Tuesday, August 11, 2009

health care

I confess...I don't know nearly enough about the healthcare debate to make an informed post. But I'm rambling anyway.

I get a bit quiet when the debate comes up because I know I'm a bit uninformed. And because my mind just isn't financially focused and there are financial realities that are really important to the debate. I don't have any answer....I don't know which plan is best...but I do know some of my own values.

  • I believe health care is generally a right.
  • I believe there is a better way to deliver health care than having people rely on ERs.
  • I believe we need a stronger focus on preventative care. This will require some sort of incentives. I see why companies wouldn't focus on it b/c there is no guarantee that they will see the benefit...the 30 year old you invest in may not be a member when he's 70 and the results "pay off". I think that may mean there needs to be some sort of mandate...not that I can really formulate what I mean by that.
  • I believe we need a better way to address pre-existing conditions. The tricky area seems to me to be that we can't allow people to game the system (i.e. get a cheap plan and then switch to a better one the day after a diagnosis).

And then I have a few other beliefs that I'm more nervous to share...

  • I think we spend too much on end-of-life care. I certainly want to make people comfortable but I think eventually there is a value analysis that needs to be done and I think that it makes more sense to spend the money on someone who may recover than on extending a terminal case for a month or two. I think I may get struck by lightning now. In all fairness, I do apply this to myself too...it is part of the reason I signed a living will before surgery....
  • I don't know that I really place a ton of value on the right to keep your favorite doctor. I don't mind charging people more to pick a certain MD...assuming, of course, other qualified folks exist. You should have the right to a specialist where appropriate and to a second opinion, but I would sacrifice choice for savings.
  • I don't know how to work it, but I think that there should be price benefits for people who make healthy choices. Don't punish people for what they can't control (cancer in the family, etc). But healthy choices deserve a reward. That said, I think it needs to be done fairly. A program that gave a benefit for losing 20lbs would anger me since I'd be less healthy if I lost weight and would be punished for starting in a healthy range.

I'm sure there's more...but I'll stop. Now, someone important read this and make all the money stuff work :)

No comments: