Saturday, October 24, 2009

Insurance or Entitlement?

The current debate about health care reform wavers from insurance to entitlement. Is healthcare an entitlement to be provided by government or is healthcare insurance an obligation to be mandated by government? The topic of debate changes so frequently that it is impossible to determine the real agenda.

First; we have already determined that health care is not an inalienable right granted by the creator, nor is it a right granted by the constitution, nor is it a biblical mandate. (Link)

It would be appropriate to ask if health care should be an entitlement paid by the government. We would point out that virtually nobody is denied at least a minimal level of essential health care services. Medicare, Medicaid, the Veteran's Administration, and federal government employee insurance pay for medical services for over 40% of the population today. In addition, all hospitals are mandated by law to treat anyone who comes to their emergency room regardless of their ability to pay. Therefore, healthcare has become an entitlement in spite of the fact that this may be unconstitutional.

Political posturing notwithstanding; it seems that the progressives in congress and the President are determined to increase government involvement from 40% to 100%. It is all about revenue enhancement. (Link)

This effort is so unpopular that the proponents have shifted their focus from entitlement to insurance.

Insurance is when a group of people pool their resources to indemnify each member against a future occurrence of an uncertain event. Our culture has done a severe disservice to us by allowing us to believe that we should insure against first dollar loss.

For example: Everybody needs to go to the doctor from time to time, just as everybody needs to eat and drive to work. We don't expect someone else to pay for our food or our commute to work. Why do we expect someone else to pay for every penny that we spend on healthcare? It is a colossal waste of money to insure against every little expense.

We should insure against the future occurence of an uncertain event. Visiting the doctor is certain. Hiring a surgeon to remove our colon is uncertain. Not everyone requires such surgery (praise God) so this is an uncertain event against which one could purchase insurance.

The most cost efficient method is to purchase insurance against something that would cause a severe financial loss. One should purchase insurance against catrastrophic losses and budget for ordinary expected expenses. Unfortunately, our culture gives employers and insurance companies incentives to provide more and more perks so that we have lost our perspective of the role of insurance.

My uncle was a sales manager for an international distribution company. As he interviewed a prospective sales representative he said, "You pay your own expenses. They are lower that way."

When a third party, like your insurance company, pays for your medical expenses; you have no interest in what they are. A redundant test? No problem, bring it on. A tummy tuck, breast implant, or viagra? YOU BET. My self esteem demands it. Premium or generic drugs? Hey, I deserve the best.

My wife and I subscribe to our employer's flex spending accounts that allow us to divert pretax money into a medical flex spending account. This is not insurance but tax advantaged forced savings which allows us to set aside funds for day to day medical needs. This system has several flaws; but it is a good start.

There is limited access to Health Savings Accounts. These too are nothing more than tax advantaged forced savings accounts that allow participants to save for their medical expenses. The HSA includes a provision for high deductible health insurance to pay for catastrophic health expenses. The progressives in congress hate HSA's and have deliberately placed restrictions on these to limit access to a common sense approach to health care reform.

The progressives and their synchophants in the mainstream media will not tell you that the Republican party has proposed a number of creative healthcare reform innovations that would lower costs, improve access, and put the responsibility for your healthcare in your control. Follow this link for more information.

My personal preferrence is a Health Savings Account coupled with the Wal Drug Plan (Walgreens, Walmart, and others offering generic prescription drugs for $4).

It is NOT in the public interest nor is it constitutional to require everyone to have health insurance. This is not the same thing as driving a car. Driving is a priviledge. All states require that you demonstrate financial responsibility before you can exercise the priviledge of operating a motor vehicle on public roads. The key here is "demonstrate financial responsibility";i.e., carry liability insurance or post a bond with the government.

Health care is a personal responsibility and you have a constitutional right (10th Amendment) and a biblical right to behave irresponsibly (Romans 1:28 through 32).

It is estimated that as few as 70% of licensed drivers carry liability insurance. Those that get caught are fined or imprisoned.

What evidence do you have that mandated health insurance will be any different? What are you going to do when someone gets caught without health insurance? Put them in jail? This is reminiscent of the debtors prisons from the eighteenth century.

We need to keep health insurance in it's proper perspective in our society. We need to allow insurance companies to offer innovative health coverage plans. We need to find a way to allow them to offer these plans in multiple states.

We do not need to:

Demonize insurance companies

Place the federal government in competition with insurance companies.

Place more mandates on insurance coverage.

1 comment:

  1. Galynn,

    Nice blog! Glad to see you are making good use of your time. Just one question: Are you getting tired of paying for the medical bills of uninsured people who show up in emergency rooms? I am! They are a direct cause of increasing health costs, which insurance companies pass on in the form of higher premiums. Just a thought.....

    Joseph
    -Austin, TX

    ReplyDelete