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Category: Undeniably Right Undeniably Right
Published: 16 March 2023 16 March 2023

Republican candidate for the party's nomination for president, Nikki Haley, is talking about reforming Social Security in order to maintain its solvency. She's also mentioned Medicare and Medicaid as needing reform. As with most politicians her solutions are not solutions at all but rather putting another Band-Aid on a patient that had his leg ripped off buy a bear.

Planning for one's retirement should be not only an individual responsibility but an individual choice. The government's involvement should not exceed anything more than providing a favorable tax treatment of those savings and ultimately the distribution of those savings. Having the government run any type of pension plan takes away our ability to plan our retirement. We have no idea how much we will get when it's all said and done because rules will change. Just look at what is happening in France.

The return on our investment is abysmal. Some people prefer to take more aggressive investments, while others prefer a conservative approach. Some even decide to put their money in real estate or a business that they own and run hoping to sell someday for a profit. Trying to treat everyone the same doesn't work. If people don't have the discipline to do it themselves then you can let them opt in voluntarily to some form of Social Security but let it be their choice.

With regards to our health care system, we need to understand that there are two separate questions or problems. Too often, when people are talking about health care, they are really talking about how we pay for health care, primarily through some form of insurance. We need to be sure that we are addressing all the causes of the problem. But one thing health care has in common with Social Security is the federal government's involvement.

The federal government has taken competition out of the healthcare marketplace. More than 50% of people in the United states are covered by some form of government sponsored health payment mechanism. Medicare, Medicaid, Tricor, and other government controlled healthcare delivery systems, account for more than 55% of all people. That means the government essentially dictates what healthcare providers can charge, what services they can provide, and even more concerning, who can receive the benefits. Free market forces have further been minimized by the removal of the consumer from the equation.

First, let each state decide how they want to deal with the delivery of health care as well as the payment of health care. That allows different states to address the unique needs of their population. Some states may provide a better system for delivering health care services and paying for those services which might attract more people to the state along with businesses. Importantly, doing so would also comply with the Constitution's enumerated powers. The one area of the government could get involved in is through Interstate commerce by allowing insurance companies to sell across state lines. People in New Mexico or other less populated states would certainly benefit from being able to participate in health insurance plans available in Arizona or Texas.

Secondly, put the consumer back into the equation. Have you ever gone to a doctor's office for a visit and told him you're paying cash because you don't have insurance? The cost of that office visit is usually cut in half. The doctor doesn't have to spend money and time filing paperwork with the insurance company or government program. Neither do they have to wait to get paid. So I've proposed making that concept the core of what I think is a good payment system for health care services.

Insurance companies like certainty when it comes to setting rates. Let insurance companies offer plans that let the consumer choose how much coverage they want. You could have a series of plans similar to what we have under Obamacare; gold, silver, bronze. Each plan would offer a schedule of payments for common procedures. For example a gold plan might pay you $100 for a office visit, while the silver plan would pay $80, and the bronze plan would pay $50. Premiums would be higher for the gold plan and cheaper for the bronze plan. You decide which doctor you see. It doesn't matter what the doctor charges you for an office visit, you are going to get what the plan says you will get. If you choose the bronze plan but the doctor you want to see charges $60 for an office visit, then $10 comes out of your pocket. If you choose the gold plan you will receive $100 for the office visit but if you choose a doctor that only charges $90 a visit, you profit $10.

The insurance company likes it because it has predictability. The doctors like it, because they get paid quickly and don't have to worry as much about the bureaucratic side of the business. Consumers like it because they are now in control of the level of service they get and what they paid for it. Competition is put back into the system so medical providers at all levels would have to respond to market forces which generally brings costs down.

Finally with health care, tort reform is needed. The practice of medicine is an art that uses science as a tool to help them practice that art. It has become too easy to sue a medical provider for malpractice and get a judgement in favor of the 'victim.' Any medical provider can come in after the fact and say they would have done something differently. Because none of us react in the same way to prescription drugs or other types of treatment for the same or similar conditions. The standard to prove medical malpractice should be increased to gross negligence. One should have to prove that the medical provider acted with reckless disregard or did not take reasonable means to determine an appropriate course of treatment. That would also bring down the cost of providing health care.

The common theme in dealing with these two problems is getting the federal government out of the way. More importantly, it's putting the consumer, also known as the citizen, back in control. I know it's a novel concept, especially to those that have graduated from government school in the last 30 years, but it's been proven to work pretty well.