Where does healthcare reform begin?
The way I see it, healthcare reform needs to begin with individuals.
After WWII, many companies needed workers but couldn’t compete with wages that were still being artificially elevated by the war era controls. Companies therefore used incentives which included medical benefits.
What began as an incentive program has morphed into the current healthcare fiasco we see everyday.
The only real solution for reform is to begin creating a new mindset and a paradigm shift in everyone’s thinking. This has to begin with the individuals and they must begin to shoulder more of the responsibility for directing and paying for their own healthcare.
Currently, our system does not reward people for being healthy and few people change their lifestyles or behaviors when it comes to obesity, smoking, preventative screening, exercise, etc.
Having nearly 60 years of free or nearly free healthcare has created the mindset of healthcare having little value compared to what it actually costs. This is what absolutely has to change before any real reform will occur.
The fundamental question of whether healthcare is a right remains the central tenet in the debate.
If it is considered a right, it loses its distinction between what is necessary and what is incidental. It also imposes obligations on employers, states, and governments to fulfill these rights.
Many businesses as well as government cannot shoulder this burden and shouldn’t have to.
Individuals need to be responsible for their health and their healthcare. If government is obligated to provide the healthcare, then individuals should be obligated to maintain their health along the government imposed mandates.
As the richest country in the world, we should be able to agree on a minimum set of healthcare standards that we provide and that everyone pays for through taxes or some other mechanism. We should have safety nets in place for the truly indigent and helpless.
Not meaning to sound cruel, neither the government nor the employers should be obligated to pay for all healthcare. Healthcare has never been a right and individuals are not entitled to every medical procedure available.
In all service oriented enterprises, individuals purchase the services they choose and accept the fact they cannot have everything. Healthcare remains a service oriented enterprise.
We have a long way to go in defining and implementing basic medical care, but until the cost is primarily paid by the individuals, I do not see many things changing.
National Review Online recently had an editorial on the President's plan for change that would be helpful.
http://article.nationalreview.com/?q=NmI0OGVlMzZlYWZiZjZlODY5MWEyMDVmNDFmNzVjNmU=
After WWII, many companies needed workers but couldn’t compete with wages that were still being artificially elevated by the war era controls. Companies therefore used incentives which included medical benefits.
What began as an incentive program has morphed into the current healthcare fiasco we see everyday.
The only real solution for reform is to begin creating a new mindset and a paradigm shift in everyone’s thinking. This has to begin with the individuals and they must begin to shoulder more of the responsibility for directing and paying for their own healthcare.
Currently, our system does not reward people for being healthy and few people change their lifestyles or behaviors when it comes to obesity, smoking, preventative screening, exercise, etc.
Having nearly 60 years of free or nearly free healthcare has created the mindset of healthcare having little value compared to what it actually costs. This is what absolutely has to change before any real reform will occur.
The fundamental question of whether healthcare is a right remains the central tenet in the debate.
If it is considered a right, it loses its distinction between what is necessary and what is incidental. It also imposes obligations on employers, states, and governments to fulfill these rights.
Many businesses as well as government cannot shoulder this burden and shouldn’t have to.
Individuals need to be responsible for their health and their healthcare. If government is obligated to provide the healthcare, then individuals should be obligated to maintain their health along the government imposed mandates.
As the richest country in the world, we should be able to agree on a minimum set of healthcare standards that we provide and that everyone pays for through taxes or some other mechanism. We should have safety nets in place for the truly indigent and helpless.
Not meaning to sound cruel, neither the government nor the employers should be obligated to pay for all healthcare. Healthcare has never been a right and individuals are not entitled to every medical procedure available.
In all service oriented enterprises, individuals purchase the services they choose and accept the fact they cannot have everything. Healthcare remains a service oriented enterprise.
We have a long way to go in defining and implementing basic medical care, but until the cost is primarily paid by the individuals, I do not see many things changing.
National Review Online recently had an editorial on the President's plan for change that would be helpful.
http://article.nationalreview.com/?q=NmI0OGVlMzZlYWZiZjZlODY5MWEyMDVmNDFmNzVjNmU=
Labels: healthcare, rights
posted by Anonymous at 5:55 AM
12 Comments:
HB -
While we're usually on a somewhat similar page with respect to the issues associated with healthcare & insurance, I'm afraid I disagree with you on this one.
My initial thought (in good humor, for the most part) is that the National Review's endorsement of President Bush's proposal as being "solid" (to quote the article) is kind of like suggesting that Fox News or Bill O'Reilly's endoresement of the President's performance is likewise objective. It just aint so. Being the voice of the conservative right, its hard to take anything touted by the NR without scratching one's head at the objectivity, or lack thereof. In looking at the otherheadlines and stories on the NR, they're pretty consistent in their criticisms of Gore (Kyoto story touting the repblican comments that the Kyoto treaty is a failure"), that the democrats' criticism of Atty. General Gonzalez was "overblown" (a topic for another day...) and that John Edwards proposal for universal heathcare is "doing nothing more than to call for increased taxes on the wealthy" (See Wm. F. Buckely's editorial). My point is not to debate which side of the political spectrum upon which we each might fall, but rather, citing the NR as a source isnt the most credible, in my mind, and requires a grain of salt when pondering the souce. NR editorials can have merit - however, perspective and context are always important to remember.
Turning past the sources to the substance, I do agree that the system fails to reward a healthy lifestyle - and that if there was any way to do truly & objectively such a thing - it would be a very interesting idea. I dont see the health insurance industry as able to fairly do this, just based on past experience. The slippery slope in my eyes, is based upon the potential harm put upon those with health issues not of their own chosing - genetic predispositions and whatnot. My question is whether someone fighting high cholesterol or a family history heart disease of hereditary origins (like yours truly) somehow be charged more despite my otherwise healthy efforts to eat well, exercise and avoid smoking? Maybe, maybe not. In my opinion, smokers - a conscious decision with vast KNOWN health consequences, certainly should pay more for health coverage. Otherwise, its hard to say what a "healthy lifestyle" means as far as healthcare coverage ratings and premiums are concerned.
The suggestion regarding whether businesses and the government should shoulder this "burden" is a likewise difficult point. As an employer of a small office, I'm painfully aware of the incredible expense to provide healthcare benefits for my staff. But, I cant see past the President's suggestions as anything more than a way to aid big business by allowing them to discontinue offering health coverage under the excuse that employees would come out just the same at the end of the day by paying their own healthcare costs and then getting a "tax break". Again, while wearing my "employer's hat", I'd love to find a way to take the sting out of the gouging health care costs, but I think that hte President's plan would once again, at the end of the day, leave the hard working people behind, while further aiding big business. I dont know that most Americans can find the extra cash on a monthly basis to pay their own premiums, regardless of whether they're going to get a great "tax break" at the end of the year.
I'm not saying that the article doesnt present a very intersting idea - I think that it does, and we're both agreed that something needs to change with respect to health insurers. My main concern is really just that the President's plan, along with the NR's endorsement, isnt neccessarily aimed at what is the best for employees & insureds.
Just my thoughts. Sorry to ramble.
Healthcare is free or nearly free? What planet do you live on?
A couple of points about company benefits and a healthy lifestyle.
1. The companies enjoyed tax incentives by offering these benefits and they got addicted to them during the good times. Now that profits are slimmer they want to take them away.
2. Most corporations today want you to develop a healthy lifestyle because it helps their bottom line not because it's good for the employee. And in a corporate environment like today, where Jack Welsh used to say, "yesterday's newpapers wrap today's fish", we must get up at four in the morning to exercise and yet not miss our numbers.
One last point. When corporations go from a family oriented environment to a corporate environment and number crunchers become powerful, employee moral will go down. No more water coolers. Come on!
Employer paid health insurance premiums are part of the remuneration you receive as an employee. If you were paid that amount as additional salary, employers would still deduct that amount as a business expense for tax purposes.
Employers provide benefits to retain their employees. If my employer announced it was ending its company-sponsored health plan, paying the amount of premiums to the employees as additional salary, and everyone was on their own to find healthcare coverage, my guess is that alot of employees would be tempted to move to another employer.
As I have stated on here many times, primary care physicians make much higher dollar decisions on their patients' healthcare expenditures than those patients do. A patient typically doesn't know, for example, the cost/benefit of an expensive diagnostic test in a particular situation. They rely on their physician to make that decision. The incentive on whether to make a wise decision on those healthcare dollars and then shop for the best value should placed on primary care physicians.
Anony 10:23-
An interesting point. However, I dont know that primary care docs know what the local hospital or imaging center charges for an MRI, etc. I'm sure physicians, like the rest of us, know the relative costs between x-rays and more advanced diagnostic tests, but honestly, it doesnt really matter that much, as I want my primary care physician making his medical decisions based upon what tests he thinks are the most appropriate - and not what it might cost. If I need a test, I want him to order it, and not to waste any time wondering if I can spare the cash for it...
And therein lies the crux of this issue.
Can you think of anything else you are willing to buy, willing to pay any price for, but you don't really know what it is, how or why it works, whether you need it, or if it will even help your problem?
Lawguy,
to clarify my stand. I do not believe the president's plan is perfect in any sense. It has some good ideas and there are many other equally good suggestions.
The current system needs a serious overhaul for many reasons and anyone thinking a single government run system is the way to go will be sorely disappointed.
We will always have a two tiered system to some degree. What we need to decide is what a basic healthcare plan should cover and everyone should be responsible for paying their part.
Those who want more will pay more.
6:09 AMEN
HB,
Any ideas on what should be included and excluded in that "basic healthcare plan"?
Mark
The current system needs a serious overhaul for many reasons and anyone thinking a single government run system is the way to go will be sorely disappointed.
We will always have a two tiered system to some degree. What we need to decide is what a basic healthcare plan should cover and everyone should be responsible for paying their part.
Those who want more will pay more.
I agree that we will all be sorely disappointed if we have a single government system, but the way things look now, I think it's inevitable.
If we end up with a two tiered system. I think people will be more frugal with their healthcare decisions and physicians, hospital and pharmaceutical companies will make less money. Then the powerful pharmaceutical companies will lobby Congress to put more of their products over the counter and the consumer will self medicate themselves and rely on our own knowledge and the knowledge of our pharmacists and nurse practitioners
and we will all probably end up healthier.
How about this? If you are a legal citizen, emphasizing legal, once you are born you are given a very basic, rudementary coverage, like Medicare. This gives just very basic coverage, no bells and whistles. If you want a Cadillac version of healthcare the individual purchases supplemental coverage from competing healthcare companies. I feel this satisfies the humanitarian side and the pragmatic/economical side of this very difficult issue. I realize that medical professional hate dealing with government restrictions and guidelines but that is something that can't be avoided with the cost of healthcare for folks who don't pull salaries that are like some of the medical professionals. Unfortunately, some folks are restricted in life by their genes. These genes not only effect how successful they are financially, but also how healthy they are.
I believe the difference in plans here is in how much the insurance covers and how much is paid out-of-pocket. I would find it difficult to believe a plan would not cover any commonly covered medically necessary procedures.
Post a Comment
<< Home