Justin Jelincic

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Health Care reform vs. Health Insurance reform

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You will note that I have joined many in referring to the recently passed Health Insurance Reform Act as ObamaCare.  It is because many in the party have so openly declared that this Insurance Reform package is just the first step toward a total take over of the Sick Care systems in America. The claim that only Republicans are opposed to a governmental takeover of the Sick Care delivery system has agitated me into action.

We still need Health Care reform. ObamaCare is not the answer.  The government taking over the Sick Care system we have in America, is not the solution.  I generally believe the government should not run an industry where private citizens are willing to take the risk and find efficient ways to get things done.

When the government takes over an industry, and removes the profit motive, costs tend to go up, service tends to go down, and concern to respond to customer demands end  when the government monopoly takes hold.  When profit motives remain, managers look for cost savings and efficiencies, and understand the customer should be listened to, or they might go somewhere else for the goods and services they seek. There is a natural tension in capitalistic markets between profit and service. 

 Because of this tension, and concern for the outcomes, there is a need for insurance regulations, and many States, like California,  have a Department of Insurance to regulate the industry within their borders. 

With ObamaCare the President and Congress by their actions have said, “the States are not doing what we want, and the citizens are not doing what we want, and the employers are not doing what we want, so we are going to make them do what we want, we are going to begin to take over the Sick Care system and tell them what to do, what to buy, when to get care, and perhaps even what to eat.”  They would never say these words, but their actions declare them.

History has shown that a desire for profit drives experimentation and innovation.  The Man Made Modern Medical Miracles that have been created, have been the result of individuals seeking the American dream. In pursuit of profit and property, Americans get innovative. We find a need, and fill it.

We have seen Doctors move to specialization, because that is where they can make the most money.  We already have a lack of Primary Care physicians, and the requirements of ObamaCare, will magnify that shortage and increase wait times.   This has now been acknowledged, but not until after passage, even though both Democrats and Republicans who saw the problem were trying to point this out.  With the possibility of reduced compensation for being a Doctor, our best and brightest will not seek to become doctors in the future.

The regulations in some States have helped create our uninsured population by driving up the cost of insurance with the inclusion of unfunded mandates, and government required limitations on plan designs. These mandates have increase the expected costs within the insurance pool, and therefore have driven up premiums and some can no longer afford to buy the minimum allowed insurance plan.   

It is equally obvious that the profit motive has contributed to the problem as well, as advertisers and specialist seek to do more to make more.  Modern is “better then generic”.  Complex is better than simple. …..

Also we see costs driven by the desire to be treated as if we will live forever. We want insurance to pay to keep our loved ones alive in the hope some new Medical Miracle will come along and restore their quality of life.

On April 22, 2010 the Medicare Actuary, (the number crunching evaluators who forecast the future Medicare expenses) said that ObamaCare would drive up cost, and the proposed price cuts on Medicare are likely to drive down access, and perhaps drive hospitals into bankruptcy and closures. The problems and complexity of our sick care delivery system are significant. 

Employers originally provided  sick care insurance, as a work around to federal wage / price controls. Having employers become, and remain, the primary purchasers of sick care insurance, instead of individuals,  has created the environment where American lose insurance, when they lose their job, and then are denied insurance because of  preexisting conditions.  If we purchased our own plans, we would not need to worry about insurance disruptions from gaps in employment. Late in life as we naturally develop conditions related to aging, by having employer provided coverage, we expose ourselves to having to requalify for coverage should we need to change jobs. 

Obviously, employer funded insurance means wages are limited as employer dollars are directed to sick insurance premiums.  I suppose that many of the young and healthy, given a choice, would take the money over the sick insurance, and those of us getting older and more cautious would take the sick insurance.

In CA, auto insurance is required if you want to drive, in ObamaCare sick insurance is required just because you are alive.  

This requirement was added, and the multiplier allowed for older insured was tied to the cost of the young so that the young and healthy will subsidize the older, and less healthy.  Because of the multiplier limits, insurance companies will be required to overcharge the young in the risk pool to cover the cost of the older portions of the risk pool.

While I think children should support their parents, and have compassion on the elderly, I do not believe government mandates, can ever be as healing, as a society that teaches children to be responsible and caring.  

Think about it, which would you rather have visit you in your home, a government funded social worker, or a friend or neighbor who cares about you?

This is why I say we need Health Care reform.  Not Sick Insurance reform, but Health Care reform.  As Americans we have become less healthy in our life styles, and the sick insurance industry is being required to cover the cost of us abusing our bodies.  Which means the healthy who take care of themselves are paying too much to cover the cost of those who are abusing their bodies.

We need preventative Health Care.  Primary Care intervention.  Health Coaches who tells us the risk of our behaviors, rather than just take care of the bills when our behavior lands us in the hospital or emergency room.

I think we need a system that encourages us to see a doctor when we are healthy, establish a baseline of health and a relationship with someone who is motivated to keep us healthy, instead of looking forward to the income to be made when we get sick.

We need a care system where the care giver, and the one receiving the care, have a shared motive of health.  Third parties, insurance companies, employers, family members, the government, do not improve the relationship between a doctor and an individual.  Doctors should be motivated to keep us healthy. 

Some classic old movies highlighted the family doctor, who knew his clients when they were well, and treated them when they were ill, it was a good model.  It lacked specialists, and exotic, experimental, and expensive procedures, but it provided care.  That type of care would be less expensive than what we demand today.

  If I could buy that plan I would.  What do you think, do we need a Health Care system where doctors want to keep us healthy, or a sick care system where they look forward to us being ill?


Written by Justin Jelincic

May 5, 2010 at 10:07 pm

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