mad anthony

Rants, politics, and thoughts on politics, technology, life,
and stuff from a generally politically conservative Baltimoron.

Monday, March 22, 2010

Some musings on the new healthcare bill...

As you can imagine, as a self-described fiscal conservative, I'm not pleased about the health care bill passing. I generally favor the individual over the collective, the private sector over the government, and nudges over mandates, and from what I can gather, that's pretty much the opposite of this bill.

I suppose that means I'm an evil person who wants everyone who is sick to die. Not so much. As someone who had open-heart surgery at the age of 4, I can't really blame anyone who wants to make sure that life-saving medical care is available to everyone. But I'm not sure this bill does that.

In fact, I'm not all that sure what this bill does, despite hours of news channel viewing and blog reading. And I'm not sure anyone else does either.

A few problems that spring to mind from what I've heard, though:

- Stay on your parent's plan until age 26 - When I graduated college, it took me about 9 months to land a real, full time job, so I can understand giving kids a grace period. And since twentysomethings are generally healthy, having them in the insurance pool is probably a net win. But something about age 26 just seems like going a bit too far - by the time I hit 26 I'd bought a house.

- treating models like they are gospel - proponents of the bill keep saying it will save money, based on the CBO's estimates. But estimates, especially ones that go 10 years out, tend to be off. When the unexpected happens - a "black swan event" - they tend to be way off - see, mortgage crisis. The other thing is that part of those savings come from cutting medicare payment 21% in 2018 - something unlikely to happen, and from changes to student loans, something completely tacked onto the bill.

- No denials for preexisting conditions - yes, this sounds great. But insurance companies don't just deny for preexisting conditions because they are evil bastards who want you to die. They do it because otherwise people would not buy insurance until they are diagnosed with an expensive illness. It's like being able to wait until your house is on fire to buy homeowner's insurance.

I'm sure there are a ton of other things about the bill I would hate, if I understood them, but those are a few that spring to mind.

So what would MadAnthony do if tasked to reform health insurance? Probably something similar to the Whole Foods plan - their health insurance plan, not making everyone eat tofu and organic beets. I'd like to see an emphasis on catastrophic care coverage and health savings accounts. You would pay out of pocket for small stuff - physicals, allergy medicine, ect. - and insurance would be for the big, life changing stuff like cancer or heart attacks. After all, that's what people need to worry most about, and those advocating health care reform have trumpeted lives it will save and bankruptcies it will avoid - presumably those aren't from the common cold. So if the government wants to do something, how about a tax credit for the amount that people pay for catastrophic care coverage, plus untaxed health savings accounts that don't expire or need to be used up at the end of the year, and that can be contributed into by employers and employees?

The way I look at it is that health insurance should be more like car insurance. I don't expect insurance to pay when I need an oil change or when my gas gauge gets near E. I expect them to pay when I sideswipe a Pontiac driven by a pizza delivery girl. It's for major, unforeseen events, not for day-to-day manageable expenses, and I think it's sad that it's an idea that wasn't even really discussed in this whole process.


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