ASK Musings

President Obama, Secretary Sebilius and others are working hard right now to try to solve the nation’s health care problem. I hope they do it soon.

However, I don’t think what they are proposing (as well as I understand it) is the right solution. The main reason is the reliance on employer-provided health care.

Can we stop with that? Having one’s health tied to one’s job seems like, and has been in my experience, a really horrible idea. It keeps people in jobs they don’t like (that others might do better, which could improve the nation’s productivity) and prevents people from leaving for jobs they might do better. It causes stress and crazy debt for people. 

And think about a really bad day. You lose your job. So that sucks. And then, you find out that not only do you not have a job, but if you want to keep health insurance on the chance that you don’t get a job within 63 days, it’ll cost you up to $400 / month. And that’s just for you – if you have a family, it could $1,000 or more. A month. While you are unemployed.

I don’t know if a government-run system makes the most sense. But private competition with no requirement to cover people seems to be doing squat right now. It punishes people for taking care of themselves. For example, one must list all medical issues within the last ten years. So if one is responsible and visits the doctor while the cough is still a cough, instead of waiting for it to turn into pneumonia, it gets listed. And if one gets diagnosed with a non-life-threatening condition that could develop into something worse, one gets denied outright. Nevermind that one could have just forgone doctors appointments for a couple of years and the condition would have gone undiagnosed, thus allowing the person to get health insurance. It’s this system of perverse incentives (don’t go to a doctor and hope you’ll get better on your own) that seems to be contributing to people who, once they do get sick, are really, really sick, and end up costing us all a lot of money.

I have some ideas. One is removing the job-health insurance connection. Another is preventing companies from denying patients coverage. They have loads of data one how likely people are to get certain diseases based on their past history. So let’s say Sue has had condition X for a year (one that requires little to no medical care), and 5% of people like her with condition X develop condition Y, the treatment of which is quite costly. Can’t they instead just charge her 5% extra for her coverage? Or 5% x % increase in cost? There are obviously some not-so-well researched conditions, but I’m guessing there’s a lot of data on obesity and heart disease, or asthma and other respiratory ailments. 

The Economist had an interesting article probably five years ago about requiring all to have health insurance. I love that idea. If all were required to do it, we’d have to fix the system. Hopefully remove it from any sort of tie to employement. Use the tax breaks given to employers to provide tax breaks and subsidies to consumers.

There was also an excellent article in the NY Times Magazine on the topic of restricting health care (posted below).

This is admittedly not the most well-thought-out musing I’ve ever posted, but I couldn’t not comment on it. I’m about to leave my job, and while I’ll have coverage when in London, I won’t have coverage at home, so I’m going through all of the options. COBRA is ridiculously expensive, and the various private options are hit-and-miss. I could go without, but I’d give my mother a year of stress that she doesn’t need, and myself a hefty hospital bill should something happen to me when I’m outside the UK.

Politics