Now that
I have watched the latest televised presentation by the president on
ObamaCare (the one in which he lied), and studied research and
suggestions from various organizations and columnists, I am ready to
present my "Oh!BarbaraCare" plan.
I
realize that I'm no more qualified to have my own health care plan
than most citizens. But all citizens of a representative democracy
should acquire enough solid information so they can guide their
representatives on vital issues. So if you don't like my plan, feel
free and competent enough to do your own.
We must
first use our rational faculties to challenge assumptions before we
begin offering solutions.
Assumption One: All of us are entitled to health care.
Question: At whose expense? We can't be entitled to something that
someone else must be forced to provide. Aside from the payments,
what if no one wants to be a doctor or a nurse?
Yet: We
as a society have decided that we want all Americans (and legal
immigrants) to have at least basic and emergency health care. To
ensure this, we must be careful not to discourage providers and
hospitals by paying them less than the service is worth to them.
Assumption Two: The U.S. health care system is broken.
Reality:
The U.S. health care system is the best and the most effective in
the world.
However:
There are some problems, and it does need to be reformed.
Assumption Three: The U.S. health care system is too expensive.
Consumers, define "too expensive." How much is it worth it to you to
be healthy?
However:
It's reasonable to assume that health care could cost less if waste,
fraud and inefficiency were addressed.
Anyway,
President Obama says that HisCare will be funded by addressing these
things, so that the cost doesn't add to the deficit.
Oh!BarbaraCare says, address those things now with existing
government programs, before adding even more people to a wasteful
system. Let's get those legitimate savings, then proceed to address
the real problems, which are:
1.)
Cost. Some low-income people, not eligible for Medicaid, and many
small businesses, really can't afford expensive health insurance.
Oh!BarbaraCare would continue and expand the programs that subsidize
basic insurance for the poor. For all of us, the focus should be on
insurance for catastrophic health events, requiring almost everyone
to pay reasonable deductibles and co-pays (see "not entitled,"
above).
One big
change here: Oh!BarbaraCare would not use business to provide
insurance. Business provides the jobs that allow us to afford life's
basics. Let's encourage more job creation, not additional expenses
that hurt that basic business mission.
If we
consumers own our own health insurance, as we own our automobile
insurance, then we keep it even if we lose our jobs. Also, our
unemployment is less likely if the government doesn't burden
businesses with mandated expenses.
There
should be tax breaks for buying basic insurance and for health
savings accounts, paid for by no longer allowing tax breaks for
business-supplied health insurance. Since the latter includes
Cadillac plans for executives and unions, the savings should be
substantial.
We
should be able to choose from many health insurance companies across
the nation to maximize competition. And, we should be able to
organize in our own groups — small business, baseball fans, redheads
— to allow for economy of scale, just as seniors do for AARP
services.
Another
way to cut costs is to address malpractice insurance — paying
patients for avoidable mistakes and clear negligence, but not for
the assumption that we are all entitled to every test. And for truly
frivolous suits, the loser should pay all court costs.
2.)
Pre-existing conditions. Clearly, if insurance companies must cover
all pre-existing conditions, then no one would buy insurance until
he was sick! No one would pay into the system until it was time for
him to take out of the system.
So the
only way to cover pre-existing conditions is to mandate that
everyone get insurance and that there are companies for everyone to
choose from.
When we
own our own policies, with Oh!BarbaraCare, anyone who has been
paying all along for health insurance will be covered, at the level
they originally chose, when they get sick, even if for some reason
they have changed policies.
For
those who make a case that it is unconstitutional to force citizens
to get insurance, Oh!BarbaraCare would allow them to opt out of this
requirement if they sign a statement that they will not expect the
system to pay for their care. They can self-insure, or when
necessary, roll over and die. However, compassionate Oh!BarbaraCare
would provide hospice care to make the end easier for them.
Which
takes us to the controversial ...
3.)
End-of-life counseling. It's true that extraordinary costs accrue
during the final months of some patients' lives, when they are kept
alive with extraordinary efforts.
Oh!BarbaraCare would advocate living wills and more choice for
patients who want to leave peacefully on their own terms. Death is
natural, we should learn to accept and embrace it when the time
comes.
However,
Oh!BarbaraCare would provide legal assistance to elderly patients
who were being pressured by family or providers, rather than
counseled.
So there
it is. Of course, I'm always open to bipartisan negotiation with
anyone who doesn't lie.