Monday, September 7, 2009

You're a Mean One, Mr. Mackey -- But You Have Some Good Ideas

I am beginning to realize that no matter how we try to reform healthcare, it is not going to be the right thing. Maybe a public option is the best thing for now, but it is so complicated; there is no easy answer.

CEO of Whole Foods, John Mackey, spurred a massive boycott of his company when he asserted in a Wall Street Journal Op-Ed that "While all of us empathize with those who are sick, how can we say that all people have more of an intrinsic right to health care than they have to food or shelter?"

Mackey's viewpoint is disgusting. We try to help the poorest among us by establishing welfare programs and rent-controlled housing because we DO believe that all people have an intrinsic right to food and shelter. Many people are still homeless and starving because of a combination of underfunded programs and a lack of personal responsibility. Many rich people despise these programs because they simultaneously don't want to be forced through taxes to pay other people's living expenses, and they know from their own experiences that perseverence and personal responsibility are the keys to improving one's situation; receipt of handouts virtually guarantees that a person will remain in the situation that led them to receiving welfare because it removes the motivating factor to "pull oneself up by one's bootstraps." However, does this mean that we should not act with compassion towards these people? Does this give us an excuse to let people die in the streets because they should have had the foresight to purchase health insurance? Who Would Jesus Cover?

Although Mackey maintains a callous disregard for those who do not have coverage, I do not believe it is entirely coldhearted. In the WSJ piece, Mackey presents eight of his own recommendations for healthcare reform that do not include single-payer or a public option. While I do think that government should guarantee coverage for catastrophic illness and injury, I agree with most of Mackey's points:

• Equalize the tax laws so that employer-provided health insurance and individually owned health insurance have the same tax benefits. Now employer health insurance benefits are fully tax deductible, but individual health insurance is not. This is unfair.

Agreed, not much to say here.

• Repeal all state laws which prevent insurance companies from competing across state lines. We should all have the legal right to purchase health insurance from any insurance company in any state and we should be able use that insurance wherever we live. Health insurance should be portable.

Agreed, and to continue this line of reasoning, there should be uniform guidelines & forms used by all insurance companies to simplify the process.

• Repeal government mandates regarding what insurance companies must cover. These mandates have increased the cost of health insurance by billions of dollars. What is insured and what is not insured should be determined by individual customer preferences and not through special-interest lobbying.

Agreed, with a HUGE caveat -- we cannot just repeal all coverage mandates and expect that the profit motive will be enough to get insurance companies to cover expensive treatments, at least not at an affordable rate. This is why I believe that we need to enact a single-payer system ONLY to cover catastrophic illness and injury.

• Enact tort reform to end the ruinous lawsuits that force doctors to pay insurance costs of hundreds of thousands of dollars per year. These costs are passed back to us through much higher prices for health care.

I don't know enough about this aspect to comment. However, if a person dies or is handicapped due to a doctor's poor judgment, shouldn't they have the right to seek compensation through a lawsuit?

• Make costs transparent so that consumers understand what health-care treatments cost. How many people know the total cost of their last doctor's visit and how that total breaks down? What other goods or services do we buy without knowing how much they will cost us?

I don't see what this has to do with anything.

• Enact Medicare reform. We need to face up to the actuarial fact that Medicare is heading towards bankruptcy and enact reforms that create greater patient empowerment, choice and responsibility.

Again, I need more information to make an informed comment. Of one thing I am certain: If government healthcare reimburses providers BELOW-COST, it is a bad system. Reimbursement should be at-cost! This is not okay.

• Finally, revise tax forms to make it easier for individuals to make a voluntary, tax-deductible donation to help the millions of people who have no insurance and aren't covered by Medicare, Medicaid or the State Children's Health Insurance Program.

Sounds great! Who is going to collect and administer these donations? Perhaps the GOVERNMENT through a PUBLIC OPTION.............. perhaps in conjuction with a small tax to be applied only to those who sign up for the program..... except that if there was a tax, I expect that rich people would rather let the poor people pay everything so they can keep more money for themselves (even though they have millions in their bank accounts that is just being hoarded).

Sigh... what a quandary.

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