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April 27, 2006

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My husband is a doctor too, so it's encouraging to see posts like this. We need to talk about the solutions instead of simply complaining about the problems.

As for equality in quality of health care, I recall seeing (somewhere) a study that found money doesn't guarantee better quality. Americans pay more and get less across the board, according to the study (and I wish I could remember where I saw it.)

Based on my extensive professional and personal experience with health insurance, I have seen and heard all types of suggestions and complaints about health insurance in America . As a result, I have formulated some ideas on how the system can be made substantially better.

I have been a health insurance agent for more than twenty years and my wife recently passed away after a three-year battle with breast cancer, with medical bills (covered by insurance) of close to $1,000,000, so I can speak to the issues better than most.

I oppose a government run single payer health plan for many reasons. The idea of having the government deciding what medical procedures I can have is not what I want, and I believe that most Americans would not enjoy that aspect of a government run health plan.

Another very significant reason I oppose such a plan is that it will result in health care rationing. Many people point to the Canadian system in advocating a universal single payer health plan. Right now, many Canadians are forced to wait and wait for various procedures. Those who can afford it, come to the U.S. and pay for their treatment.

There are three significant, but not that difficult or costly, things that can be done to significantly improve the situation:

1) Allow health insurers to offer their programs nationally and agents to sell across state lines. There is already legislation that has been introduced in the House and Senate to do this. The result would be more options for all Americans and more competitive pricing on health insurance policies.

2) Create an "assigned risk" system that requires each health insurer to take their fair share of high risk individuals with a ceiling on how much more they can charge these people over their preferred and standard rates. Spreading that risk equally between all insurers in the market would enable those people who can not now get individual health insurance to do so and could be done without making the cost of health insurance for healthier people that much more expensive.

3) For those who can afford to obtain health insurance and choose not to, make it impossible for them to discharge their medical bills through bankruptcy or statutes of limitations. This would create the incentive for everybody to purchase health insurance and would result in lower costs for everyone.

I am sure there would be some fine tuning required on the above ideas to make everything work, but this sure beats more costly, bureaucratic program that would limit our choices and truly result in rationed health care.

There is a lot of health insurance rhetoric out there, but there are solutions other than getting the government more involved in our private lives. While I agree that some government intervention and mandates are necessary to fix our healthcare system, a socialized program is not the answer.

Thank you for taking the time to consider my suggestions.

Sincerely,

Steve Gorman

President

Alternative Health Insurance Services

Thanks for sharing your story and your suggestions, some of which I think are very good indeed.

I do, however, tend to dismiss this "government making medical decisions" argument as fearmongering. The fact is that Medicare is an example of a "government-run" medical insurance system, and I don't think it suffers the problems you mention.

Also, I wonder how we'll end up defining who "can afford" health insurance and what penalties they'll end up suffering. Of course, this was an issue with my own suggestions above too.

While Medicare has some good aspects, I do believe that as millions of "baby boomers" hit Medicare eligibility age one fact will become evident: there will not be enough money to meet the demands, and rationing will result for those who can not afford to purchase additional supplemental policies.

Decisions will need to be made regarding how to use available funds to pay for ever increasing high technologies and new, expensive medications, including who should be given some of this care.

It's a complicated problem with no simple solution. Ultimately, I believe that both the government and the private health insurers need to be involved in the solution.

Thank you for putting some good thoughts out there which will stimulate more discussion on these issues.

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