Friday, February 26, 2010

A Question We Need to Answer

I’m not at all sure where we are on insurance reform after the photo op earlier this week. The only thing I took away from the “summit” was that President Obama was unkind to Senator McCain.

I’m about to delve into a subject that I’m not qualified to write about; but, what else is new?

Insurance simply put is people joining together, pooling money to protect themselves against a contingency that they expect would cost them more than their contribution to the pool than if they incurred the risk on their own. Well, not so simply put.

You can arguably reduce health care cost by culling people of higher risk and those that can’t pay the going rate; but, if you do, you really only transfer cost to public health, Medicare and Medicaid budgets. Those in good health and those with disposable income still pay the cost of health care for those in poor health and those without enough money.

Who is in the pool that is sharing the risk?

Unless we want to decide as a society that only those that can afford to care for their own health should be afforded care, we are left with some paying more than others. Think it through, I pay more than some and less than some for roads, police, fire protection and so on. The question becomes is health care a necessary societal cost. If it isn’t, we can quit talking about it. Let it go as it is with many getting inadequate care at a high and rising cost to all of us. Or, quit funding health care to those that can’t pay and see where that leads.

If you take health care for the country’s population as a societal necessity, the best way to provide the most care for the least cost is to make everyone participate and use economy of scale and regulation to keep cost in line.

Sorry to some of you; but, that is universal health care, public option, whatever you want to call it. You can start from the private side if you want with regulation of coverage availability and scope and cost of coverage; but, you get to the same point.

The private sector can do what it is doing now. It won’t provide health care that extends to our entire population, indeed, it won’t provide health care for those that now have it at a cost that we can afford over time.

It’s time to be honest. Do we want real insurance or not?


fermicat said...

Wow, no comments yet. It is a complicated issue. I work in healthcare and don't know what the right answer is.

I'd say we (the USA) have top notch CARE, but we have a messed up care delivery SYSTEM. I am reminded of that by something nearly every day at work.

Dave said...

You are right to distinguish. I think I'd be more accurate to talk about access. As to comments, I never know what will spark them.

Lifehiker said...

I agree 100% with you, Dave. Health insurance should be universal and the premiums should be means-tested.

However, I still contend that we currently spend way too much on care that has few benefits; we spend many millions treating individuals who have short-term terminal prognoses, for example.

Solving the health care problem will require both spreading the risk universally and reducing the gross amount spent on health care.