What constitutes a good healthcare system?

  1. One that is affordable such that every citizen with a meaningful job can purchase it.
  2. One in which doctors and the legion of healthcare providers are paid well for the life-saving services they render.
  3. One in which the health insurance companies can make profits while insuring our health. By the way they are primarily profit-making enterprises and they have to stay in business.
  4. One in which there can be multiple plans such that people with varying levels of income can go for whatever plan their income can afford.
  5. One in which people with pre-existing conditions will not be denied coverage because they have pre-existing conditions but one also in which those with pre-existing and possibly expensive-to-treat conditions do not expect to be covered under the same kind of plan that healthy people have.

There are Medicare and Medicaid issues that lie in-between. There are issues of whether taxpayers’ money should fund abortion or contraception. There are issues of whether taxpayers’ money should fund organizations such as Planned Parenthood, which provide abortion, among other services, to women. There are chatter about cutting funding for WIC, the healthy-food supplement program for pregnant women. There are issues with how ridiculously expensive prescription drugs are in this country in comparison to Canada and other industrialized nations. There is a disagreement whether there should be an individual mandate to force individuals who can afford health insurance to buy it or face penalty. There are issues of having all employers, including small businesses who may not afford it, provide health insurance coverage for their employees. And then there are some other issues.

So how does a leader, whose intention is to pass a comprehensive healthcare law that will be fair to the health insurance industry, the healthcare practitioners, and the end users, go about addressing these issues?

In this country, we require anyone who can afford to buy a car to purchase some kind of auto-insurance for the car. It must not be the comprehensive coverage. But a sort of auto-insurance. There are many legitimate reasons for that. And it is an offense punishable by jail time in some states and citation in some other states for driving a car without some sort of auto-insurance. Nobody has ever risen to complain that mandatory auto-insurance for drivers is a tax burden on the driver. I do not know why someone who have a reasonable job, which can be analogous to owning a car, should not be required to purchase a health insurance. Those many legitimate reasons for purchasing an auto-insurance also applies to health insurance.

I had this debate with a Republican coworker of mine yesterday. And regarding my analogy with mandatory car insurance as the reason for mandatory health insurance, he opined that owning a car is a luxury which we do not necessarily need. And car owners therefore should be mandated to purchase auto-insurance. But no one should be mandated to purchase a health insurance. To which I asked him who he think will pay for that uninsured fella who suddenly falls sick and ends up in Ben Taub or Memorial Hermann? Those of us who live in Houston Texas knows what am talking about. Will it not be the government that will be paying for their treatment? The same government Republicans have been complaining is taking on too much social responsibility? And he had no response to that. The individual mandate is necessary to maintain balance in the insurance marketplace. And will not be truck out.

It costs the health insurance companies lots of money to cover the sick.

I wanted to join the Navy in the Fall of 2013. Everything went well until I got to MEPS for my physical. I was a young man brimming with life and vitality. With a master’s degrees, I was doing the kind of job folks with GED does. So, imagine my stress level. Long story short, my stress caused me some chest pain and when they asked me at MEPS, I honestly told them I’ve had some chest pain. And that rolled back by a century my recruitment into the Navy.

When I eventually got a career job and with my employer-provided health insurance, three weeks into my new job, I went straight to the hospital for the cardiology to carry out all manner of cardiovascular analysis on me, the results of which I was to return to the Navy, to prove to them that I was physically sound to join the service. I was passionate about serving in the military.

I was barely 3weeks into my new job. I got paid biweekly. And only one deduction towards my plan has been made on my paycheck. Way less than $200. But when I saw the costs of all the sonogram, and treadmill, and EKG and some other stuff that was done on me to prove that I was sound, I wondered how the insurance companies get the money to pay for these bills. This was just one visit to a cardiologist.

After my visit to my cardiologist, I embarked on a visit to a family doctor for blood work. Because it’s been a while I had a comprehensive health evaluation to determine if something was wrong with me. Every conceivable test in the book was carried out with my blood and urine. And the cost on the insurance company kept piling up.

This was like 2 months into my job and I was already burning up to 30k of Blue Cross and Blue Shield’s money. By the way, BCBS is a good company.

I know the reader do know where I am headed to with this storyline.

To be fair to the insurance companies, the provision in Obamacare for people under the age of 26 to be under their parent’s plan need to be struck out. Some of these kids make six figures a year and because of their youth and vitality are not that susceptible to sickness. And if those of these productive youths are made to join the health insurance marketplace, even if they only purchase a health insurance that is equivalent to liability-only auto-insurance, just the fact that we have many of them in the marketplace, can balance out the pressure on the bottom-line of the insurance companies, put by the elderly who are prone to sickness. There needs to be a balance. Health insurance companies are first profit-making enterprises. And if they are to remain in business to continue insuring our health, they need to make profit.

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