4. Change the law to make health care insurance a deductible thing for individuals, and make employers give the total amount of money they would be paying for health care insurance to the employees. That would make the costs obvious, and the choice the consumer's.
5. Start studies on health care IT around the world, and the available technologies.

More later. I have to go earn my health care coverage.