THE BEST DAMN HEALTHCARE PLAN
The current healthcare system sucks and "ObamaCare" is not the answer. Before your bleeding heart and small brain stop functioning, read on and be patient for a second. A 2000+ page bill that is too massive for anyone to comprehend, let alone follow, is not the answer. It punishes businesses and encourages companies to offshore even more than they already are. In a nation that has the highest corporate tax rate in the WORLD, this is not the answer.
Ok, so you’re probably thinking, "well (Jackass), if you’re so smart, then what IS the answer?" The answer is the the "Best Damn Healthcare Plan." You are free to call it BDHP for short. Here’s the breakdown, and it won’t take 2000 pages to do it:
THE PROBLEM
Healthcare costs have been skyrocketing, leaving many unable to afford it and many employers to end up cutting back the care they can provide. This results in ER rooms filling up with people suffering from common colds and leaving the hospitals and the taxpayers to foot the bill.
This is the common problem we’re all familiar with. But let’s be honest, here is the real problem.
THE REAL PROBLEM
We’re too damn fat. We eat too damn poorly, and we are more inclined to flop on the sofa and fall asleep to Dr. Oz rather than do what he actually says. Heart disease is the number one killer in the United States. One out of every four deaths is due to heart disease, which is almost entirely preventable. ONE IN EVERY FOUR. Not to mention the ridiculous cost of medical care for all of the "weight-challenged" and the smokers who keep plugging along with their triple bypasses and narcotic arsenals.
And that’s not the end of it. In fact, two out of every three deaths in the United States are due to 5 health conditions which are largely preventable:
- Heart disease
- Cancer
- Stroke
- Lung Disease
- Diabetes (Type 2 being the most prominent and only preventable)
Notice I said "largely preventable," not "entirely preventable." Even the most in-shape, healthy-eating individual can still get cancer or die from a stroke, or even get lung disease. However, each of these are still largely linked to diet and exercise.
To further explain, one in three Americans is currently considered obese. No, this is not a little chubby, this is not your "freshman fifteen" or a little extra baby weight, this is obese.
THE DETACHMENT PROBLEM
If you drive like crap, get tickets on a daily basis, and have had four accidents in the past year, what do you think your monthly insurance premiums are going to look like? If you irresponsibly leave every television in your house, every light, and every computer on, what do you think your electric bill will look like? Really damn expensive--that’s the answer. So what is your motivation to turn off your lights? What is your motivation to not get a speeding ticket? Simple, you don’t want to pay for it, so you put forth efforts to keep those dollars in your pocket.
Now take your health insurance. You weigh 300 pounds and enjoy a selection of fast foods every evening for dinner. You smoke two packs a day. You consume at least 4000 calories per day, and your idea of exercise is pausing the DVR to get up and get seconds. "Well, we’re all gonna die someday... if it ain’t the fried chicken or ciggies it’ll be something else" - right? You’ve heard that one before. So you eat that extra piece of pie, take another smoke, shrug it off and go to bed. When you start getting blood clots in your legs, does your monthly premium go up? No, it stays the same as everyone else at work. When your doctor puts you on a variety of medications to keep your blood pressure down, your cholesterol down, and to keep you from keeling over and dying any minute, does it financially hurt you that much? Sure you might have to pay a bit more in co-pays, but it isn’t quite the same as someone who can pay $50/month for car insurance because he is a safe driver, whereas the champ next door has to pay $500/month for the same insurance.
This is the problem with health insurance in America. We are detached from our responsibility to take care of ourselves and, other than non-monetary personal reasons, have little motivation to to do it. And frankly, judging from a walk down the street on an average day, the personal reasons do not seem to be nearly significant enough to motivate the average American.
Let me pose another hypothetical. If you are a good, careful driver, you expect your monthly premiums to go down right? How would you feel if you happened to live near two idiots who cannot drive, and because of your proximity to them, your insurance rates triple. How would you feel about that? We should all share in the responsibility right? Bull crap. You would be pissed and I would too. Why on earth should I be responsible for someone else’s bad decisions? The simple answer is, you shouldn’t. However, when Larry Smokesalot, your co-worker, decides he’d rather fill up his lungs with cancer than worry about his family, guess who gets to pay for it? You do, along with all of your other co-workers who are trying to live healthy lives.
This is the problem with health insurance: the people who deserve to be paying more and paying significantly higher premiums usually do not; everyone else on the plan, and even in the community, shares in with the consequence, buffering the blow for the ones who are actually causing the expense.
THE PLAN
So in sum, the actual problem with health insurance is that we are too detached from the financial consequences of our actions. There is no immediate effect or financial pain when we screw up and fail to take care of ourselves. I know I avoid going more than 5mph over the speed limit because I don’t want another ticket, and I don’t want my insurance rates to go up. But if I can sluff off the gym and hit Jumbo Jim’s Burgers on the way home, I do not feel any immediate effect. Sure I may feel a little more sluggish and be less energized, but this probably just means I will be even lazier tomorrow because hey, I just don’t have the energy... especially not the energy to "cook" a "healthy" dinner.
So how do we correct this problem? You can’t FORCE someone to take care of his or herself. No, you cannot, but you are FORCING everyone to foot the bill for your own poor decisions, so there should not be a problem in requiring the individual who is making the bad decisions to be held responsible.
1) Discrimination and Pre-existing Conditions
We hear the word discrimination and we think bad thoughts; and we should, it is usually a bad word. But in this context, insurance companies SHOULD be encouraged, nay, required, to discriminate against those who make VOLUNTARY decisions that will affect their health in the negative. In fact, insurance companies should not be allowed to pass the expense onto others in the company, the state, or elsewhere. If Bob the lazy co-worker weighs 300 pounds and chews tobacco, his insurance should be a helluva lot more expensive than Sally the part-time fitness trainer who works in the next cubicle. Insurance companies should not be able to bundle it all up and share the burden among the whole company. Put simply, insurance should be individual.
So what about people who take care of themselves but still get cancer or otherwise injured or sick?
This is where big brother needs to step in, and is at least one of the few bright spots of Obamacare, however, Obamacare does not do enough. While insurance companies should be required to look at individual applicants to determine the proper insurance premium based on their voluntary health decisions, they should NOT be allowed to discriminate in ANY WAY based on involuntary health factors, such as a previous history with cancer, cystic fibrosis, muscular disorders and other hereditary and/or involuntary conditions. (I am not a doctor, a team of doctors should make the determinations as to all involuntary conditions that should qualify.) This is where the insurance company SHOULD be able to share the cost among the company, the state, or even the nation. We have an obligation to help those who cannot help themselves, but no obligation for those who voluntarily kill themselves and send us the bill.
2) Mandatory
Another bright spot in the Obamacare plan is that EVERYONE has to have insurance. The Supreme Court gave the OK, and I think this is a good thing. If the taxpayer has to keep footing the bill when your cheapass neighbor doesn’t get insurance and goes to the ER for everything, making everyone have insurance is a good idea. And let’s be honest Republicans, even though you fought against this provision, it was still a Republican idea in the first place. By requiring everyone to have insurance we increase the pool of customers and decrease the overall costs of insurance itself. It’s a good thing.
3) Increase Competition
It does not make sense that insurance companies have to set up a whole other business when they go into every state. It’s stupid. It’s arcane.
In this day and age, when I can buy a blender from a small retailer in Maine over the internet because they have the best deal, why can’t I do the same when it comes to insurance? It’s good for competition; it’s good to lower the overall cost of health insurance, and allows me the option of shopping for the best fit for me and my needs. We need to drop the borders and allow companies to compete across state lines with minimal interference. Why should you have to drop your insurance plan when you move? If they provide competitive rates and they are happy to have you seen by out-of-state doctors, there is no reason. All insurance companies should, if they desire, be allowed to advertise and compete against each other, regardless of state borders. More competition means a lower cost and, hopefully, better quality.
4) Tort Reform
One would be a fool to forget that at least part of the increasing cost of healthcare is due to exorbitant medical malpractice suits. One could take an asinine approach like Texas and just cap the maximum amount of damages an injured plaintiff can get, which the insurance companies really love, but which really screws the legitimately injured. No, we need a better system. I would propose that injured plaintiffs have a burden to demonstrate before even bringing a lawsuit; if they cannot establish this basic burden, then the case is barred.
Some states have medical panels that you have to present to before filing suit; such is a good idea, and the decision of the panel should be decisive and binding. In other words, both the plaintiff and the defendant will have a mini-trial, with a cap on costs, before a panel of judges; perhaps 3 medical doctors and 2 attorneys. If the plaintiff cannot establish the likelihood of success in a full-blown trial, then the case cannot go on and is barred. This allows plaintiffs who are legitimately injured not to be capped at an amount of recovery when they are really, really injured, but it would prevent frivolous claims of malpractice when one doctor did something that was just as reasonable, but different, from what another doctor might have done. Doctors have to make judgment calls and utilize the best information they have during a critical period of time; not every decision that ends up with a less-than-desirable result is malpractice. This would filter the frivolity out, but still allow those who are legitimately hurt to have their day in court. This would cut costs.
CONCLUSION
So there you have it. You increase competition, you increase the customer-base, you increase personal responsibility, you decrease red-tape, you knock out the frivolous lawsuits, and you eliminate discrimination for involuntary health conditions. People who want to smoke can still smoke, people who want to live at the fast food restaurants can do so, but they are all going to pay a helluva lot more for it.
It didn’t take 2000 pages to describe this.
Ok, I realize this is an extremely simple overview, but that’s what America needs: something they can comprehend. Are there more details? Absolutely, the details will certainly be fairly extensive: we will need a list of conditions that are not based on voluntary choices that cannot be discriminated against, we need a list of voluntary health decisions that provide a basis for increased rates, we need specifics as to how insurance companies can operate across state lines when states often mandate different requirements for insurance companies, we need to establish the specific consequence of failing to procure insurance, we might want some small government-subsidized incentives for employers initially obtaining an insurance policy (if there are a bunch of unhealthy people there, lets give them a little time to start changing their lifestyle choices before getting whacked), etc. There is a lot to consider, but this is a reasonable basis that takes the best from both sides of the political aisle and adds in a healthy dose of personal responsibility: something many people lack these days. Is this perfect? No. Is it even close? Probably not, but at least it’s a starting point.
Will anyone listen? Probably not; but if one of the candidates wants to pick up and run with this idea, America will likely follow, at least the few Americans who still believe in personal responsibility.