In the 1950’s most folks paid cash for their healthcare expenses. Doctors and patients worked
out payment for services between themselves. There wasn’t much healthcare insurance.
In steps the federal government. They established a salary freeze on employers after WW2.
In order to compete for employees, employers started offering benefit packages…including
healthcare insurance. Thus began the practice of health insurance that’s tied to the
workplace. Now, employers decide which insurance options their employees will have, and
how much they will pay for them. Employees don’t know how much their health insurance
costs, and often they don’t know what it actually covers until they have to use it. If employees
are unhappy with the coverage, there’s not much they can do about it. Now, for offering this
health benefit, employers are granted a tax break to help offset the premium costs. If an
employee quits or is laid off, they may find themselves unable to get insurance because of a
pre-existing condition.
Let’s think about what may be a better plan here: how about insurance plans that follow
the patient throughout their lives, regardless of where they work, or if they work. That
would largely eliminate the pre-existing condition exclusion. Let’s say an insurance company
isn’t allowed to exclude you for coverage if you’ve had continuous coverage and are merely
changing insurance carriers.
How about letting the patient decide exactly what kind of insurance they want. How about
giving patients a real tax break on their premium costs and medical expenses. How about
allowing employers to contribute to a health savings account for their employees—much
like a 401k. The money can only be used for medical expenses and premium payments.
That account stays with the patient whenever they leave that employer. Let’s say you can
accumulate a lot of money in that health savings account, so much that you could afford long-
term care insurance, or maybe pass the account on to your heirs, or donate it to charity.
After Medicare was passed in 1965, another law was passed that banned private insurance
companies from offering full medical insurance to anyone over 65—thus forcing all elderly
Americans onto the government system, even if they didn’t want it! They then required that
retirees couldn’t collect their social security check unless they were enrolled in Medicare! All
this and we somehow think that government can solve our healthcare problems??
But wait, there’s more! The government also decided that each state should require that
every insurance policy sold in that state have a minimum list of coverages-- called “insurance
mandates”. This includes the basics, like emergency care, hospitalization, things like that.
Many states have gone overboard with these required coverages—New York and New Jersey
for instance, have the longest lists of mandates. The longer the list, the higher the insurance
premiums. In Colorado, a single male is required to have maternity care coverage! Why
should a single man have to pay for maternity care? Well, it’s to subsidize the premium
costs of other people who DO need maternity coverage. IS THAT FAIR?? If you don’t drink
or do drugs should you have to pay higher premiums for substance abuse treatment? How
about this: how about we get rid of state insurance mandates and let everyone decide for
themselves what they want to insure themselves for, and what they may be willing to use
the cash in their health savings account to pay for? Insurance agents would walk their clients
through the process, just like they do with homeowners or auto insurance. You decide what
coverage is best for you. Free market hasn’t been in healthcare for over 50 yrs.
It’s time to think “outside the box”! Let’s get the government out of our healthcare-- They’ve
messed it up enough! Let’s put control back in the hands of the patient where it belongs!
(Note: This commentary is by Dr. Jill Vecchio.)
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