Thursday, February 13, 2014

Quick look at Health Care

Here are a couple things I have learned about health care in the past five years (seriously, it has been almost five years since I wrote that post?!?! crazy that this blog has been around so long).

#1 Employee/Employer based health care doesn't work. It just doesn't. We are the only country that relies on employment for (some of our) health care needs. Totally asinine. Want to see employment levels struggle? Burden employers with heavy regulations -- like having to offer their employees health care. So stupid. I've spent much time studying the creation of this model and the various presidents who have championed it. I don't think it's roots were totally evil, nor do I think Nixon and the Republicans were totally off their rockers when they wanted to expand it 40 years ago. But that was 40 years ago, and after 60+ years of this kind of system lets all just admit defeat.

It. Does. Not. Work.

One of the more obvious reasons: there will always be millions of people who are willingly unemployed. Retirees, children, students, stay at home moms, etc etc. Should our spouses/parents/former employers/the government really have to shoulder the burden of providing us with health care? Should employers really have to shoulder the burden of providing their workers (loved ones) care? Think about that.

Back when I was employed the family plan I was under would have been the same if Ben and I had, had 10 kids. Married couple = $300, family of 12 = $300. What?!?! I understand that in order for insurance pools to work some people have to pay more than they use and others have the joy of using more than they pay; but seriously, why should an employer or an insurance company have to shoulder the burden of one couple's decision to have ten kids?

The fact that employment reliant benefits does not work has become my latest go to point whenever anyone gripes about Obamacare, and surprisingly people seem to think this means I love Obamacare. News flash, Obamacare IS employment based health care.

#2 The most basic place all health care discussions/debates have to begin is: Do you think everyone should have basic health care? The answer to that question will direct the entire conversation. If two people answer that question differently there is almost no point in even discussing/debating health care reforms. I don't mean to say a person with a yes and a person with a no should shut down all conversation, but before they can even have reasonable dialogue they must know each other's answer. There has to be a starting point, and whether or not everyone deserves basic care is the starting point.

If each party answers yes, then you can move forward with the following discussion. What constitutes "basic?" How can we make care affordable to all? Should we use insurance as the primary mode of providing care? What role can/should employers play in providing benefits? How involved should the government be? How do we minimize abuse/overuse of health care providers? How can we create plans that are versatile? What can the minimum amount of coverage be while still offering the maximum amount of emergency care? How do we keep special interests and lobbyists out of the way? Etc. Etc.

Also, it is important to note that just because two people may both answer yes, neither one will get everything they want in regards to all the other questions that follow. One opinion I held five years ago that hasn't changed is that there is no perfect system. No one will get everything exactly 100% just how they want it. Compromise is crucial. Compromise is beautiful.

If the answer is no then you move forward with the following discussion. Do we need to revise the Emergency Medical Treatment and Active Labor Act (1986)? How do you suggest the uninsured get the treatment they need? Does everyone who uses care need to be covered by insurance? Do we create debtors prisons for those who are unable to pay bills after they receive treatment? You realize answering no is equivalent to being pro-abortion, right?

To date I've never actually had anyone answer no. Though many people have alluded to the idea that they do not feel like basic health care is a basic right, no one seems to have the heart/courage to come right out and say so. It's ironic really, people who are pro-abortion are stereotyped as also loving universal health care. Conservative Christians who are the loudest anti-abortion voices often come across as not caring one bit about what happens to life after it is born.

My stance? I think it is a moral imperative that if we, as a country, can provide basic care for everyone (which we can) that we do so. As for abortion, see here. 


Tiff said...

I agree that health insurance shouldn't be employer based. I'm not sure how or why they started this but it's dumb and I think it raises the cost of healthcare.

I think we shouldn't need health insurance except for extreme cases like a trip to the ER maybe or cancer treatment. Like car insurance. Maybe we could have free checkups like most plans have, but colds and other doctor appointments should be out of pocket. They could keep down the costs by not seeing doctor. We could have health clinics where you see a nurse practitioner or whatever for most things.

Liz Szilagyi said...

I like those ideas Tiffany. Insurance that covers true emergencies and basic well checks (possibly varying options for covering specialists? but that could all be chosen by the consumer). I also like the idea of paying up front for the costs of smaller things like sick visits, and visiting a Nurser Practitioner instead of a Dr. I've had fabulous experiences with Nurse Practitioners.

I don't know everything there is to know about the history of employer based coverage, but I can give a brief history. It started as a result of FDR's salary caps. Employers needed a way around maximum wage regulations so they started offering non-wage benefits like health insurance (before this most people didn't have insurance and simply paid up front for the costs involved with health care). When Nixon wanted to extend health care to all his proposal was to make all employers offer health care, even if they only had a couple employees. That never took off. Then Obamacare took a slightly less aggressive employer based approach than Nixon's plan, and it passed but still left a large pool of uninsured employees. Not to mention all the people who aren't employed.

Related Posts Plugin for WordPress, Blogger...