July 1994 - Volume 13, Issue 7

Do we really want or need health care reform?

I think it fair to warn you that I do not have group health insurance. Rather, my wife and I do have a health disaster policy that protects us after $10,000 of costs incurred by each of us in one year. The cost is only $175 per month. We are not covered for pregnancy, botched suicides or abortions.

Thus, I am one of the great unwashed and uninsured in the health care debate. It is amusing to go to a doctor's office or a hospital emergency room and see the concern on the faces of the admitting staff when I inform them that I don't have a group heath policy. Yet, we often are charged considerably less than those who use health insurance for the same procedure. The reason is simple. . . No paperwork required and we pay cash immediately!

Why is health care such a big issue?

First, let's identify the major problems facing the health care system. The areas most commonly suggested as reasons requiring action are:

Hillary Clinton, Ira Magaziner, and their working panel of faceless, nameless governmental bureaucrats has brought forth a proposal of reform for about 1/7 of our gross national product. If enacted, government will control about 50% of all the GNP. The real issue is not health care but control of the American society.

Second, the best example of government controlled medicine lies in the Veterans hospitals and the Indian health service. Most people who have had to rely on these entities for their health care would opt for freedom of choice.

Third, the Clinton plan relies heavily on governmental mandates, HMO's, cost containment through bureaucratic oversight, and a reduction in the number of physicians who can enter specialized training. It also creates a whole new class of criminals if you want to have your personal physician treat you. As if we don't have enough laws that are not enforceable.

Fourth, the end result will be a disaster for the American public. Congress originally adopted Medicaid as a $7billion program. Now the cost is over $110 billion a year. Can we believe any of the estimates put forth in the debate over health care reform? The projected cost is only expected to be another $100 billion or so.

Business is to pay 80% of the cost of the program.

So what, if many small businesses will close. After all, they only represent 50% of all employment. Whether they can raise their prices to survive is not an important consideration.

Can we afford this?

At what point, do the taxpayers say, NO! We can not afford this! Moreover, if it is so important, let's not rush it through but thoroughly understand the reform bill. With all the competing programs now being developed, can any person truly understand what is actually being proposed.

I would be willing to bet that most members of Congress have not even read all of the Clinton plan, let alone the others. When you are determining the fate of 1/7 of the U.S. economy, should you take the word of someone else?

The Clinton plan is a Big Brother solution!

According to most studies, the cost of health insurance today averages about $200-$300 per month depending upon many factors. The best estimate is that the Clinton plan will increase the cost by 20-30%.

Any federal and/or state insurance reform package will end up costing more in the end than if you take the responsibility for your own well-being and that of your family. The reason is called "governmental overhead costs."

Yes, I am opposed to any insurance reform bill that allows the insurance industry and/or the government to dictate my choice of doctors and the amount of payment. By definition, a single payer system will increase costs.

The only effective solution is to eliminate from the payment cycle the large payers like insurance companies, or under Clinton, the government, who purport to act upon your behalf. Neither the insurance companies and/or the government have any real incentive to operate except as cost-plus entities. They have no real incentive to reduce costs while improving care and each patient becomes little more than a statistic!

We need to replace it with a system that allows each individual to select their own doctor, determine the extent of the diagnostic tests required, and provide the individual the means to pay his/her own medical bills.

A solution.

My proposal follows and is based upon the concept that individuals and their families should take responsibility for their own health care.

THE MIA account

We have about 250,000,000 people in the U.S. If the first year costs of the Clinton system are only $100 billion, the U.S. government could give every man, women, and child $400 each to be placed in a personal Medical Insurance Account (MIA). Based on the CBO figures, this is the estimated cost of the Clinton program each and every year. Since when has any estimate for a new program been on target and I'll bet the farm that the Clinton health care forecasts are no different. All the estimates were made in a smoke-filled room!

Beginning on January 1, 1995, each living American citizen would receive an MIA with a balance of $400 in it as a loan with interest to be paid at the federal funds rate from the U.S. government. The loan could be paid off at any time by the MIA holder.

Further, against the individual's 1994 federal taxes and in every subsequent year adjusted for inflation, the individual could contribute an additional $2,000 per year to the MIA. Any income earned on the MIA would be tax free.

From the MIA, the individual would be responsible for paying any health care costs. The individual would be able to negotiate a price with the health care provider. In fact, there might be two price levels. One would provide that the individual would not sue the health care provider. The second would cost additional money but allow the individual to retain the option of suing. (Some of my health care readers have suggested that this might lower the cost of heath care by almost 20%, i.e., they could practice medicine and not practice defensive medicine.)

Cost shifting would be largely ended as every person would have an MIA account. The question of large cost exposures in the early years can be easily covered with catastrophe insurance. For $100 per person, I am sure that some insurance company would be willing to write an insurance policy to cover all costs over $4,000.

The expensive cost of dying

Studies have shown that over 80% of all medical bills are incurred during the last six months of one's life. The quality of life during that period is also very poor. When the quality of life for our pets deteriorates, we kindly end the suffering. For some reason, our society is unable to look with favor upon those who want to end the suffering of loved ones and provide them the same compassionate care we give to our pets.

The end result is a massive transfer of money from either the family and/or the insurance company to the medical community. And where did the insurance money get theirs from - policyholders!

I propose that it should be up to the individual and/or a person holding a power of attorney to determine if life should be prolonged. The decision to end an individual's life should be determined by the individual and not by the medical community's desire to continue life-support to collect additional insurance benefits. Of course, we would have to amend our laws against euthanasia and assisted suicide.

Therefore, I would propose that all medical costs over and above the costs to be paid from a MIA would be deductible in full by the taxpayer and/or direct family members. Upon the death of an individual, any funds remaining in the MIA would be transferred tax-free and without estate taxes to the deceased's immediate issue proportionately. If there were no issue, the funds would be returned to the state.

It is past time for the individual to take responsibility for his/her own health and ultimate demise. Are we just slaves of the state, or are we truly "free people."

But then - - 'Tis Only My Opinion!

Fred Richards
July 1994

This issue of 'Tis Only My Opinion was copyrighted by Adrich Corporation in July 1994.

It is intended to provoke thinking, then dialogue among its readers. Quotation with attribution is encouraged.

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