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Healthcare for Newbie'sPosted Tuesday, January 26, 2010, at 9:19 AM
After months of talking and fighting, after the output of millions of words (and about as many dollars), it appears attempts to reform our healthcare system have hit a snag.
On Jan. 19, the first Republican candidate since 1953 was elected to the United States Senate from Massachusetts. Thus the Democratic Party no longer holds the so-called "super majority" in the Senate. Hopefully this means we can get back to the two-party system of passing laws. One might suspect, whatever one's politics, this is a good thing.
The two-party system, certainly imperfect, has served us reasonably well. Served best, though, when neither Party could ram through their particular agenda. Not a historical expert, but can't recall when a one-party system worked.
On the other hand, we may be in for another year or so of healthcare "debate."
The junior Senator from Massachusetts should understand, however, debating is not to be confused with actually solving anything. Actual solutions are simply too simple to be politically possible, to wit:
Simple Solution No. 1 -- Tort Reform
"Tort" refers generally to the system of Civil Courts setting dollar awards for personal injury. A big part of medical costs arise from the need for malpractice liability insurance to cover such awards; and a big part comes from doctors ordering test to "cover" their assets. "Just in case" tests being something with which I am quite familiar.
Unfortunately Tort Reform is politically impossible. As I understand it Tort Reform was not even being considered as part of the medical care solution. There is simply too much money to be made by too many "supporters" of office holders to affect meaningful change.
Simple Solution No. 2 -- Medicare Reform
Medicare is an "entitlement" program. This means that both I and the richest man in America get the same benefits. We're entitled by our ability to live 65 years. Making it an entitlement was the only way President Johnson could get Medicare through Congress (he had to have something both parties could swallow). If it were a "benefit" program the rich would have to pay really big deductibles, saving a lot of Medicare money.
Making Medicare a benefit program is the simple solution, which makes it politically impossible. There are simply too many actually-go-to-the-polls-voters who don't want the system changed. The good news is that my grandchildren's generation will no longer be able to support Medicare as it now exists, and they will have to change it. Maybe we should start right now calling them the "bankrupt generation?"
Simple Solution No. 3 -- Commercial Reform
Heard those commercials for life insurance "no medical exam necessary?" If you read the fine print you'll find that dying in the first two years nets your beneficiary only premiums paid. This method of selling life insurance comes out of every state adopting a variation of if you die after two years the insurance company cannot claim you had a pre-existing condition. There's a LOT I don't know about it, but somewhere along the line the states were quietly stuck with this provision, and the states in turn imposed it on insurance companies.
Solving the problems with health insurance could be just that simple -- quietly tackle one problem (like pre-existing conditions) at a time. Unfortunately reforming healthcare one piece at a time is also politically impossible -- just ask every American President since Teddy Roosevelt. Why not? See Tort Reform above!
The good news is that with the election of Senator Scott Brown looks like we can get back to the simplest of all possible politics -- sound and fury accomplishing nothing good!
David L. Lewis is an observer of and sometimes commentator on life who may be reached via e-mail at firstname.lastname@example.org.
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