Health Care - A Conceptual Idea

As my screen name implies, I am a somewhat simple man who probably has no business writing in a public forum among so many truly gifted people with exceptional skills of written expression.

But I’m going to anyway.

 Being retired and disabled, I spend a good deal of my time watching and listening to cable news TV while surfing the net and pursuing my passion of trading the stock market. Accordingly, I have heard many debates and differing points of view about Health Care reform. My first observation is that it is impossible for the average American citizen to understand what the hell is going on because one needs a Masters Degree in Political Science and a PHd in Child Psychology just to cut through the partisan politics and TV commentators who are protecting their investment in President Obama.

 Whereas most people get their ideas in the shower, I get my best ideas sitting on the can. And an idea came to me this morning regarding the Health Care debate . At the risk of making a fool of myself, I am going to post that idea here.

 At the epicenter of this debate seems to be what role Government should play in providing Health Care to Americans. As we would expect, the Democrats want Government to  take control of it and lead us in the direction Socialized Health Care. As a free-market Conservative, I don’t want Government making my medical treatment decisions,  and I  think most Americans agree with me. That said, I think Government can play a role in improving our Health Care system while preserving the free-market principles upon which this country was built.

 Here’s my idea: let Government define 3-4 different Health Insurance Plans, each of which leaves no room for any doubt as to what each one covers and what it doesn’t. The plans would range in coverage from a low-deductible, “full coverage” plan that pays virtually all medical expenses to a plan for the young and healthy that carries a high deductible and is used primarily for “catastrophic” medical issues. The plans would be written in plain English with no wiggle room whatsoever for the insurer to apply their own interpretation of the coverage provided.  That is key. Denial of legitimate claims is a very real problem today.

 The Government would then allow all private insurers to voluntairly advertise and sell each of the Government-sanctioned plans, but only with the following stipulations:


  •  If they adhere stirctly to the terms of each plan in as it applies to coverage provided – no exceptions.
  • Insurers can charge whatever they want – so long as everyone pays the same cost for that insurer’s plan regardless of their medical history.
  •  Nobody can be denied purchasing a plan because of prior medical history. If United Health Care advertises Government-sanctioned plans A through D, then anybody who buys the same plan from United will be charged the same cost and cannot be denied coverage for any reason. 

Health Care providers can choose to participate, or not. No Government mandates. The “hope” is that at least some providers will participate up front enticing Americans to buy coverage from. It would be a strong selling point for a provider to advertise compliance to a Government-sanctioned plan issued under the scruitny of Government watchdogs. If other providers see their customers running toward those plans, they would be incentivized to offer the same plans themselves.  Such an approach will bring about competition, because Plan-A sold by Blue Cross/Blue Shield is identical in every way to the same plan sold by United Health Care. Disputes between the insured and the insurer and the costly litigation with it would be virtually eliminated by virture of plans so clear and unambiguous that even a Liberal Democrat could understand it. Americans will know exactly what they are getting when they buy a Government-sanctioned insurance plan. No surprises when the bills are sent to their provider. The issue of pre-existing conditions goes away.  So does Obama’s $ One-Trillion-Dollar tax increase to pay for his Socialist plan.

 Government could take a role in educating the public as to what each plan entails. Government could also assume the role of “watchdog” to keep the providers honest and come down hard on providers who abuse the rules. A clear and simple line of communications could be established for patients to submit complaints directly to the watchdogs so as to avoid the need for hiring a costly attorney. This idea could only work if Congress is kept out of it. Otherwise, each plan will end up looking like the U.S. Tax Code in 10 years. Maybe an independent Commission consisting of members of the insurance companies, the medical industry, and everyday citizens would be more productive.

 I will be the first to admit that this “idea” is rough and even crude. It is presented not as a detailed plan, but rather as a “concept” that might hopefully ignite a few sparks in the minds of the others and trigger a brainstorming tsunami that could lead to a legitimate alternative to socializing our health care system.