INDEPENDENT IDEAS FOR HEALTH CARE REFORM (cONTINUED)
More Details/Rationalization on These Complex Proposals
For years now a lot of the debate on improving quality and lowering costs in how we experience Health Care in the United States has ultimately become mainly about who's going to get the political credit and special interest payoffs when all is said and done.
That's insane, and obscene; because while the partisans endlessly preen and bicker, our health care costs and uncertainties keep rising; employers face increasing confusion and market instability in their role as the prime drivers of insurance pools and coverage for most Americans.
Meanwhile, public options like Medicare for Seniors and Tri-Care for military members are working well, by and large, and remain popular with those who have access to them. The data indicates that Medicare for example, continues to chug, chug, chug away effectively on behalf of its users (mainly Senior Citizens) thanks mainly to federal subsidy support, the efforts of many unsung public servants nationwide, and the herculean flexibility of medical practitioners across the nation. So don't let the partisans on cable news or the Internet mob fool you: Despite all the political chefs stirring its soup, Medicare performs competitively as an innovative government-provided health insurance option (though for a limited number of American citizens.) It is indeed a good model for future expansion of government-driven options in the wider health insurance market.
And yet, despite all of this talk in Washington, D.C. by politicians and industry lobbyists on "the importance of finding solutions on Health Care", the fact remains that tens of millions of our neighbors still lack access to any stable source of health care services or can't find properly affordable coverage for their families. This issue is especially vexing in smaller cities and rural areas like we have in the 4th District.
Health care workers, despite the heroics we have come face-to-face with in recent months -- still face continued uncertainty in their workplaces, muddy career paths, and limited training for professional advancement. American leadership on the advancement of medical treatment options and innovation on key medication access and cost has stalled.
Does any of this sound like progress to anyone?
So it makes sense in 2023 for Americans to switch-off the fruitless partisan and talking-head debate around health care and focus instead on common ground where we know fixes can (and must) be made right now (even in our bitterly divided Congress): In 2022 traditional, employer-driven health insurance provided by for-profit entities is how most Americans access health care; so let's start there.
- First, in January 2023 let's come to agreement on smart ways to begin eliminating geographic limitations on insurance pools without removing local oversight of costs, consumer protection, and service quality. Something done in this area is better than the nothing we have gotten since the ball started rolling in 2008... So let's not allow the "unattainable perfect" to be the enemy of the "do-able good things" even minor tweaks in the system -- that we can get started with.
- Changing the 1944 law that was designed to protect regional insurance monopolies and fat cats is do-able in the present political environment. True, finally allowing insurance companies to sell plans competitively across state lines isn't without risk (especially in that it will make the consumer protection mission of local and state regulators more difficult). But opening up competition to new entries in every American market does get us a step closer to seeing that more Americans have access to buy into innovative health insurance plans wherever they live or work; if the federal government also makes sure to support state regulators as they protect consumers from fraud or graft, this change should assure the availability of policies at rates, co-pays, and service fees that are more fairly calibrated to each consumer's reality.
- Second, some sort of permanent or at least temporary "portability" of health insurance through life's changes has to be on the table right now: So we must also agree in January 2023 on practical and fair ways to expand the portability of personal insurance plans so that "regular Joneses" like you and I can keep our health insurance plans (and basic rates) if we like them when we retire, move between jobs, get furloughed from work, have major life changes, etc.
- There also has to be policy put in place in the next Congress to go beyond COBRA protection and see that government and employers work together to (at least temporarily) subsidize what has been the employers share of health care premiums when Americans are between jobs or change their employment status for whatever reason.
In 2023 we also have to further strengthen the protections the Affordable Care Act introduced against excessive profiteering or exclusionary practice when it comes to pre-existing conditions and “actuarial demographics” such as age, race, gender, ethnicity or lifestyle.
- All consumers must have equal access to health care insurance at an equitable cost that has nothing to do with these factors, period.
- Might this standard mean less of an available profit margin for this industry in the future? Perhaps. But let’s face it: Health insurance is an entirely unique industry to be operating a free market enterprise in. (In fact, we are one of the last nations on Earth with such an unbridled free market philosophy in the Health Care space.) But as much as Americans still support at least some free market enterprise in this sector, very few of us would want the health care insurance market to be a circus where anything goes. So if you want to make a profit in this industry (and bless you if you look to do so by offering a better product at a maximally fair and competitive price) this is what you should recognize as a cost of doing business for profit in Health Care.
In 2023 let's also get bright young minds in the health care industry together to create a "not-for-profit" government insurance option that operates like a private company in all the good ways private enterprises innovate to succeed:
- First, let's get the best available public health and business efficiency experts to help the United States to create the world's leanest and most effective government-administered health insurance program ever devised (essentially a new Medicare that will be aimed at working Americans).
- Let's have this new option made available to all working Americans to buy into just as they would their employer-provided health care plan. If an employee selects the new public program instead of their employer's provided plan, or if they work for a small business that does not provide employee health plans, lets be innovative and split the difference on the employer contribution. Let's figure out an innovative blend of employer subsidies, tax considerations and burden-sharing to see that small businesses currently unable to participate in employee health programming can do so in the future without sacrificing competitiveness in any way.
- Let's structure this new government health insurance option to compete on cost, efficiency and service quality in the open market with for-profit plans.
In addition to helping expand the portability of coverage of for-profit, employer-driven insurance coverage options most of us use today, let's look to empower community organizations, faith-based institutions, and other community non-profit organizations to establish insurance pools of their own to offer interested members or neighbors.
Finally, let's work with industry to bolster the skills training options, career path and life-work balance management, ergonomics and workplace quality of life, and the everyday personal safety conditions experienced by our dedicated health care providers. This is an effort we need to focus on immediately in 2023 by coupling the research and innovation capabilities of the federal government with practitioners and making investments that ensure continuous improvement and career development in the industry for decades to come.