Perhaps the most hopeful thing coming from the Supreme Court arguments on the Affordable Health Care Act was found in a New York Times editorial this morning written by Adam Liptak (Appealing to Justice Kennedy's Idea of Liberty). In it he discussed Justice Kennedy's unique perspective of what liberty is. He pointed to Kennedy votes upholding abortion, but also to votes to uphold restrictions on abortion. In other words, he looks for compromise and the middle ground.
At issue is the Individual Mandate. Mr Liptak pinpointed the central exchange in the entire three day hearing. The Solicitor General pointed out that liberty must include the ability to get affordable treatment for serious diseases. Justice Kennedy then stated that young people without insurance "uniquely" effect the price of insurance that everyone else has to pay. And the opponents to the Act stated what kind of liberty forces people to buy insurance then bans the very insurance they need the most...catastrophic insurance.
Therein lies the Achilles heel of the Affordable Health Care Act. In classic progressive overreach, Obama, Pelosi and friends decided everybody should have a Cadillac policy that covers everything. Birth control pills and abortions are the most visible and obvious culprit of this overreach; but there are lots of other expensive goodies that King Obama and Queen Sebelius have decided should be in there.
So in the heat of the final debate, have the players in the Supreme Court high drama stumbled upon the truth? If you want to drive down the cost of health care, then people need to pay the bills themselves. They will seek out the best and cheapest care. There is some point when that becomes impractical. That's when you need catastrophic insurance...a car accident, a serious illness like cancer.
It is catastrophic insurance that should be the center of the health care debate; not these budget busting government mandates that no one can afford. What is the minimum needed to achieve the stated objective making it attractive to those who have willingly opted out of the system to buy insurance? More importantly, it should be affordable and available to those squeezed out of the system....those in their mid 50's and over and those with pre-existing conditions. So here might be a possible framework to a solution:
1) Insurance companies should be required to provide catastrophic insurance covering illnesses whose expenses exceed $10,000.00 the first year, with a $3,000.00 deductible every year thereafter for the same illness. It should include prescriptions. The government can state what it covers and what it doesn't with the assumption this is a CATASTROPHIC policy only with a sufficiency test of reasonableness.
2) These policies shall be offered to anyone who wants them, with a health savings account attached to it if desired by the purchaser, who can contribute, tax free, up to $3,000.00/year to be used against future deductibles.
3) Subject to reasonable government regulation and approval, the insurance companies may set their own prices for these policies and may compete in the open market across state lines.
4) A payroll tax will be charged to all Americans, with an equal tax credit deducted against their income taxes if they have a health care policy equal to or better than the above mentioned catastrophic policies through their employer or through individual private purchase.
5) If an individual is not insured, the health care payroll tax is not deductible, and placed in a fund to which health care providers can make claims for treating those without insurance.
6) The government should provide tax incentives to stores like Wal Mart or Walgreens to operate fee for service clinics to handle mundane medical matters through nurse practitioners and provide these providers with substantial protection from malpractice claims.
7) Provisions should be made to expand Medicaid to cover those who are not otherwise covered and meet minimal financial requirements.
I believe that this type of approach maximizes incentives to buy insurance, taxes those who don't, provides alternate medical treatment centers to emergency rooms for routine medical matters, provides for savings for future expenses, balances those with pre-existing conditions against those young folks paying into the system but not using it much, and allows price competition in the market in the market place.
If anyone can figure out how I can get this to someone who counts, let me know.
No comments:
Post a Comment