This is the first in a series of posts that I promised regarding what I think Congress should do.  I hope it will generate much debate and we will end up with a list of planks to a platform that will inform the voting public.

I heard a speaker on “health care” last Wednesday.  His most important point was this:  If you want to learn about sickness, you study sick people.  If you want to learn about Health, you study healthy people.  If we want a health care plan that will actually make our country healthier, we should emphasize those things that build health, not those things that fix sickness.  His point is a good one.  Our system of health care in the U.S. today really is a system of “sick care.”  Most of what we do today is spend resources fixing what is wrong with people instead of preventing those things from going wrong.

Here’s an example of how our government looks at ‘Health Care’ or as I prefer to call it “Sickness Care:”  In the American Recovery and Reinvestment Act of 2009 (the Stimulus Bill to most of us) over 18 Billion dollars of the almost $800 Billion was earmarked for Health Care.  Aside from the question as to what that has to do with Stimulating the Economy, what part of the $18 Billion do you think went to study health and wellness as opposed to the amount targeted to support our Sickness Care Model?  The answer is that $1 Billion Dollars was earmarked for the HHS Prevention and Wellness Fund, $650 Million was set aside for “evidence based clinical and community based prevention strategies, and $300 Million HHS Wellness Fund Immunization Fund.  that is less than $2 Billion of $18+ Billion or 10% of the total for “Sickness Care.”  They spend almost as much ($1.68 Billion) on the National Coordinator for Health Information Technology.

In my opinion, the current version of the Congressional Health Care Bill is all about politics and little about health.  It has a very strong emphasis on modifying a system that needs more than modification.  We need to start from scratch and and set goals.  Then we need measures to see if we are achieving our goals.  It seems that the package in front of the Congress today has as its number one goal, “Put together something we can get through Congress so we can say we ‘fixed health care’ in this country.”  To me it seems that the goal is entirely political.

The health care debate today is centered on insurance.  The purpose of insurance is to pay for the unexpected/unbudgeted cost of sickness care.  I have not read the entire bill, but, I would guess that most of it is concerned with preserving the status quo of employer sponsored medical insurance – sickness care insurance.

Here is a partial list of what I think Congress should set as its goals:

1.  Find incentives to help citizens make healthy lifestyle choices, e.g., eating right, exercising, being part of a close knit community, etc.

2.  Create disincentives for unhealthy lifestyle choices, e.g. smoking, excessive use of drugs and alcohol, etc.

3.  Divert to the study of healthy people, many of the dollars set aside by government to sponsor scientific research.  In the Stimulus Bill alone, the Federal Government planned to spend $7.4 Billion on scientific medical research.  Why does all the money have to go to find “cures” to sickness?  Why can’t we learn what makes people healthy?

4.  Reform Medical Insurance:  a) remove restrictions to portability of policies; b) remove inconsistent State mandates; c) Remove restrictions to competition; and  d) remove the necessity for most medical insurance to be tied to employment.  Medical insurance is an important part of family planning for medical care needs.  It should be available  much like fire insurance or auto insurance where there is less control of the market by government intervention.

5.  Reform our system of  ‘medical malpractice’ law and insurance.  A big cost of medicine today is not just the insurance Doctors and Hospitals pay to protect against legal liability lawsuits.  It is also the cost of excess procedures and tests that are prescribed by Doctors and hospitals who do so to cover their backsides due to fear of lawsuits.  Limiting awards for ‘pain and suffering’ must be part of the discussion.  When the trial lawyers buy a seat (or lots of seats) at the table, Congress gives too much weight to their desires.

6.  Realize and establish in the law that Sickness Care is not a Right.  It is a privilege.  A person may earn the right to medical care in a number of ways.  He or she may join a group that works together (pools) to better be able to purchase insurance.  Or, it might be that a person will best be able to afford medical insurance by doing those things that lower his or her risks of medical problems.  In a true free market, people could choose to buy insurance or pay as they go.   They could literally live or die based on their choices.  In a utopian (some would say socialist) world, everyone would have equal access and all medicine would be paid for by the state.  That means the Responsible would pay for the irresponsible.  This blog, from the start, has been all about Responsibility.  Part of any solution to our Sickness Care, Health Care, Medical ‘Crisis” needs to be a return to individual responsibility.

Here is a partial list of things that I think have no place in Health care legislation:

1.  If any employer or group (government, union, corporation, club) wants to compensate its employees or members in a way more favorably than the general public, it should do so by subsidizing that employee’s or that member’s costs for medical care or insurance, not by having special treatment written into law.  Special incentives to certain groups or regions of the country to ‘buy the vote’ of that group’s/region’s legislators should be a thing of the past.

2.  Any provision that would exempt any group from paying for medical care or medical care insurance on a different basis than the general public should be removed from law.

3.  Any provision that would treat lawmakers, union employees, or government employees on a different basis than the general public.  Any member of Congress, any member of a union, any employee of a government agency should compete for the same medical care in the same way as the rest of the population.

There are many more issues to address and questions to ask about health care.  What would you add or change from the above?  Would you vote for a candidate who used this as his/her health care platform?

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