National Health Care and the Age of Responsibility

No matter where you stand on the issue of National Health Care, it's coming soon in one form or another. So, I've been talking to freinds about how they would like to see it handled, and some ideas deserve some consideration. Here's one in particular that my room mate and I discussed.

If the main concern of government in this debate is getting everyone covered, then roll all of Medicaid and Medicare into the national insurance system and provide a basic coverage for all citizens. This coverage is basic, and while it's free, it has some strings attached. I'll get to those in a minute. This coverage is mainly for health maintanance, and includes visits to the doctor for routine physicals, emergency room treatment that qualifies as a true emergency, programs for smoking cessation and weight control, diabetic supplies, and other such basic medical needs. Again, this coverage is available to all citizens, regardless of status.

This would be the "public" coverage that Washington and the Obama administration keep talking about having. Any citizen who desires to purchase medical coverage over and above this level would be able to do so. Private insurance companies continue to operate primarily the same. Costs should be lower due to the government taking over paying for emergency treatment and many other common costs. Costs will also be lowered because of those "strings" I mentioned earlier. And here they are....

Part of being able to partake in the government health program is that citizens will be responsible for their own healthcare. When joining the public plan, everyone will be expected to do what is necessary to be in optimal health. If your doctor tells you that you need to stop smoking and lose 25 pounds, you will be given all the resources you need. Counseling is covered, a gym membership, specialists like nutritionists and those who will help you quit smoking are all part of the program. Then you have two years to follow through. If, at the end of two years, you return to the doctor and are found in the same condition, having made no effort to improve your health, you can be removed from the insurance rolls. Um, yeah, really.

An entire nation of citizens who are taking care of themselves can bring down the overall cost of health care. Cases of diabetes, cancer, cardio-pulmonary disease, heart disease, and osteoparosis would be reduced. And two years is certainly enough time to make some progress in ones health. But if you choose to do your own thing and not take care of yourself, why should the rest of us have to do it? We live in a society that tells itself "someone else will be responsible for me." Combine that with living under the current administrations aim to take care of every societal ill that effects us, whether self-inflicted or not. It's the "Nanny State Syndrome." This is a very expensive train wreck we're heading toward.

So in summary, I think there is a way forward. This plan would cover basic medical care. It would encourage all Americans to focus more on their own health and provide resources and incentives to do so. It offers an option to increase coverage through private insurance companies who can lower their costs. Physicians can opt out of the public program just like they can for Medicare and Medicaid or any private insurance. Patients using the public system will be encouraged to get healthier if they plan on maintaining eligibility. And those who are detemined to need more extensive treatment will have the option of obtaining the additional private insurance at any time, regardless of past medical history. There could be a private fund set up for those on the bottom rung of the economic ladder who absolutely cannot afford private insurance.

And the bill in congress that puts this in motion will include a clause that does not allow additional coverage for this group or that. This bill should contain nothing more than the parameters of coverage and be un-amendable. I know what congress would do if they were able to add to it down the road. And this is just an idea. Attainable? I don't know. It seems too simple in a time when congressional bills and laws are printed with well over a thousand pages. This could be written on 20 pages. It would take courage to put something like this in place, and I frankly don't think many in government have it anymore. They would have to ignore the unions, lobbyists, and social scientists who would insist that their constituents are getting screwed by the simplicity of the program. If they are so concerned about covering everyone, then they should be ready to sacrifice their own seats to get it done. Where's Patrick Henry when we need him?