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Health Insurance and the Faulty Premise

Contributed by: Donna Feldman on 9/12/2007

While politicians and social activists are busy trying to re-jigger our existing 1940's system of health care insurance into the 21st Century, it helps to step back and see the big picture. The entire conversation about health insurance in this country is predicated on a faulty premise. Comments in the Online Letters Discussion manage to sum up the faulty premise perfectly, if unintentionally: "The best (single payer system) appears to be Japan - everyone is covered and ... they have a higher life expectancy and the lowest infant mortality rate". And "Every other country manages to provide healthcare at lower cost with far better results."

In other words, health is something handed to you by the healthcare system, for money. Health is not something you create yourself. It is something you get from doctors. This is false.

Japan, ironically, is the perfect example of a culture and cuisine that facilitates health. Lifestyle diseases are, so far, uncommon. The Japanese don't buy health from the healthcare system. They have lower expenses and higher life expectancy because they have healthier lives. They don't use the healthcare system as much because they don't need to. By contrast, in the U.S. the growing obesity rate is a symptom of a sedentary culture and deranged cuisine that promotes ill health. We use the healthcare system to fix these problems, and the cost for this fix is rocketing out of control.

As long as our view of healthcare is based on the faulty premise that health is something we buy with health insurance, then the system will eventually collapse. No amount of tinkering with the current system will solve the problem, because the current system facilitates and rewards unhealthy lifestyle choices. We need a system that rewards healthy behaviors.

The so-called Blue Ribbon Commission for Health Care Reform in Colorado has come up with 4 nitwit plans that will not fix the problem. They are all predicated on the faulty premise that health is something you buy from doctors. It doesn't matter which plan they pick - it will fail, and you can take that prediction right to the bank. Invest in companies that invent new sleep apnea machines, new knee and hip replacement systems, new diabetes drugs, new ways to open coronary arteries and new stomach-stapling devices. If it has to do with lifestyle diseases, the demand will be insatiable, because all these plans reward disease. Healthy lifestyle choices are rendered financially irrelevant.

What would real reform look like? First, it would never, ever include employer-based health insurance. That 1940's relic should be abolished. Health insurance should be purchased from insurance companies. Everyone should be able to choose which plan and which deductible suits them. The premiums should be fully tax-deductible. Insurance companies can devise ways to reward health. We would have a system that rewards individuals who take responsibility for their own health

What about people who can't, or won't, buy their own policies? The first time such a person shows up at a clinic or medical facility, they will be instantly enrolled in a public, bare-bones insurance program: limited services, generic drugs, long waits, treatment by doctors-in-training.

This option should be open to anyone, from a dishwasher to Warren Buffet. Fund it with taxes on items that contribute to lifestyle diseases: gasoline, cigarettes, couches, big screen TVs, video games. As for taxing supposedly unhealthy food, that idea is a non-starter.

Sprinkle a few vitamins or some fiber onto the "unhealthy" food and, voila, a "healthy" food is born. Exhibit A: vitamin-enriched soda pop. We don't need to encourage products like that with perverse taxes.

This plan would work. Unfortunately the political will to dramatically restructure health insurance doesn't exist. Politicians are too cowardly to tell their constituents that health starts at home, not in the doctor's office.


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CONTRIBUTOR INFORMATION

Donna Feldman

Louisville , CO

Donna Feldman has posted 130 stories and 1 comment since joining on 9/14/2005. Donna Feldman 's average story rating is 4.9.
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