Tuesday, July 21, 2009

Thoughts on health care

Having reached my late 60's with no major illnesses that I know of, I can comment on the current health care insurance debate with the cool perspective of an objective observer.

I'm also an objective observer of the free market system, as I don't own a business of my own, although I've had relatives who did, even in the insurance industry, as well as other relatives who were/are socialists or libertarians.

If we had the opportunity to design the health care insurance apparatus from scratch to ideal specifications, we would not make it a part of the free market system, useful and practical as that is.  One reason for this is that there is no room for profit, especially if we want to pay doctors, nurses, health care aides and therapists of all kinds the money they deserve for the work they do.

We need to have a low-overhead government run system similar to Social Security, which taxes everyone according to their income and pays for the health care expenses of everybody.  Possibly the government should also pay malpractice insurance fees, with an eye toward retraining medical professionals who seem to be accident prone, into another side of the profession where no one could get hurt.

What if we also paid for disease prevention for everybody, helping people to exercise every day, stop smoking, achieve a healthy weight, eat 5 or more servings of fruit/vegetables every day, cut down on refined and processed foods, for instance?  We could incentivize it by offering, say, a 1% cut in your income tax if you reach a certain percentage of health maintenance milestones in a year.

There may be millions of dollars in our present system being wasted on scams of one kind or another.  We could also incentivize reporting and whistle-blowing to uncover fraudulent activity and unnecessary or unhelpful services.  Maybe offer another 1% income tax cut for the person who provides information leading to the conviction of a perpetrator of health care fraud; or a 1/2% cut for showing a service is unnecessary and unhelpful.  (But don't try to take away my homeopathic allergy pills and drops!)

The problem with designing a more effective and efficient health insurance system is it can't be implemented without displacing the multitudes of people who work in the private health insurance businesses; and the multitudes more who have health insurance and pharmaceutical companies in their investment portfolios and retirement/pension accounts.  (Are these the same companies?  Have the Insurance companies all bought pharmaceutical companies, and the pharmaceutical companies all bought insurance companies?)

Then our problem becomes finding work projects for the people and money displaced by the new, more efficient system of paying for health care.  Some of them can find work in the government health care administration, although we won't need the thousands of people charged with rejecting claims.  
We could put the money into investments in businesses to promote healthy living, such as neighborhood gyms and smaller-scale regional food production farms.

Freed up investment money could also support businesses involved in energy independence, such as promoting and implementing geothermal in new and existing buildings.  Here's an idea for development:  neighborhood gyms could produce kinetic energy to power the whole block by fitting the treadmills and elliptical machines to turn human energy into electricity.

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