What Reform Should Take Place Rather Than Obamacare
What the US has right now is employer-based health insurance, where one's employer provides the insurance coverage. This is also known as a defined-contribution option. What Obamacare goes toward is a government-centered healthcare system where it is the government who will have control of healthcare matters. What conservatives propose is a patient-centered healthcare system. This means one's employer would provide contributions towards healthcare. But the individual would have various choices of healthplans towards which the individual can apply those employer contributions rather than being stuck with whatever plan and company that the employer has already chosen. This way, the individual can choose and tailor whatever healthplan best fits him or her. This would also create a marketplace where different insurance companies would compete for the individual's choice, resulting in lower costs and excellent healthcare plans. For example, young persons could choose a plan with less check ups but more catastrophic coverage or part-time employers could choose a plan with less coverage but more drug coverage. This kind of choice would put the patient, as a consumer, in charge rather than the government or employers. This kind of reform is being done in Utah.
The answer to how we have coverage for people with pre-existing conditions: high risk pools. This would be a pool of money that already exists in some states that's funded by the rest of the healthy citizens of that state. Republicans have said that they want to fully fund these pools and have them in every state. This would be in combination with tax breaks for the uninsured. This would cover the people with pre-existing conditions without rehauling the entire system where the government would take control of the entire industry.
Another solution to pre-existing condition is a market-based solution where you can buy insurance against developing a pre-existing condition that stays with the person and not with an employer. As Professor John Cochrane of University of Chicago explains in this Wall Street Journal article, a truly effective insurance policy would combine coverage for this year's expenses with the right to buy insurance in the future at a set price. Today, employer-based group coverage provides the former but, crucially, not the latter. A "guaranteed renewable" individual insurance contract is the simplest way to deliver both. Once you sign up, you can keep insurance for life, and your premiums do not rise if you get sicker. Term life insurance, for example, is fully guaranteed renewable. Individual health insurance is mostly so. And insurers are getting more creative. UnitedHealth now lets you buy the right to future insurance—insurance against developing a pre-existing condition. The right to future insurance could be transferrable to another company, for example, if you move. You could have the right that your company will pay a lump sum, so that a new insurer will take you, with no change in your premiums. Better, this sum could be occasionally placed in a custodial account. If you got sick but had something like a health-savings account to pay high premiums, you could always get new insurance. Insurers would then compete for sick people too.
These market solutions can be refined. Insurance policies could separate current insurance and the right to buy future insurance. Then, if you are temporarily covered by an employer, you could keep the pre-existing-condition protection.
Here is another doctor who says the primary problem is not lack of coverage but the rising cost of healthcare. He proposes that insurance companies must pay for services ordered or performed by any physician that is a "provider" for that insurance company. Only catastrophic or major illness insurance should be required by all. This should be private, not government run. Allow individuals to buy insurance through affinity groups. Direct to consumer marketing by drug companies must be banned. Government mandates should be abolished.
The Republicans offered their plan in which their main point was to lower costs of healthcare. This can be done by tort reform where we end junk lawsuits; promote health savings accounts, and allow inter-state competition between insurance companies and policies which would create more competition and lower costs.
Here is a list of reform proposals by the CEO of Whole Foods:
- Promote the Health Savings Accounts.
- Equalize the tax benefits so that both the employer-based health insurance and individual health insurance have the same tax benefit.
- Allow insurance to compete across state lines.
- Repeal government mandates regarding what the insurers must cover.
- Enact tort reform.
- Make costs transparent so that the patient knows how much treatments cost.
- Enact Medicare reform.
- Revise tax forms to make it easier for people to help donate towards people who cannot afford any form of medical insurance.