A Free Market Proposal For Healthcare Reform

The healthcare debate revolves around twothat restrict individual liberty. In essence, a
systems that share common problems - namely,government that controls your healthcare controls
the issues of cost, access and individual choice.your body.
Within the current system, consumers areA Consumer-Driven Solution
removed from the reality of what medical careA health care system that provides consumers
actually costs. Since medical costs are shifted towith more information, accountability and control is
employers, insurance companies, healthcaredesperately needed. Consumers who don't know
providers and government, the real economicor feel the economic impact of their decisions will
impact of healthcare decisions are hidden fromput cost pressures on any healthcare system.
consumers. This encourages consumption andThey will also cede the ability to make their own
helps institutionalize inefficiencies within the systemdecisions to corporate or government
- which translates into greater costs, less accessbureaucrats. In both cases, the outcome that
and fewer choices. Conversely, a government-runbest serves the system is when you no longer
or "public option" is likely to expand theseuse it. More bluntly, there is an institutional bias
problems, while adding a political context that willtowards your exit in the current and proposed
limit the ability to optimize the system.systems. An alternative system to consider would
The Problem of Costturn this model around and create an advocate
Although inefficiencies exist within any system,for your life and liberty.
most healthcare costs are a result of sick, injured,Plan for Dealing with Catastrophic Care
diseased and dying people. Improving technologyI can purchase a healthcare plan without
integration, tort reform and streamlining processescatastrophic care for my entire family at around
can help reduce some costs - but, ultimately, the$200 a month. This plan can include reasonable
consumer's behavior and condition will have theco-pays, doctor visits, prescription benefits and
greatest effect on the expense of any system.wellness. Catastrophic care, however, would cost
Since these costs are primarily absorbed by themy family over $1,000 a month if I purchased
system instead of the consumer - behavior is notcoverage on my own. Families, businesses and
guided by its economic impact. The consumergovernments face the same financial reality. One
doesn't care if a procedure costs $20 or $20,000.alternative to this broken model, however, might
Under the current and proposed systems, thebe a system that operates much like Life
consumer's primary concern is whether or not aInsurance. In fact, Life Insurance might be one
procedure or medical service is covered or nottool that individuals could use to meet their health
covered. This places the onus of cost on theinsurance needs.
system - whether that system consists ofWhat if everyone ineligible for Medicare or
private insurers, government, business or aMedicaid had a life insurance policy where a
combination of these.percentage of the payout could be used for
Increasing access to the current or proposedcatastrophic care? For instance, if you had a
systems isn't likely to bring down costs. It will,$500K policy, you could use $300K to $400K to
more likely, spread costs to others who wouldn'tpay for the care to save your life. Under this
ordinarily use nor need either system - as well asoption, you will either forgo or reduce the payout
to employers, tax payers, shareholders andprovided to your survivors. Insurance companies
consumers. Again, when consumers are removedwould be placed in a position where advocating
from the economic affect of their behavior andfor your life makes good business sense.
conditions, bringing down costs become anConsumers, on the other hand, would be given a
abstraction that interjects corporations and politicalgreater role and incentives for controlling costs.
decision-making into individual choices.What's more, difficult end-of-life decisions will not
Individual Liberty and Choicebe made by the government or corporations -
In order to control costs, a structure has to bebut by doctors, families and patients.
put in place to determine what and who isMonthly payments would be significantly lower
covered and not covered. No system has infiniteunder this option. For under $100 a month,
resources and must address economic scarcity inemergency coverage could be made available to
some way. Within the current system andmillions of Americans. In the event of a
proposed reforms, consumers lack the knowledgecatastrophe, the cost of services within this plan
and incentives to address this scarcity issuecould be based on Medicare payouts or the
themselves - as they do so well in many otherlowest negotiated rate. These costs would be
areas of economic life. Instead, the system mustdeducted from the plan's payout. In this way,
impose rationing, restrictions and punitivecost of care will cease to be an abstraction that's
measures to address costs. These measures -absent from consumer decision-making processes.
whether from government or insuranceInstead, the real value of care and its impact on
companies - are in direct opposition to the ideal ofthose left behind will become a part of our
individual liberty and choice.healthcare calculations.
The current system limits an individual's liberty andA Plan for Dealing with Basic Care
choices in ways that go beyond healthcare.The same type of option that addresses
Employees can become indentured servants tocatastrophic care can be expanded to deal with
employers that substitute health insurance forbasic healthcare costs. Whole life insurance
higher wages, upward mobility, flexible schedulingprovides a model to cover costs associated with
and rewarding work. The shackles of the currentroutine care, doctor's visits, prescriptions, and
system also provide a disincentive for aspiringnon-life threatening conditions. Unlike medical
entrepreneurs and small business owners. Insavings accounts, consumers would essentially be
effect, our current system of employer providedborrowing against the matured value of their
health insurance inhibits the efficiency of jobpolicy to pay for medical costs. If these costs are
markets and limits economic opportunity.low, the consumer is rewarded with savings that
Proposed reforms, including the governmentcan be applied toward their children's education or
option, offer some hope of portability...but at theretirement. Again, the cost of services within this
expense of politically-charged infringements uponplan could be based on Medicare payouts or the
individual liberty and choice. Within a privatelowest negotiated rate. The premiums for this
system, you're not likely to care if I engage in anoption would be affordable enough to create
unhealthy lifestyle or other behaviors that increaseportability for most American workers, while
healthcare costs. However, once your tax moneygiving consumers greater control and incentives to
goes to pay for the results of my behavior andmanage healthcare costs and quality of care.
lifestyle - at the expense of your children'sGovernment, for its part, can subsidize premiums
education, your community and your financialfor low income, unemployed and chronically ill
security - you have a stake and a say in what Iconsumers who don't qualify for existing
do. My lifestyle and behavior suddenly take on aprograms.
political context - flavored with interpretations ofEffect of Alternative Plan
"fairness" and "justice". What used to be just aA plan that gives consumers more control,
doughnut and a morning smoke - evolves into anflexibility and accountability over their own
affront against someone else's economic future.healthcare will benefit our nation's future. It will
This leads inevitably towards greater governmentaffect wages, personal savings, innovation, job
involvement in all things that impact my health andcreation and tax revenue. What's more, it will help
the costs of the healthcare system. Listening toto re-establish the sovereignty of the individual
the calls of those affected by my decisions,over their own lives.
government will be compelled to impose remedies