mind over blather

1.  Detach health insurance from employment.  This is a necessary first step.  The system cannot be adequately reformed until healthcare can be considered on its own merits.

2.  Eliminate all state regulations over health insurance.  Make it totally transportable across state lines.  You should be able to buy the same health insurance – at the same rates – in any jurisdiction.  (Alternatively, provide a factual and rational analysis that conclusively proves New Jersey consumers should pay more for less coverage, sourced through fewer providers, than their counterparts in Pennsylvania.  Can’t do it?  This is simply another instance of gummint not being able to get out of its own way.  State regulation adds nothing of value or importance in this – and most other – matters of business and economics.)

3.  Redefine “group” as “two or more people”.  You and your kids are a group.  You and your siblings are a group.  Your kids’ school is a group.  The Boy Scouts are a group.  Your church or synagogue is a group.  Your Thursday night poker group is a group.  Your golf club is a group.  Group rates should be the only rates.

4.  Provide means-based health insurance vouchers to citizens (note the specific use of the word “citizen”) who fall below certain income thresholds.  Let’s face it, the thing the government does best is redistribute money and, fundamentally, that’s a central element of this issue – getting money for healthcare coverage from people who have it (the money) to those who need it.  No need to tart it up with a bunch of ideological nuances.

5.  Restructure Medicare so that it ONLY provides coverage to individuals who (a) have significant medical challenges or (b) have reached the lifetime maximum limit in their private coverage (this turns the “public option” into a health-related option, not an age- or income-related option).  People with significant chronic conditions – juvenile diabetes, autism, AIDS, cancer, etc. – should be covered by Medicare.  (Done right, this should also reduce or eliminate the unfunded deficit attributable to Medicare.)

6.  Allow prescription medications to be purchased from any source – not just domestic sources.  If Canadian pharmacies provide lower prices and better service, too bad for Rite Aid and Merck.  (This is called free market capitalism.  The drug companies should get used to it.)

7.  Do not allow health insurance providers to refuse or terminate coverage for any reason – but allow them to price coverage for smokers, drinkers, and others who engage in chronically risky behaviors at higher rates.

8.  Adopt the British tort system.  The medical care industry uses the threat of litigation – and high negligence insurance costs – as a crutch for unnecessary testing and higher rates.  Take the argument away from them – but in a way that cleans up litigation abuse conclusively and still provides access to the Courts for injured parties.

9.  Finally, attack the causes of disease.  Cancer does not appear spontaneously or randomly.  Obesity is not the result of a roll of the cosmic dice.  The things that are really driving up the costs of healthcare are related to larger issues that must be addressed.  The way we are polluting the air we breath and the water we drink.  An industrial food supply that fills our diets with toxic substances.  Tobacco and alcohol related illness represent a huge portion of our healthcare budget.  High fructose corn derivatives have invaded almost every food product we regularly consume.  Fossil fuels have enveloped us in atmospheres of carcinogens and filled our waterways and oceans with some of the most toxic and harmful chemicals imaginable.  It is simply ludicrous to spend more and more to treat the consequences without vigorously attacking the causes.