Take politics out of health-care reform and make sensible changes
The health-care debate rages on. Soon, the U.S. Supreme Court will make a decision on Obamacare. Letters to the editor and Local View columns in the News Tribune have laid out positions for and against the Patient Protection and Affordability Act...
The health-care debate rages on. Soon, the U.S. Supreme Court will make a decision on Obamacare. Letters to the editor and Local View columns in the News Tribune have laid out positions for and against the Patient Protection and Affordability Act. As in any debate there are two sides -- with meritorious claims for each.
As a long-time (40-plus years) employee-benefits practitioner and frequent user of health care (I am healthy but very accident-prone), I decry the process that has been used and that has led us to our present dilemma.
President Obama and the Democratic majority showed a definite lack of leadership. There were advance overtures to big health-care providers such as drug companies, insurance companies, health-care systems, etc. And then there were deals and promises to various states such as Nebraska and Louisiana. Such actions neither honored democracy nor were in keeping with Obama's campaign pledge to be open and transparent.
The Republican opposition was no better: It was against the process without really laying out noteworthy counter proposals.
The claim is frequently made that health care should be a "right." Virtually always overlooked is that with rights come responsibilities. As individuals we are responsible for ourselves, our dependents and the lifestyle choices that are made, including eating nutritious foods, getting fresh air, exercising, maintaining a healthy weight and ingesting appropriate substances. If people are born with health issues, or have an accident or contract a random disease, then society should and must extend a helping hand. But is it fair to ask responsible people to pay for those who make irresponsible choices? Robert Ingersoll once wisely posed, "In nature there are neither rewards nor punishments; there are consequences." As humans we are certainly part of nature's cycle.
Is our present health-care system totally flawed? No. Is there room for improvement? Yes. How do we approach this in an open and transparent manner?
How about a SWOT analysis, meaning an analysis of Strengths, Weaknesses, Opportunities and Threats? This long-standing business technique lends itself to the health-care debate, if not actual health-care reform. Appoint a nonpartisan, blue-ribbon panel of involved parties -- including physicians, drug companies, insurance companies, health-care systems, claims administrators, consumers, regulators and others -- to reassess health care. Preserve what is good; phase out what is bad; modify and tweak the remainder.
Consider for a moment what car insurance would cost if every ding, every tune-up and every tire change was covered. Accordingly, health care needs to build in responsibility for all parties with consequences for poor choices. Remember, elective surgery is not covered in virtually all current plans, so the element of choice already is ingrained in our system. (Laser eye surgery is another non-covered item, and it is interesting to note how its cost has dropped dramatically over the years.)
Build in incentives like discounts for healthy lifestyle choices, including not smoking, maintaining a healthy weight, fitness efforts and more. Health Savings Accounts (or HSAs) have worked well. Build in preventive measures. Limit other traditional, up-front coverages via co-insurance and deductible formats (if not an HSA). Provide catastrophic coverage. Remove conflicts of interest. Address
"defensive-medicine" practices. And create a genuine "level playing field" for tax purposes, etc.
We need to hold people -- our leaders, health-care providers and ourselves -- accountable.
Health care should be a right, just not an open-ended right without accountability: Health care responsibly delivered comes with responsible behavior by all involved parties.
Thomas B. Wheeler, CLU, ChFC, REBS, CASL and MSFS, of Duluth is president of Wheeler Associates, an independent, family-owned employee-benefit and financial-planning firm.