During the 2012 holiday season, I spent Christmas in the hospital. I wasn’t sick, but someone very close to me was sick and was in the hospital for 3 days. I stayed with them day and night and through it all, I made a lot of observations about the healthcare system. There are some real fundamental problems in the system. Some of it can be fixed through legislation, but others need a dialogue and real discussion about how we value life in America. Here are the problems I observed:
- No one questions the costs
- Need another MRI? Sure, whatever you say! Need to have your blood re-tested? Sure, what do I know! Need another bag of IV Saline solution? Um, yeah, of course! Doctors can and will order tests because they don’t care about the cost. They really don’t. Ideally, they would like to provide patients with the least amount of intervention to get them better, but many doctors order tests and do unnecessary screening because they are afraid of our litigious culture…they’re afraid of being sued.
- No one is willing to put a price tag on life
- So this will cost $1 million to keep me alive for 3 more days? I’m worth it damn it! Someone pay for it! Sounds insensitive, but its true. No one is willing to say “it’s not worth the cost” when it comes to their life or the life of a loved one. In order to really bring down healthcare costs, we must question the value of the service relative to the benefit it brings.
- There is no transparency
- I have no idea what costs were being incurred during the stay at the hospital. Though many want to and should stay focused on getting better, I felt extremely uneasy not knowing what costs were being incurred, minute by minute, hour by hour, and day by day. I will only know when I see the bill.
- There is no accountability
- This person who was in the hospital first went to the ER on 12/21, but was discharged. This person went back to the hospital on 12/23 and was admitted. You can bet that there is no one reviewing why this person was not admitted on 12/21 unless we ask. Since my insurance picks up a bulk of the cost, it is really on them to investigate. But with the barrier to competition in the insurance market being so high, there is always a pool of revenue in the form of premiums, particularly now with the every American mandated to buy health insurance.
- There is no competition
- The barrier to entry in healthcare is extremely high. You can’t just go to a bank and ask for a loan to build a hospital. There is so much involved to build the infrastructure to a hospital system, that there is usually only 1 hospital that dominates a city or county. Additionally, if you call an ambulance, you’re not in a position to shop around. It’s also equally just as hard to start a health insurance company or a pharmaceutical company.
Many of the above simply cannot be changed and is why the cost of healthcare will continue to climb despite, or possibly because of, the latest changes with the American health care system and Obamacare. However, there are other ways to “bend the cost curve”, and I’ve outlined my plan below.
I Am 1 Percent’s Health Care Proposal:
- Repeal Obamacare. This does nothing to “bend the cost-curve” of healthcare. It only increases taxes on most everyone including the people whom it intended to help.
- Repeal state minimum coverage. Everyone should be able to shop for the coverage that best suits them and their families. If I don’t want to pay for chiropractic services or acupuncture, I should not have to. The other advantage to removing state minimum coverage is the ability to shop for plans in other states.
- Remove the tax break for companies to provide health insurance and give tax breaks for individuals to purchase insurance. This way, a young person can purchase a long-term health insurance policy and not have to worry about being dropped because he wanted to change jobs.
- Provide safety net coverage in the form of Medicaid for 3-4x poverty limit..no exceptions.
- If you make greater than 3-4x poverty limit and choose not to purchase insurance, you waive your right to free healthcare services annually on your taxes
- Medicare should be optional for people less than 55 years of age
- If you’re born with a pre-existing condition, you’re covered. Insurance cannot deny you coverage. If you develop a condition later, you should’ve had insurance in the first place.