Although the bill currently being considered by Congress is being advertised as health care reform, it actually includes very little in the way of real reform. It is a thousand-page disaster which attempts to address problems which were created by government regulation with more government and more regulation at an enormous cost. There are real problems with high costs and millions of citizens with no health coverage, but raising costs even higher and mandating insurance for those who cannot afford it, enforced with draconian penalties is not a rational solution. It is a crude attempt to address the symptoms without looking at the causes. It's like giving a patient with skin cancer some makeup to cover his unsightly moles instead of removing them and curing his cancer.
The root problem in health care in America today is massive over-regulation, government interference in the marketplace and a lack of essential competition which would keep the costs of care and insurance reasonable. Past attempts to address problems in health care have consistently taken the wrong approach and have built on each other to create a tottering house of cards where everyone pays too much and the quality of service is too low. Real reform cannot be achieved by adding more bad ideas on top of old failures. Real reform requires tearing down all the old, failed measures and starting over again. It requires creative thinking and charting a course which is almost exactly opposite of what Congress and the President are currently considering.
We need to start over from scratch, tear away the mistakes of the past and really rethink how we manage health care in America today. It can't be done overnight, but here are five simple and powerful ideas which would be the beginning of substantial change in the right direction.
• Insure individuals, not groups. The current system of giving businesses tax credits for contributing to employee insurance takes away free choice and discourages competition which would encourage insurers to provide better service. Plans are picked by company management based on price rather than on benefits and service quality. Employees then have to pick only from the plans their employers offer, which may often be only one plan and is rarely more than three. This eliminates the force of free market competition. If individuals picked and paid for their own insurance, the better plans would get more customers and the insurers with poor service and benefits would either improve or go out of business. Prices would also be lowered as insurers worked to attract more customers, because insurers could no longer count on guaranteed large pools of customers from group plans. Businesses which no longer had to pay for health insurance would increase salaries so that employees could pay for themselves. This would also help with the problem of the uninsured, because many of those currently uninsured are self-employed and cannot find competitive plans, because most insurance is currently marketed to groups rather than individuals. Give individuals a tax credit only if they purchase insurance themselves. Encourage people to self-insure and eliminate regulations like HIPAA which give special protections to group plans. Insurance companies will rise to the challenge by providing better and cheaper coverage and more variety of plans.