Saturday, March 07, 2009

A Health Care Broker's Hard Look at THE SYSTEM

...While the employee of a regional electric utility is complaining about monthly payroll deductions for his family that now exceed $500 or more on a $60,000 annual salary, the longtime employee of a local small electrician is looking at monthly payroll deductions for his family of $1,500 on a $35,000 annual salary. His apprentice is younger, and so is "fortunate" to have monthly deductions for his family of only $900 on a $20,000 annual salary. The electrician's helper making $9/hr can't afford even his half of the premium for just himself.

Individuals on personal health insurance policies are also feeling the "pinch." Most of my individual clients see increases of 18-25% a year.

It is all of these folks (and there are tens of millions of them), coupled with those who have already been priced out of the market altogether, who will fuel the fire for radical reform. It is these folks who complain - long, loud and bitterly - that the American dream is leaving them behind. It is these folks to whom the politicians will ultimately listen, because they're the ones making all the noise. It is these folks who will ultimately define what the next set of reforms looks like - and those reforms will NOT be confined only to the small group and individual markets - nor do these folks give a rat's rear end if the insurance industry is involved.

This man gets it.

He understands that when the dust settles those whose insurance has been non-existent and whose health care has been poor can out-vote those who have been negligent.

I'm leaning more and more toward a two-tier system: a universal government-sponsored safety net for all, as well as private (for-profit or not for profit) alternatives for those who want and can afford them. I see thrifty alternatives, convenience clinics, and assisted living communities. (But Medicaid clients will be a revenue stream only for CMS-approved vendors.)

Those who can afford gold-plated arrangements may have them. Along with vacation homes, club memberships and other amenities that come with a comfortable lifestyle should not be denied those who can afford them. In fact, they should have a more generous medical tax break than those of us using the public system.

Update, March 12

Commenter Carla left this at John Sinibaldi's post.

To get anywhere, we are all going to have to go to a 12 step program and admit our problem: "Hi, my name is Carla and I'm a physician, I'm addicted to our current healthcare system and have been completely focused on pushing through as many patients as possible, because that's what pays."

"Hi, I'm an American patient and I'm addicted to our current healthcare system because it fulfills my every whim and doesn't have time to help me do the hard stuff to improve my health."

"Hi, I'm your health insurance company and I'm addicted to our current healthcare system because it enables me to insert myself in the middle and make a nice profit, without really adding much value."

Mr. Sinibadi, thanks for being the first one to stand up at the meeting."

1 comment:

Deron Schriver said...

A two-tiered system is a good compromise. It will have a greater chance of success if we all become better consumers and demand more value from the system.