1/27/2012

The conservative plan for solving our healthcare 'crisis'.


    The conservative plan for solving our healthcare 'crisis'.

    I am going to set up an analogy to make it clear the roles fedgov, private enterprise and individuals are.  We have a game called football.  This game has rules that have been agreed to, rules that were made by 'we the people' .  We have teams (represents private enterprises) that play on this field and we have referees (represents fedgov) to ensure all the rules are followed and the game is played fairly.  As you can see, this situation is mutually agreed upon and constitutional. 

    The game is played, and when new rules are warranted, they are added by 'we the people'.  When one team or another breaks the rules, the referee steps in and calls a penalty.   The game is fair yet the outcome is uncertain for there are no guarantees of success .

    But, what happens when the referees suddenly take sides, favoring one team over another?  This creates a very unfair situation, regardless of who the referees are favoring.  This is exactly the situation that the 'Stimulus' bill does, it favors spending on certain industries (green tech for example), or propping up failing companies (Solyndra for example), or funneling cash to states that otherwise need to fix their own fiscal problems rather than hide them (California for example).  This is unfair to well run companies who are playing by the rules, or industries who are providing goods and services that we need and it's unfair to states who do have their fiscal houses in order.

    What happens when the referee ALSO fields a team (aka Obamacare)?  Who can compete against that?  The answer is no one can.  The Referee team can pretty much do whatever they please because  they are also refereeing the game.  Anything goes because there will not be any penalties called on themselves.  It is a huge conflict of interest.  A private entity has no chance of succeeding against this team/referee combination for 2 huge reasons: 1) The referees aren't going to call any fouls against themselves, yet will call fouls on their opponents for any reason whatsoever to get them out of the game; and 2) The referee team, if they get into a financial bind can print their own money whereas a private entity cannot.  What private entity can succeed against that?

    When a private entity does wrong, it can be sued and people can go to jail.  If fedgov does wrong, it doesn't get sued and people don't go to jail.  Why?  Because in the case of fedgov performing operational tasks such as Obamacare, the regulatory agency is ALSO fedgov.  Fedgov is not going to sue itself. 

    What is the solution?  It's actually quite simple.  Fedgov continues in the regulatory function (referee) and 'we the people' set up the parameters of this game thus:
    1. Set up the rules governing minimal coverage that people must have; rules to dealing with changing plans and rules for 'pre-existing' conditions (for which will be moot issue)
    2. Eliminate barriers to competition by eliminating the restrictions of selling policies across state lines.  Fedgov has been quashing competition in this way, which drives up costs.  Of course there will be consolidations in this industry, but that is all good for competitive reasons. 
    1. Allow 'we the people' to set up medical savings accounts (MSA) that employers and individuals can contribute to.  (Rules governing these accounts come from fedgov).  An MSA is yours to do with and is your to manage, they follow you from job to job, so all you need to do is tell your employer where your MSA is, and they will contribute accordingly, thus there is no break in coverage due to changing jobs.  An individual can contribute to an MSA account themselves.  For example, if your parent is ill, you can add money into it to help her out.  Medicare and Medicaid payments also flow into these accounts.  If you know you have an upcoming procedure, you can begin to contribute to it ahead of time.
    2. With an MSA, you can choose your own healthcare insurance policies.  You go online, and select the federally (and state) mandated minimum coverage, and then you select whatever options you wish above that.  Because there is no more interstate barriers, you will now have hundred's of companies to choose from.  The choice is now yours, not your company's.  Because there is greater choice, there is greater competition which drive efficiencies and  cost savings to you. 
    1. With an MSA, you choose your own doctors according to whatever plans they accept.  It is your money so it is your choice.
    1. With an MSA, you can choose WHO to cover, and you can pool your MSA with a spouse(married or a legal domestic partnership, depending on the state).  Every child must be covered, so when a child is born, you tell your employer what to withhold (just as you do now).    Rules need to apply for changing accounts and coverage.  You can choose who to cover so you can cover anyone you wish, including a live-in-boyfriend.  You just pay the premium for his coverage. 
    1. With an MSA, the plan is yours and it follows you from employer to employer.  It also is yours when you are unemployed, and you can contribute to it via cobra, or medicaid if need be. Or, your rich uncle can contribute to it.  But, because you have the account, you are covered.  Thus, eliminating the majority of uninsured people, as well as eliminating the majority of 'pre-existing conditions' issue.
    1. Hospital visitations are done by who is being covered, not by who is married to whom.
    1. Tort reform must be addressed as it is a huge cost driver of healthcare.
    2. Rules surrounding 'pre-existing conditions' must be dealt with.  As an analogy, let's say you have no auto insurance, yet you get into an accident.  You then call Geico to get insurance.  Would it be fair for Geico to give you insurance for the accident that already took place?  As you see above, we are trying to eliminate this condition, and with MSA's, we attempt to eliminate them entirely.

    As you can see, this plan tackles all of the goals that Obamacare is trying to achieve, but it does so in a way that fedgov still plays referee, but does not field a team.  Costs are driven down for an individual because of enhanced competition, and tort reform.  Costs are also driven down for employers because they do not need to administer plans anymore.  'Pre-Existing Conditions' is being tackled by attempting to eliminate the issue entirely.  Gay spouses can be covered, whereas they are not in most states now.