The Boston Globe ran an op-ed suggesting that health care needs to be severed from employment status. The blogosphere responded with the traditional left and right arguments to the concept, but Buckeye Surgeon suggests one idea that really should be implemented:
We need to involve patients more the decision making process . . . If you want the most expensive medicine, the body scan, the dubiously indicated MRI, then you have to contribute to the costs individually, outside the coverage parameters of your insurance plan.
Universal insurance should cover the minimum standard of care. Anything more that the patient demands, such as unnecessary antibiotics, MRIs, or nuclear stress tests, should be paid for out of pocket.
Related posts:
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- Health insurance doesn’t automatically lead to health care
- Why this private health insurance CEO is against a public plan
- Health care and health insurance are not the same
- Pharmacy run employer-based clinics
- Talking health care reform in Congressional Quarterly and WORLD Magazine
- Doctors and patients need to learn to live with health insurance companies
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That’s ironic since their candidate, Obama, is currently slamming McCain for his proposal to decouple insurance from employment.
The Globe is right about severing the link between insurance and employment.
Buckeye Surgeon’s idea is even more important. Patients with money at stake approach the decision about additional tests or procedures very differently from those with little or no copay. We need more of that desperately.
The problem with “Universal” insurance is: what is the minimum standard of care? And a corollary to that is: who gets to decide?
Is it only me that sees the rabbit hole this creates and financially where we’ll end up if we go down that hole? Do we *really* want to emulate the Canadian, British, or Australian models where people die waiting for basic tests, people sit in ambulances so the hospital’s number look good, and the shortage of medical professionals becomes so acute that people can’t find anyone to care for them?
I agree that health care should be decoupled from employers, but I’d like to see health care in the US be a national market instead of 50+ regional markets, and let people decide themselves how much insurance they want to buy.
Why anyone proposes that the government can handle everyone’s health care when they can’t handle what they have (Medicare/Medicaid)is beyond me.
Oh, good. Ask Alan Greenspan how well deregulation works; he has more insight into now than most.
On the topic of decoupling insurance from employers, I have yet to read a good explanation of how this won’t increase out-of-pocket costs for consumers, other than, perhaps, young and healthy people. The rest will end up paying more for less, as has been the ongoing trend in private insurance coverage.
The determining factor of how much health care people will buy is what they can afford, not necessarily what is best for their circumstances.
“Anything more should be paid for out of pocket.”
Uh, well, with a $5000 deductible, I already *am* paying for virtually all routine medical care out of pocket. I know a lot of other people with deductibles of $1,000 or $2,000. And you better believe we are price-conscious.
The notion that consumers aren’t paying a dime for their care is becoming rapidly outdated.
The biggest opponents to a national health insurance market, as opposed to the present 50 states solution, have been the health insurance companies themselves. The Bush administration had 8 years to pursue a change in this policy and chose to do nothing.
The only complaint that I have about high-deductible individually purchased insurance with a HSA is that I wasn’t able to get it 30 years ago when I was 20 years old.
And it isn’t just for the healthy. I have a diabetic dependent and chronic conditions myself. In fact we actually have met the deductible, now 5000 dollars most years in the 9 years that we have had it and we still come out ahead of where we would be with a conventional full plan. I like not having my employer jerk me around changing my coverage (and covered doctors) every couple of years. i like being able to switch jobs without changing or losing my coverage.
I wish I could have been building up that HSA account for 30 years–it would buy an awful lot of heathcare now if I had gotten it young.
I wish I could move it across state lines and have even more freedom. Since we are now basically uninsurable, we are stuck with staying in the state that we are in and keeping this plan. At least I can move employers on go free-lance.
As Americans, we ought to be putting a higher value on our freedom than on being taken care of by our employers. What I envision is a set up where people can buy a plan from a national company when they leave their parents home–with guaranteed renewability in the face of illness and be able to keep it for life where ever they go–real insurance that just pays what they can’t save for while they stash money while healthy to cover the premiums and deductibles later if they should be too sick to work. There would be some transition problems with older sick folks but that can be solved with temporary measures.
I also think it very important that people have the freedom to not buy insurance if they don’t want to. People should be free to take risks of their own choosing.
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