Saturday, December 28, 2013

HEALTHCARE IS A PERSONAL THING

© 2013 Rick Adamson
By Rick Adamson 12.28.13

Healthcare is a personal thing.  It is primarily an individual’s responsibility to determine how it should be paid for.  In addition, it is appropriate for society and government to render assistance if it so chooses.

What it is not is an employer’s responsibility, although employer’s may choose to provide assistance if they wish.

Healthcare is not only about insurance. Insurance is a tool that people, society and governments may choose to use to help manage the cost of healthcare.  Until now this tool has worked reasonably well in that individuals and businesses could purchase as much or as little of it that they wished.  Insurance companies are in the business of providing indemnification based on risks. Purchasers tell the insurers what they what and they are given a price for that product which is based on the insurer’s assessment of the risk involved.  The government has no business setting down minimum (“mandated”) coverage requirements.  The market will take care of that quite well. In addition, the government’s involvement upsets the business model of insurer’s such that they became pawns of the government because they cannot price their products based on their assessment of risk.

Given my beliefs about healthcare, it is totally inappropriate for the government to require (“mandate”) any person or any company to purchase an insurance policy relating to healthcare.  If the government or society as a whole thinks someone should have an insurance policy they should provide it and not put it on the backs of employers. Moreover, the mandate only applies to certain employer's, those with 50 or more employees, which leave out millions of employees.  They are essentially own their own.

On top of everything else they have put the IRS in charge of enforcing the law.  That will insure that only law abiding taxpayers will be subject to enforcement.  Those who do not file will be out of the reach on the IRS and will, therefore, not be subject to the law.  

Until now there has never been a government requirement for an employer to provide an insurance policy for healthcare just as there is no legal requirement to provide employees with vacation days, sick days or paid holidays.  The market determines what benefits an employer provides and it is pretty efficient in doing so.  Before you know it the government will be mandating other benefits that have never before been their concern.

No one seems to like insurance companies and they think that premiums are too high.  With respect to health insurance, high premiums result because purchasers are not allowed to buy policies across State lines, frivolous malpractice lawsuits and the multitude of duplicate tests that physician’s order just to cover their behinds.  And that is not to mention the fraud and rampant manipulation (gaming) of the system that health care providers engage in.

In addition, if individuals had to pay for their healthcare services and file a claim with their insurance company in order to be reimbursed prices would go down. This is simply because the insured would know the cost of the service and would balk if the price seemed out of line. So why not increase the pay of every employee and let them purchase the insurance that suits their need in an open (50 state) market. The way it is now the insureds do not know (or care) what the cost of a service is because the health care provider bills the insurance company directly. So there is no oversight by the insured and the provider's tend to over bill. In order to prove my point, the next time you visit your doctor ask what the price will be using your insurance then ask for a cash price-the latter will be lower every time illustrating that the provider is going to over bill the insurance company.

If we could address the above issues the cost for health insurance would go down and be more reasonable.  You see, we purchase life insurance, auto insurance and home owner’s insurance on a national basis (across State lines) and we do not see continuing year after year double digit increases in their cost.

Obamacare has approached the issue of reducing the cost of healthcare (and at the same time providing coverage for everyone) in an entirely inappropriate manner.  It does not address the costs that provider’s incur in providing services (including malpractice insurance required to protect against lawsuits) competition across State lines, fraud or the fact that the providers bill the insurance companies rather than their patients.

Further, the people and businesses in America are independent minded and they do not like mandates from the Federal government.  The policy will not succeed in it current form because the people will not be mandated to do what is necessary for it to be successful.



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