Health Care for All (in a way that would work)

04/15/10 by AX.

The current health care law has unconstitutional mandates for compelling individuals to purchase health insurance from private companies. Although in past entries we have suggested that it may be a good idea have citizens show in some way that they have some means of providing for their own health care costs, that idea always had problems. While the very wealthy may be able to show complete self insurability; determining where to set the bar of minimum level coverage is problematic. Additionally, the current law forbids exclusion for pre-existing conditions, but the penalty for failing to have insurance is less than almost any policy. Buying insurance on the way to the hospital isn’t insurance, it’s cost shifting. Shifting from you to someone else. All this does is make insurance companies nonviable.

There is a much better and simpler way to ensure that everyone has a level of health care available to them that is reasonable. Setting up government health care facilities that are open to the public and only provide a predetermined level of care. Because anyone that makes it to the door is treated, we would indeed have universal coverage. The level of treatment would be limited in several aspects. Elective cosmetic procedures would not provided at these facilities. Only cosmetic surgeries that are medically necessary would be covered. Three or four patients per room would be the norm. The hospitals and clinics would be largely self regulating in the level of treatment because of budgets. The budgets would hold at reasonable levels in much the same way welfare and food stamps don’t runaway. Because some 85% of the population has health insurance now, if that figure doesn’t change (and it shouldn’t significantly), the people paying without benefiting would want to keep the budgets to a reasonable level that allows those in need to receive treatment without breaking the bank.

Employers and individuals that have or provide insurance would not be eager to give it up because the benefits are still valuable compared to the government system. Having a separate system allows those treated in the government facility the dignity of not walking past the single occupant room where someone just had a “not government covered” procedure.

The education system works in this same way now. Everyone pays for the government system, but those who wish to pay extra can take advantage of a better, separate private system and all people are compelled to show that their children are covered by some sort of education (including home home schooling, which would be the equivalent of being self insured). Public and private education levels are not the same but government funding does not require equity of outcome. The government schools will continue to provide education to failing students until they either progress or drop out on their own. The hospitals would be no different.

Many hospitals already operate in a manner  similar to this concept already. Almost anyone that lives in a big city can think of facilities they would rather go to compared to others. Usually the least preferred hospitals are the heavily subsidized facilities. To attempt to equalize the conditions in the various hospitals by law is to eliminate the reward for achievement in a country that became the best on Earth by promoting the idea that you get what you earn. If no matter how hard you work you can never get ahead, why even try?

AX

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