Vail Daily letter: A new healthcare model
I was halfway through Jacqueline Cartier’s Valley Voices commentary (“Chess, not checkers,” Oct. 7) when I had a “deja vu all over again.” I’m not kidding. This is the third time I have encountered the same description of Affordable Care Act (aka Obamacare) program elements complete with the same page references. The first instance occurred shortly before Affordable Care Act was enacted, and the second occurred right after it became law. Each was a forwarded email to me by conservative friends alerting me to the dangers of Affordable Care Act. The original email author was a radical, wing-nut, ultra conservative retired judge from a small Texas town. Unlike Cartier’s commentary, the email contained a House bill number.
I pulled up the bill on the Internet and discovered it was a bill that never made it out of committee, and consequently, never brought to the floor for a vote. I scanned the referenced page numbers. The quoted contents were not contained within the prescribed page references.
As a cross check, I pulled up the Affordable Care Act and checked the referenced pages to see if the quotes or general subject matter were contained within the bill that was passed. They were not. Cartier’s “sources who are reviewing the new medical plan” drew these obvious lies from a three and half year old email that has circled the globe numerous times and yet is still perpetuated by commentaries like Cartier’s who might want to spend more time verifying her facts.
So, will the federal government set all doctors fees, pay all specialties the same, impose a prohibition on hospital expansions, allow cancer hospitals to ration care (why would they voluntarily?), age limit patients for eligibility for cancer treatment and require end of life planning for Social Security recipients (a good idea but not as a mandated regulation)? No.
Medicare has established maximum allowable fees based upon service codes (CPT codes), but doctors can accept Medicare assignment or not. A certificate of need law regulating hospital expansions was part of the original Medicare Act of 1966, but disappeared into the rear view mirror many years ago.
In closing, I urge employers (small, large, private and public) to begin extracting yourselves from the responsibility of selecting which insurance plan(s) to offer your employees and then having to explain why you are shifting more of the premium on to them and/or reducing the benefits of the plans offered. We are the only developed country in the world that depends upon an employer-based system for health care insurance for the general population, and there is plenty of evidence that proves this model does not work.
There are two specific elements of the Affordable Care Act that facilitate this transition. The health care exchanges offer your employees a transparent free market environment in which they can select the plan that best meets his or her needs. Next, the Affordable Care Act provides means-tested subsidies which can substitute all or in part, your contribution to their health care premiums. If you need incentives to attract the best talent, there are plenty of other perks you can use that are more specifically directed to organizational success.
What will the new system look like? One possibility is a Medicare for all, financed through general tax revenues with a means test as to what part of the cost is born by the individual/family. The specifics (covered services, deductibles, etc., need not mirror current Medicare). This model would remove the commercial health insurance industry as we know it, but removes issues involving the individual mandate and employer offered health insurance coverage.
Another option would to simply use the exchanges for all seeking health insurance coverage. This creates a direct relationship between the individual and the insurance company without an intermediary (the employer). Here, too, a means-tested subsidy could be employed to offset premium costs for those needing assistance. This option does not address the issue of the individual mandate. Well, I’ve always believed that individual responsibility is a strong characteristic in the culture of our nation.
So, if you incur a cost for which there is no insurance, then you owe a debt that must be paid off just like a student loan. We should stop treating our young adults like they are still children. Nothing makes you grow up faster than having financial responsibility for your own actions and decisions.