Posted on Jun 12, 2009
John M Grau
I can't decide how I feel about health care reform. It's now near the top of the legislative agenda and lots of proposals and ideas are being floated by the House and Senate committees working on a bill.
Almost every American has a stake in the outcome. The health care industry is a huge segment of our economy. We all use health care services and most of us are covered by some type of insurance. We almost all agree that there's something wrong with our current system. But we’re also afraid to change it.
Both sides of the reform debate seem to agree that there should be some form of mandatory coverage. Under our current system, those who have insurance end up paying more for coverage to subsidize services for those who don't. If everyone were required to have health care insurance, the overall cost should even out and insurers should be able to guarantee coverage even for people with pre-existing conditions.
The idea of allowing individuals to select coverage from a number of competitive plans also appeals to me. I understand how the concept of employer-provided health insurance got started, but is it really the best way? Why should the employer be responsible for health care, and why should an individual be restricted to the type of coverage provided by his or her employer?
Every individual has different health insurance needs - just like we do for auto or life insurance. If we had guaranteed access to coverage, we could pick the type of coverage that best suits our individual or family needs.
Now comes the harder decisions.
Should there be a public option among the competing insurance plans? In other words, should the federal government offer an alternative to private insurance? Would the government plan eventually force the private plans out of business so that we would be left with only government-controlled health insurance?
An even bigger question is how do we pay for all this? Some ideas include taxing the individual for coverage beyond a certain amount and/or limiting the deductibility of insurance premiums paid by the employer. I know the unions aren't too happy about this idea, since most unions plans offer top-tier coverage. From an employer's point of view, wouldn't that create some incentive to control the cost of health coverage in our labor agreements?
I like the fact that the United States has the best and most innovative health care system. I like the fact that we have free access to the doctors and hospitals of our choosing and that we don't have to wait months for elective care. I hate the bureaucratic morass of insurance claims statements, bloated costs, unnecessary tests, waste and fraud.
So what do I want from health care reform? Something better, but exactly what, I can't tell you.