No easy fix for health-care costs | VailDaily.com
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No easy fix for health-care costs

Much of American culture is predicated upon incentives. So wouldn’t it seem reasonable that one of the keys to solving our health insurance woes is not more government intervention but offering incentives, including those that promote more responsible and healthy lifestyles and thus reducing health risks?There is not a single solution to America’s national health care problem (or crisis as some proffer). Throwing money at the situation is not the answer because our health insurance problem is not a single problem at all. It’s a myriad of related and complex issues. Many “progressive” one-size-fits-all solutions do little more than create other problems:– A law requiring employers to pay for health insurance for every employee runs the risk of acting like a tax on income for those who would rather have cash than health insurance. Such laws also increase the likelihood that people would forgo taxable work and instead opt for the underground economy.– Those who favor the European model of mandatory health insurance lose sight of the fact that countries with universal health care have higher tax rates than we do (how does 60 percent strike you?) and higher percentages of their populations on the dole. — Here at home, the states with laws that require policies to be issued to people regardless of their health status provide an incentive for people to wait until they are sick to buy insurance, which creates adverse selection, leads to increased insurance carrier costs, reduced profits and starts the cycle of subsequent rate increases.A similar situation occurs in states that dictate what insurance policies must cover, because overregulation would make even Mormon teetotalers pay for alcohol treatment.Nor are community-rating laws effective because by requiring everyone buying insurance pay the same rate, it often results with people in their peak earning-years paying less, while the young (who earn less) pay more. In New York, a month after the 1993 community rating law went into effect, annual premiums for a 30-year-old single male from jumped 250 percent.It is for these reasons (and about ten thousand more) that Hillary Clinton’s well-intentioned by ill-advised task force of the early ”90s failed so miserably.The sooner America realizes that we cannot insure every American at once, the sooner we can begin to effectively deal with the issues. The minute we try to include everybody with one massive blanket health plan is the day everyone will experience a massive deterioration in the quality of our health care.This is not a cold-hearted notion, as some would have us believe, because in a nation of 280 million people, someone is going to be left out of something. That’s just the way a capitalistic and market-driven society functions. In a perfect world, everyone would have health insurance (just as everyone should have a good job, a good education and low taxes). But while everyone should have these things, supplying them and deciding who is going to foot the bill always seem to be the unanswered questions – solutions and wish lists are very different animals.Incentive-based health insurance may be one piece of the puzzle. When individuals assume a greater responsibility for paying for their health care, they’ll be more prudent in assuming responsibility for their health and well-being, as well as deciding what tests, procedures and medications they want or need. The raison d’etre should be “Insure for the emergencies but not for routine maintenance.” What is not commonly understood because of the unfavorable press the matter receives is that health insurance remains surprisingly affordable in states with good regulatory climates. A 20-something married couple living in Eagle County can buy health insurance that includes drug coverage for under $200 per month, provided they accept a $500 drug and a $5,000 major medical deductible. While those out-of-pocket costs are significant, they’re not financially debilitating. Even if husband and wife earn minimum wage, two plus days of work by each of them would pay the monthly premium. But the cost of a $50,000 uninsured surgery is another matter entirely.Those who feel that more laws forcing government to pay for health care again fail to recognize that overregulation will only create more impenetrable bureaucracies, aged hospitals, physician shortages and exorbitant taxes. A look to our northern neighbor Canada is a good case study of how universal health care really means universal non-care. Universal health care reminds me of that old joke about a restaurant in the Catskills: “The food may not have been very good, but at least the portions were small.”So we may want to ask ourselves if it’s possible to benchmark certain preventive medicine and health maintenance activities such as exercise programs, homeopathic care, sensible weight loss, naturopathic medicine, quitting smoking and getting flu shots with health plans. The devil is always in the details, but modifying behavior through a series of incentives (financial and otherwise) is certainly more viable than waiting for government to come up with an answer.We must prod our legislators to work in concert with the private sector; because when government removes legislation that interferes with incentive based plans on a state-by-state basis we will begin chipping away at this multi-layered problem. A good example of this is the growth of health savings accounts, aka HSAs, which require high deductibles but offer tax incentives similar to IRAs. But waiting for Washington to spoon feed us the solution by coming up with an across-the-board national health plan is not just unrealistic, it’s patently Pollyannaish.Butch Mazzuca of Singletree, a Realtor, writes a weekly column for the Daily. He can be reached at bmazz68@earthlink.netVail, Colorado


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