As a long time director of our local hospital, I can assure you that dealing with the federal government on Medicare alone is one of the most frustrating and convoluted exercises on earth. Our hospital is reimbursed much less than the actual cost of providing medical services, which results in higher charges to patients with commercial insurance. This cost shifting occurs all across the nation and has been a big driver of health care cost increases. The current reform bill relies on stripping an additional half-trillion dollars from Medicare to partially offset the costs of bringing millions of uninsured Americans into the system. Our hospital and local doctors will be further penalized by those cuts.
The legislation also strictly mandates insurance policy benefits and prohibits denial of benefits for pre-existing conditions. I understand the frustrations of those who are denied coverage because of pre-existing conditions, but forcing insurance companies to accept this risk is either going to drive up costs for healthy insureds or it will eventually drive insurance companies from the marketplace. The government has a rightful place in providing a safety net for the uninsurable, but it should not be at the sole expense of the private health care system.
If we are going to reform the system, we cannot delegate that decision to central planners in Washington. They haven”t demonstrated the discipline to control the cost of any program. And if you think pre-approval for medical procedures by your insurance company is frustrating, wait until you have to wait for approval from a faceless bureaucrat in Washington. If you think you don”t need health insurance because you are young and healthy and have other uses for your money, wait until the Internal Revenue Service comes knocking on your door to enforce the penalty for not buying insurance. The IRS doesn”t send people to collections; it sends them to jail.
The pathway to cost control and improved access needs to arise from free market, consumer-driven initiatives made possible by reducing government meddling. Let consumers buy insurance that is tailored to their needs, not to what the government says they must purchase; let them buy insurance products that are portable and can be taken from job to job without fear of cancellation or without being subject to COBRA limitations. Let consumers take responsibility for a bigger share of their health care costs, through high deductible health savings accounts that are accompanied by lower premiums and the attendant incentives to consume wisely. Let individuals and families have the option, by equalizing tax treatment, of untethering themselves from employer-provided plans if more attractive options are provided by the free marketplace.
And for those who find it impossible to purchase adequate insurance because of adverse health or cost issues, let Congress address that specific need by altering Medicaid eligibility. Better yet, Congress could authorize vouchers, similar to food stamps, that would help those who cannot afford insurance to purchase it, and it could develop reinsurance mechanisms that would allow private insurers to assume the risk of those with pre-existing conditions without jeopardizing their solvency or unduly penalizing their current customers.
Central control of anything, particularly by government, never reduces cost nor does it increase quality. What it does is stifle creativity and short circuit the dynamic interplay of supply and demand and free market competition which is the ultimate cost containment mechanism.
Of course our system is expensive. But, in return, we receive the best care on earth. People travel here from all around the world to obtain care that cannot be obtained in their countries. Aspiring doctors come here to study, to complete residencies and serve internships because of the unequaled quality of training. And who would deny that most of the life-saving technologies, drugs, medical devices and other medical miracles that have been developed over many decades have sprung from our system? It is systems like ours, underpinned by the free market and largely free of government meddling and central control, that have yielded the most enduring and meaningful advances in medical care in the world.
Let”s not destroy what we have created by allowing Congress to hand it over to the tens of thousands of minions under its control who would inevitably run it into the ground.
Tom Lincoln is a local insurance agency owner of Lincoln Leavitt Insurance Agency, Inc.
