Friday, October 02, 2009

The path less taken...

“More than any other time in history, mankind faces a crossroads. One path leads to despair and utter hopelessness. The other, to total extinction. Let us pray we have the wisdom to choose correctly.”…..Woody Allen

There have been times in my life when I knew just how Woody felt when he made that statement. In my days back at Millville Grade School, my old pal Stinky Wilmont often proposed to set the agenda for recess. I remember one time when he offered a choice between rigging a bucket of water over the door to Principal Baker’s office, or wiring a dead opossum that we found to the muffler of Mrs. Lawall’s Ford Falcon. I figured either choice was going to end badly, so I opted out, and spent the rest of the recess helping the Bartram sisters get across the monkey bars.

I get the same feeling when I hear ideas for the current health care debate coming out of Washington. There is an overwhelming opinion in this country that the only solutions to the health care crisis we are facing will come from the government.

One of those solutions involves huge government agencies that seize and re-distribute tax dollars to doctors and hospitals, heavily regulates the health care and insurance industries, and provides special tax incentives for certain insurance plans but not others. The Democrats plan is even more expensive and intrusive.

A lot of people have forgotten, or never knew, of a time before Medicare and Medicaid, when the private sector paid directly for 75% of the nations health care expenditures, close to the amount the government pays now. Individuals paid about half of that amount directly out of their pockets. (Of course, all health care expenditures come out of individual’s pockets, just not as directly as they used to.) Health care was affordable for most Americans ( the doctor’s bill when I was born was $50.00) and increases in health care pretty well kept pace with our increases in income. Since the government became involved, the increases have surpassed income by 400% or more.

Most people agree that something needs to be done, but not everybody agrees that the government needs to do it. There are plans being offered, although not many by Congress, that would go a long way towards fairly reducing the cost of health care and health insurance for all Americans.

Most of those proposals include a move away from employer-provided health insurance. Health insurance should benefit individuals instead of groups. Employment-based insurance hides the true cost of health care, which encourages people to over-use, and become overly dependent on insurance to pay for simple, everyday procedures, which automatically drives up costs. We need to let individuals control their health care dollars again, and choose from a wider variety of plans and providers. That would also serve to prevent you from losing your insurance if you happen to lose your job.

Under our current system, insurance benefits provided by employers are not considered taxable income, while an individual purchasing such insurance must do so with after tax dollars. This favors employer-provided insurance, a system we should be moving away from, instead of towards. We should also make Health Savings Accounts totally tax free, and expand their use to include all things health care related.

Competition is always one of the most effective ways in controlling costs.
People should be able to purchase health insurance across state lines, to provide more competition in that portion of the industry, and nurse practitioners, physician assistants, midwives, and other non-physician practitioners should have far greater ability to treat patients that choose to use their services.

These are just a few suggestions. There are a lot of ways to truly reduce the cost of health care. Most of those ways require individuals to take initiative and responsibility.

None of them require more government.

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