The American Spectator

Darin| 7.31.09 @ 7:11AM

With freedom comes responsibility. While it's true we need to be free to choose what insurance we want (or don't want), we also need to take the responsibility for that decision. If we choose not to have coverage, we cannot whine when something happens and we're not covered. If we have limited means and choose a voucher system, we cannot whine when it does not cover everything.

Too many have forgotten the premise of freedom and liberty. There are positive sides as well as negative sides. We can't have one without the other. Sadly, the majority of Americans have forgotten this. They want "freedom" and don't want the "responsibility" that by definition must come with it. They don't want freedom - they want a nanny state. Yet they complain when they get what they want.

Rocco| 7.31.09 @ 7:20AM

Darin, well said!

Jake Wood| 7.31.09 @ 7:36AM

Darin is spot on; we are huge hypocrites when we claim we want freedom but won't be responsible. To continue with Mr. Scandlen's theme, we should try to model health insurance after auto insurance. There is no shortage of competition there. Unfortunately our lack of responsibility issues will surface and people will opt to not buy health insurance. It's criminal to operate an auto without liability insurance and if you are financing, full insurance is contractually required. So, people are forced to buy auto insurance. Certainly not total freedom, but it is a forced responsibility most outside of Eric Peters are willing to accept.

Just as auto insurance rates adjust to claims history and actuarial science so should health insurance. Never had a speeding ticket or an accident but until I was 25, I paid increased insurance premiums for the driving habits of my peers. Same should hold true for health insurance, sorry Gramps. If I had speeding tickets and accidents, my insurance rates would increase, so if you smoke, use drugs or carry some excess weight, then you pay more.

Of course some vouchers for the truly indignant should be awarded, but there should be some penalty taken out of their other benefits for smoking and toking and binge eating as well. But this all reeks of responsibility and the majority of American would rather accept a single payer crappy system that would cost much more for everyone than accept responsibility.

Phil| 7.31.09 @ 8:50AM

A while back I read an article by Mark Steyn in which he quoted some guy who was running for something somewhere (the details elude me). When asked what his healthcare position was he replied "My healthcare plan is that you pay for your own damn healthcare". As we say down in these here parts, it don't get no better than that!

Rod Fisher| 7.31.09 @ 8:53AM

I agree with all that you have said, minus one statement and that is "allow people to go uninsured" If that's allowed, then we will be right back where we started--go to the ER for service. Although I agree with your princple, in this political climate they (the elites) will not allow this. My thoughts on this are that EVERYONE or EVERY family be given a tax deduction/tax credit to provide their own insurance but they would have to be insursed at some level. Some may choose a lower/higher level given their circumstances, but it would be like car insurance--everyone would have to have it.

mteachjw| 7.31.09 @ 9:16AM

Right On, Darin. I would add "tort reform" to your solutions. That too, would lower some of the cost. You are sooooo right about freedom and responsibility. I have a stepson who currently wants his "independence" and "freedom". He just wants to do it on my dime. You can extraplate that to many in this country who want freedom and independence on everyone else's dime.

Greg Scandlen| 7.31.09 @ 9:30AM

Sorry, folks the auto insurance analogy doesn't apply, for several reasons:
1. Although it is mandated, about 15% of drivers are uninsured anyway. That is why there is an "uninsured motorist" provision in your policy.
2. You are mandated to cover the harm you do to others, not to yourself.
3. The mandate is tied to a privilege, like financing a car or having a drivers license, not to simply existing in the United States.

As for "responsibility," as far as I know people are already responsible for paying the bills they incur. And it isn't the uninsured who are clogging up the emergency room, but people on Medicaid who can't find a doctor.

Appleby| 7.31.09 @ 9:38AM

My wealthy relatives have chosen not to have insurance, because they have found that in the long run, they pay less out of pocket than the insurance would have cost. They often get discounts for cash up front, too. That is the way they got rich.

My own view is a modified version of this. I believe that everyone should be required to carry catastrophic health care insurance, with as high a deductible as he or she may choose and with the full understanding that NOTHING of that deductible will be paid by the taxpayers. Doctors as individuals sometimes make sympathy deals for payments; my late brother in law died of AIDS and I was his executrix and paid off his doctors from the estate, so I know they were taking small payments from him each month. One of his friends suggested I "blow them off" when the bills came in. I pointed out that besides being illegal (an executrix has fiduciary duties enumerated by law), it would mean that the next person who came asking for a break would not get one. She admitted I was right.

Most people can pay their day to day health care needs if they have to. It is the catastrophic events that sink their boats. Perhaps a product similar to Term Life could be designed, that would rise in premium gradually as a person ages and that would take into account his or her lifestyle and habits. Surely enough is known about people in the aggregate to make this work. I would also suggest that there should be Maternity Insurance that pays for nothing else but childbirth and its attendant needs and possible complications. There's specific insurance for cancer already; why not for childbirth?

There are plenty of ways this so-called crisis could be solved without some busybody committee of people who don't know you interfering in your daily life.

Nittany| 7.31.09 @ 9:46AM

mteachjw- If i may humbly restate your 2-p0int plan for cost-cutting reform:
1. Tort Reform- of course; every one of us has had unneccessary tests, every one....the primary explaination is defensive medicine. There is one more reason which leads into point 2.
2. Freeloaders- we who pay are paying for someone else's care as well. Sometimes unneccessary tests are used to help cover the costs of freeloaders to providers, a rightous scam indeed but needed by providers.
Tort reform just needs political will but throwing freeloaders off the rolls will be a lot harder requiring us to reconsider if these freeloaders are our brothers and whether or not we are their keepers.

hoads| 7.31.09 @ 9:57AM

I believe wholeheartedly in your prescription for healthcare and have said much the same. If we truly had a free market system, doctors and other healthcare providers would offer every type of medical treatment and service at every level of price point. Just like in retail, there are the high volume, low cost retailers, big box retailers, luxury retailers, etc. Medical care entrepreneurs would figure out how to provide medical care that meets the needs of the market and yes, even chronic diseases, even though this area would most likely require the use of more third party payment.

Primary care physicians are perfect for "concierge" or private fee for service healthcare. There is the potential for medical models that we don't even have yet that would be developed for profit and would meet the needs of most everyone.

Think of the folks who use the ER for primary care. A doctor with an after hours shingle and low fees (ex. $25 basic consult) would attract a huge market of those who are willing to pay a sum for basic medical treatment if it means quicker service. Instead, the drugstores have co-opted this idea and the retail clinics are taking off.

We need to get back to major medical insurance instead of this prepaid crap. This is why our insurance premiums are so high however, our government has pushed for this shift because it prefers the insurance company as gatekeeper instead of the doctor. The HMOs were a result of the Nixon HMO Act and then pushed through extensively by Kennedy in the 80-90's.

Too many doctors have grown limp and accept government regulation as a given. Time to man up and take your profession back.

Teddy| 7.31.09 @ 10:12AM

I think this is a marvelous plan. But there is one thing that has only been eluded to. There will always be those people who will not accept the responsibility of taking care of themselves or their family. For those of us who have been forced to choose between food and insurance and made a tough, but calculated, decision, we know the danger and the possible results. But for those of us who have been through something like that and who live in a community of loving people, we know that many times those who need help receive it more from their neighbors than from Big Brother.

Talking about freeloaders and such...I have absolutely no problem giving to someone who is down on their luck and needs a hand up. I would rather drop 100 dollars in their hand so they could go to the doctor to get over a sickness than pay the gov't 1,000 dollars, only 20 of which might go in the hands of a person who needs it. I may get blasted for this, and if that is the case then so be it, but I say this:

1) If someone can't afford insurance, give them vouchers, sure. But also take into account that many of those may get help from neighbors. That is not always the case (which is why we still have vouchers) but it will in many.

2) If someone just sits around their house all day, doesn't work, doesn't want to work, and generally doesn't give a rip about anyone but themselves...let them go without insurance or help. It may seem mean, but when they have a need and no one is around to help them they will see the importance of relying on themselves. It's about personal responsibility. They can take it or leave it.

LQQKY| 7.31.09 @ 10:18AM

Might I suggest Point No. 3: TORT REFORM! As long as the ambulance chasers can sue for any (or no) reason, not much will change; no matter who holds the purse strings.

Randy Bacon| 7.31.09 @ 10:21AM

Greg,

I've started to advocate in print for this solution in my local newspapers. It is the only long-term solution that is self-sustainging. What's the plan to get there from where we are? The first reply that I received was from a 70 year old screaming at me that I was taking away his Medicare (I am advocating the same solution for Social Security as well). We have got to devise a way to bridge the transition that people will understand. Bush had the beginnings of a solution for Social Security and the AARP killed it.

Tom| 7.31.09 @ 11:15AM

I agree with this 2 point plan. But, then, I absolutely believe that the government should not be involved in any private enterprise. It's unconstitutional.

Bram| 7.31.09 @ 11:46AM

By far the best plan I've heard of - along with Tort reform.

Marc Jeric| 7.31.09 @ 12:06PM

One of the main complaints against private health insurance companies is that they will not accept new customers with prior conditions of serious sickness. Well, let us see:
1) A fellow works 30 years without health insurance with no trouble; thus he has "saved" about $60,000 over that time - well, much more that that if he buy tax-free municipal bonds; then, after 30 years he would have a capital of about $200,000, all of it "saved" by his not paying for health insurance. Then suddenly he develops cancer and wants to insure himself; if the company accepts him this will increase the rates of other insured customers. Better the company does not dare to inflict the costs of that irresponsible goon on me and my family; I have been paying that insurance for years and I do not want to pay his costs now!
2) Another eaxample; in California one can take up voluntarily the option to insure the house against earthquakes - it adds about $30/month to your premium. So now another fellow will not pay that premium for 30 years, saving himself about 30x12x30=$10,800 (again, investing those moneys in tax-free municipal bonds that amount would be worth some $21,000. Then an earthquake flattens his house and he wants the insurance company to accept his earthquake insurance now - after the fact. I say to hell with him - I do not want my rates to go up because of that irresponsible creep!
3) Most of us pay the car insurance - against damage, theft, uninsured motorist. A smart guy decides to avoid that cost; there is a small chance that a cop will stop him and ask for proof of insurance. But the fellow is a careful driver - and over 30 years he will have saved some $60,000 in "unnecessary" expenditures (or, when investing those "savings" in municipal bonds he would end up with a capital of $115,000). Then one day a Mexican illegal without insurance totals his car; the fellow then wants to insure his car after the fact. I say to hell with him - I do not want my rates to go up to cover his irresposible behavior that "saved" him those $115,000.
So how valid is that complaint about health insurance companies not accepting prior conditions?

Rick| 7.31.09 @ 12:37PM

Wow! Let people keep their own money and make their own decisions how to spend it! What a concept! Mr. Scandlen is 100% correct. I've often felt the same about 401(k)'s, Sec 125 plans, etc. Those types of things are good, given the complex and confiscatory tax structures we face in the U.S. But how about a low flat tax rate (mildly progressive, if need be politically), and let people keep the great majority of their paycheck to spend however they want, if on investments, savings, consumption, health care, etc. 401(k)'s and Sec 125's and the like only exist to offset the complexity and high tax rates we face. Liberals always complain that left to their own devices, many people will undersave, or not buy enough or the right kind of insurance, or will spend all their money and have nothing in times of emergency. And that is true-some will. But most won't. And most individuals couldn't do worse than local, state, and dare I say the federal government when it comes to spending, which is now running over a $1 trillion defict (and with unfunded mandates that some estimate are in excess of $100 trillion-that's a 1 followed by 14 zeros!). And with everyone keeping most of their paycheck (and I mean about 80 - 90% of it), we wouldn't have even a third of all those but-insky bureaucrats making our lives more difficult and inconvenient with upteen trillion conflicting laws and regulations. And what of those who spend all their money, run up their credit cards, save nothing and have no money in times of emergencies? Well, I think maybe it's time for society and government to say, sorry, work it out yourself. Tap your neighbors, tap your family, but don't expect taxpayers in locations far away from you to bail you out. Yes, there would be plenty of sad stories on the nightly news. But maybe over time people will see what really happens when you spend every dime of your paycheck, when you don't save for rainy days, and when you don't make wise decisions regarding health and other types of insurance. Over time, seeing what happens to profligates who no longer can depend on the government for bail-outs (in the form of welfare, unemployment insurance, CHIPS program, etc.), I suspect people will wise up and start saving large chunks of their lower taxed paychecks, buy the types of insurance that fits their situations, and be better ready to weather the inevitable emergencies and storms of life. Imagine how much simpler and less complicated society would be! And how much more money you'd have in your paycheck!

Richard Baker| 7.31.09 @ 12:51PM

It does seem as if all the government interventions do have the net effect of reducing choices for our citizenry and probably intentionally. Good plan and the KISS principle does apply.

Sheila| 7.31.09 @ 1:02PM

I'm quite surprised to find so many reasonable and intelligent comments here. Let people have their own money, get out of the way, personal responsibility, and tort reform. Remember folks, Occam's Razor - the simplest explanation is usually the right one. Of course, the AARP crowd believe they're entitled - they "paid their dues" and now want "their fair share." The young and indoctrinated want someone else to be the grownup, always. Those few left are mere keyboard warriors, afraid to say much other than in internet anonymity. Try to remember, people, that "racist," "sexist," "homophobe," and "hater" have only the power you give them. Drop the fear and embrace the term - and then go forth and speak the truth in person. I do it regularly - and I know the rest of you merely roll your eyes in frustration.

jr| 7.31.09 @ 5:22PM

Good work, Greg. Your suggestions are the cure to most of the stupidy that politicians have been foisting upon us for the past months of Obama and several years of Jorge Bush. The simple truth is exactly what you are saying - but with a little twist. There is no need to give the money back to we little people. Reduce individual income taxes, eliminate corporate taxes and watch the flood of revenue into the socialism repository, the IRS. If it goes to the gubermint first, it will be diverted to politicians' wants and fantasies. Obama wouldl have recommendations developed that will dictate the therapy for various diseases and symptoms. There is nothing today that would prevent the NIH from doing so today -- no legislation needed. Except -- it would need to tell us little people all about it, be on our guard with the medics, and assure us that the recommendations do not cover everything and everybody. The latter -- "everybody" -- under the Obamacare program, will result in deaths. But of course, that will help make his program work better, as in cheaper.

Susan Eno| 7.31.09 @ 7:55PM

You are forgetting that every state has mandates regulating what insurance companies MUST cover to sell insurance in their state. My state, Massachusetts has a gazillion mandates and insurance if very expensive. End the mandates ins necessary before individuals can possibly have any control over what they desire to buy.

Richard Baker| 7.31.09 @ 9:25PM

Susan Eno:
True that the state mandates muddy the water on this issue. Proof that politicians at ALL levels are only trying to help us, don't you know? Liberty and Freedom are the answer at all levels along with responsibility for one's actions.

Mike| 7.31.09 @ 10:05PM

There are some great ideas here in the article and among the comments. Now if only we TAS readers could get the government to pay attention... :-(

Doug| 8.1.09 @ 12:51PM

All of this talk of "insurance" is nonsensical. Our helthcare cost are high because of government mandates and people insisting that someone else pay for their care.
I agree with the premise of the author. Get the government out of the way, stop the mandates, and forcing insurance.
I have an HSA, I pay for what little care I need out of pocket and have catestrophic coverage for the "unforseen" events.
IMHO, insurance coverage just to see a doctor for sniffles is stupid. Its like having car insurance that covers oil changes - I'm sure you could do that, put who whould pay the premiums?
No one esle pays for your oil changes, why should I expect someone else to pay for my health care?

Brenda Freeman| 8.1.09 @ 11:27PM

I am one of the millions that is currently UNinsured. I want to use MY OWN money, my OWN research, and MY own CHOICE to become insured under a plan that SUITS ME. I have several insurance plans to choose from and will make my OWN educated decision. I also use BOTH sides of the paper to print on. I have just surpassed the intelligence level of the government.

Donna| 8.2.09 @ 12:50AM

Doug, I particularly appreciated your comments and the way you personally handle your insurance needs more than any other suggestions I've read. However, just a note for consideration. It really is true that "old" is 15 years older than you are. So bear that in mind when I tell you I am 67, in exceptionally good healthy, rarely ever visit a doctor other than yearly check-ups. And, yes, I've been a responsible taxpayer many years. On the other hand, my sister is 63, deaf, and terminally ill with cancer throughout her body. You may also not be aware that in the years of her youth, employment was extremely difficult for a deaf person to obtain. Therefore, difficult to prepare for the proverbial rainy day. She isn't a free-loader and hates the word 'welfare." But asking her to provide for her own medical care at this stage would be akin to taking away the oars of a canoe already in the middle of a turbulent river; no way to get there from here. Of course, if you're 15 years or more away from age 60, you might think euthanasia is "humane."

Marc Jeric| 8.2.09 @ 4:08AM

TORT REFORM! In this country we have 1,100,000 lawyers; Germany, Japan, and Great Britain together have 35,000 lawyers. How come? Well - in those countries if you sue somebody and lose, you automatically must pay all the costs of the defendant and the court, both direct and indirect; here, you just walk away and troll on TV for new "victims". Such a tort reform would have several benefits, as follows:
1) the overall cost of health care would drop from $3 trillion/year to only $2 trillion (you know - defensive medicine + malpractice insurance);
2) all those crazy law suits by our eco-nazis would be stopped, with eormous benefits to the country - drilling for oil and gas, new nuclear power plants, new hydro-dams, and plenty of cheap energy. Also, no money to finance the terrorists.

Richard Baker| 8.2.09 @ 11:16AM

Marc Jeric:
When Dan Quayle said that we had 70% of the world's attorneys and that it's not a good situation, he was ridiculed. Now his comment seems rather correct, doesn't it?

Jim O'Brien| 8.2.09 @ 3:30PM

Many complain about HMO's. They don't realize that HMO's were created by Congress, not by insurance companies, by the HMO Act of 1973. Instead of saddling us with more federal laws, Congress should dismantle the mess it has created, beginning with repeal of the the HMO Act. This of course would be one small step, with much more dismantling needed.

Medicine should be returned to free enterprise competition, which always results in higher quality, easy access, lower prices, and rapid innovation. Once again: Government is the problem, not the solution.

Liberal Reader| 8.2.09 @ 6:04PM

If I had all the money I'm going to pay in income taxes this year to my state and to the fed. government, I could probably buy about a month and a half of medical insurance.

What do I do about the other 10 months or so?

Dave Lincoln| 8.2.09 @ 7:56PM

Lib. reader. You are a perfect example of what happens when only a small majority of citizens pay most of the tax burden. If you only pay enough (including SS ??) to pay for 1 1/2 months of a simple healthcare plan, than you are not paying near your fair share of taxes (especially for a "lib" - you should be voluntarily paying in extra, shouldn't you? you know, to "contribute your fair share" and all that.... for the children? No? OK, I stand corrected).

Either that, or you are one old m.f. and would be on an extremely expensive plan for existing ailments or just what they call "Liberal Derangement Syndrome", which is not contagious, but still can be worse than an STD in some ways....

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Marc Boyd| 8.3.09 @ 1:08AM

I am on Medicare now. All I am worried about is catastrophic medical bills. I chose the high deductible on the MedSup because I can handle the rest.

My wife got laid off last year and her Cobra runs out in Sept. We need a Catastrophic policy for her, but Blue Shield rejected her application because she is on Metformen, a treatment that is working. They are not allowed to do an exclusion for a policy. Policy denied. She nor her parents have had a diabetic history. We would have been happy with a Diabetic exclusion since that outcome is remote.

The alternative is a pool policy at $1000/Month.
Can you see O" care cheaper? I don't think so.

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Richard Baker| 8.3.09 @ 1:25AM

HMO's were devised by Ted Kennedy.

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Bilwick| 8.3.09 @ 9:30AM

Mr. Scandlen's program sounds similar to my own program. It's quite radical, and ObamaNation would never consent to it. I call it "liberty."

Doug| 8.3.09 @ 1:59PM

@Donna,
I'm very aware that there are charitable organizations that assist those having a disabilities like deafness. You have to be willing to use them. This isn't something I would expect the government to take care of.
I am a charitable guy, I give at least 10% of my income to my church and other things , its not done at the point of a gun as taxes are.
Yes there are needs that many people have, but expecting solutions from the government only asks to have your freedoms taken away. There is a price to be paid when you turn to the government and I'm willing to fight to not pay it.
If I have a need that I am unable to meet myself, I turn to family, church and to my local community.
In order for the federal government to "cover" everyone, expect euthanasia to be the norm for those deemed "too old" or "too sick". No one can make my decisions better than I can make them myself.
I live in Oregon where we have "assisted suicide", and we have the "Oregon Health Plan" (public health care for the poor), they will not pay for some cancer treatments, but will pay for assisted suicide... don't tell me the federal government would be any different.
I don't want this forced on the American people at large, especially if it can be stopped now.

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