Thursday, August 26, 2004

Gov signs Health Care Justice Act into law. Let the debate begin!

On Monday, Governor Blagojevich signed into law the Health Care Justice Act. This gives us the chance (as I wrote about in my column here) to develop an actual plan for health care for everyone in the state.

I suspect we liberals are going to have to focus on those aspects of the health insurance industry that seem like a waste of resources where a universal government program makes more sense -- and then be comfortable with letting the other parts of the industry remain private. For example, I think catastrophic health insurance (hit by a bus, rare disease) should be provided to every citizen by the government. These risks can't be controlled or mitigated (largely), and the costs of those who are *not* insured to everyone else are far greater than just insuring everyone in the first place. That's insuring against medical bankruptcy. And if we had some harder figures on the costs of a previously productive person going bankrupt, losing their job, etc. because of an insurable health condition, and all this calamity would not have occurred if the government had provided catastrophic health insurance, that would help make our case. Anyone care to do a research paper on the topic?

(Speaking of which, I'm trying to help get some good research papers done with ideas for topics. Check out that page on my site, and please contribute your papers or ideas for topics. It's here.)

Another health insurance program I think the government should run is birthing. Why should women or their employers have to pay extra to cover the cost of birthing insurance? That's discrimination.

But some areas where private, for-profit companies should run the market (both in services and in insurance) include cosmetic surgery and 'alternative' care. I'm not sure where the draw the line (based solely on pragmatic assessments of the greatest good for the greatest number). Should regular check-ups be covered by a government program or should we require people to buy their own insurance -- or pay out of pocket -- for those regular recurring expenses? That's one odd thing about health insurance for regular check-ups: you're not really insuring yourself against anything, since everyone is supposed to go and spend the money for a regular check-up anyway. So what's the point of playing games? If everyone is supposed to spend the $250 to see a doctor once a year, then maybe that should just be an out-of-pocket expense, and we shouldn't encourage people to pay for that $250 by paying some insurance company a monthly premium and then having the company pay the doctor. Seems like a waste of time. Insurance should be limited to those big items, like a hospital stay or chemotherapy. I guess there's an incentive to actually go for a check-up if 'it's free' since the insurance company is covering that cost, but that treats us like children who are incapable of going to the doctor for a check-up if we have to write a check instead of pretending that the only cost is the $20 co-pay. Paying for regular, recurring, reasonable expenses (like fees for check-ups) muddies the question as to the real value of health insurance, and gets people into the game of trying to see if the cost of the premiums is more or less than what their out-of-pocket expenses were for the year. I hope we learn a ton about the real costs of the industry from the Health Care Justice Act -- and that they get started soon.

No comments: