The major problem with health care is cost. Private health insurance companies aren't solely to blame for costs. As Robert J. Samuelson wrote in his article "Rx for Health Care: Pain" in the Dec 10, 2007 issue of Newsweek, runaway health spending is. http://www.newsweek.com/id/73284
(quote) "Health spending already totals more than $2 trillion annually, about 16 percent of national income (gross domestic product). By 2030, it could easily exceed 25 percent—one dollar out of four—projects the Congressional Budget Office. From 1970 to 2005, average spending per Medicare beneficiary rose 8.9 percent a year; spending for Americans with private health insurance rose 9.8 percent annually over the same period (the figures cover similar health services)." (end quote)
The solution to the problem of the high costs of private health insurance is to bring down the cost of health care. The solution is not to shift costs, it is to lower costs. Here are some suggestions:
- Target a public health insurance option to lower-income people who can't afford private health insurance at all. It would provide very basic benefits.
- Tort reform. Exempt a doctor from lawsuits unless there is clear evidence that he or she intentionally hurt a patient. A large part of the payments to doctors and hospitals is to pay people who sue them. It's normal for some medical treatments to have a poor outcome for the patient, not because the doctor intentionally did something wrong, but because people are biological beings and a lot of things go wrong regardless of treatment. A person is often in an emotional state when a family member has a medical problem, and the first inclination is to sue a doctor or hospital if the patient has a problem. Doctors perform unnecessary tests and treatments in order to show courts that they did all they could for a patient. Instead of a constant barrage of malpractice lawsuits, public health insurance can set up a web site that lists the performance of doctors and hospitals, and patients can monitor it.
- Public health insurance should pay for the of use lower cost equipment, but not higher cost equipment. Hospitals have a tendency to buy every new piece of equipment that comes along, even when it is only marginally better than what they have. They do it because they know they can pass the cost along to the insurance companies.
- We need to acknowledge the fact that nobody wants to face: Each human life has infinite value, but the allocated fund of money to spend on health care is finite. So we have to conserve the allocated money by setting up a reasonable list of approved medical procedures and drugs. It would be great if everyone could get any treatment they or their doctors want, regardless of its effectiveness, how long the benefit lasts, and how much it costs. However, with a limited amount of money, our goal should be that the money is portioned out so that an optimum amount is spent on everybody. For example, we cannot allow a situation where tens of thousands of dollars are spent on one person for a minimal health benefit, and as a result that there is no money left over to treat hundreds of children for standard health issues .
- Financially help more people to become doctors. People who want to become doctors and come from lower income families must borrow a huge amount of money. That creates 2 problems:
1. Health care costs are higher because doctors need to charge patients a lot of money just to pay off medical school.
2. Many lower-income people can't become doctors, which results in a shortage. The law of supply and demand drives up prices.
- For the public option, put doctors on salary. Any doctor in this group may treat the patient as many times as necessary, but will not bill the patient for each treatment. The government pays for the total time these doctors treated public health care patients, according to their salaries. I believe the Mayo Clinic is organized like this.
- Treat people who receive health insurance from employers and people who buy their own health insurance the same. That could be done one of 2 ways:
1. If a company pays for health insurance, it employee receives it instead of its same value in pay. That benefit could be taxed.
2. If health insurance paid for by companies is not taxed, then health insurance paid by individuals should be subsidized by the government at a rate equal to the tax benefit the government grants companies.