Our nation’s healthcare system is broken. Do you ever wonder what happened to its simplicity of the past in which doctors made house calls, charged reasonable fees which most people paid directly, required very few forms to be filled out, and did not first need preauthorization to even treat you?
We have HMOs, PPOs, in-network, out-of-network, co-pays, co-insurance, deductibles, HSAs, “boutique” docs, and dozens of other code words to navigate to locate a healthcare provider and get them paid. And what can be most frustrating is when you have a hospital visit and some of the providers (radiology, anesthesiologists, ER docs) are out-of-network for your plan and you have no choice as to whether to use them and thus pay the higher patient contributions!
There is not enough space in this column to opine about whom or what I think is to blame for this mismanaged mess and, frankly, I would rather focus on the future than the past. But I have to mention my disappointment in government’s role during the past because with Barack Obama as President there is a good chance government’s role will become even bigger except for his recently announced plan to dump veteran care onto private insurers if a veteran is eligible for such care at their place of employment.
As the owner of a new small business, I am beginning the process of finding an appropriate group plan for my employees. It is not a pretty picture since we cannot benefit from the large risk pools that large employers use to their advantage in negotiating insurance fees. I have stated in the past, and I will say so again today, that small businesses should be able to pool their employee count with other small businesses nationwide through “association plans” to benefit from economies of scale. And we should be able to shop for a plan offered anywhere in the United States and not just from plans authorized by Tallahassee.
There is also legislative movement to give employees the option to take the value of their health insurance plan benefit and allow them to buy their own individual insurance. I strongly support such free market ideas. By having hundreds of millions of people with their “own” money to spend, affordable and innovative individual plans will be offered by insurance companies seeking the business. Such large pools of potential customers would also benefit those currently uninsured as the price of entry level policies will become more affordable for them. And the employers can get back to running their businesses.
But President Obama is considering taxing the value of any health insurance benefits provided to employees which are above a certain threshold. Such an intrusion of government into setting a reasonable threshold is akin to Uncle Sam dictating salaries. I am against such plans which will interfere with the privacy of an employer-employee relationship.
As for Medicare and Medicaid, I am against President Obama’s plans to study the possibility of determining what treatments should be offered to seniors and certain others based on their health and age. That should be kept private between a doctor and his patient. Would you want your parents refused care because the government says such an expense is not cost effective in terms of extending their lives?
Wednesday, April 01, 2009
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