A conservative view on health care reform.

Dear Readers,

I would like to take a moment to introduce my husband, Jonathan Choate. He will be guest posting on my blog today and is sharing his views on health care and what kinds of reforms he would like to see as a conservative.

My husband and I are very different.

Yin and yang. He said, she said. Mary Matalin and James Carvell.

(Which is unfortunate as that would make me James Carvell because truthfully, while an attractive man, he would make a REALLY unfortunate looking female.)

If you want further proof of our differences, just compare his post title on health care reform to mine.

See what I mean?

I wanted you to have Jon’s point of view.

I had so much more to write but I cannot.

My basement is flooding.

FLOODING.

I am only in here because my back gave out from bailing and the baby started crying to be fed. So I sit here feeling frustrated. Ugh, I can’t think of it.

Oh, well. At the end of the day none of this matters. What matters is that people keep talking. Keep sharing. If you’re like Jon and don’t want the current plan? What are your ideas? If you are like me and want a plan passed with a few changes, what you would need to feel comfortable with to have it passed? Tell us. If you are very supportive of the current bill what would you need to see happen to get to a place where reform could occur? Where are you willing to be flexible?

I have to go. The need all hands on deck. You know, because my basement is flooded. It’s the first day of school, I haven’t had one ounce of sleep tonight and I think I probably re-injured my back so honestly I do not know how much I am going to be able to be around here today.

If you want to know how you can help me?  Continue on with the example you showed in my previous post. People, I had 260+ comments, over NINE HUNDRED EMAILS and guess what? Not ONE hateful comment.

NOT ONE.

I get hate mail for the way I tie my scarf and people have managed to have a passionate, CIVIL discussion about the most emotional issue in the country.

I AM SO PROUD OF YOU ALL.

It restores my faith in humanity.

So please:

KEEP THIS DEBATE RESPECTFUL. CIVIL. FOCUS ON SOLUTIONS. SPEAK UP!

Continue to speak up with your stories, ideas, solutions from BOTH sides. If you don’t do it here, do it somewhere. Fight to keep civil dialogue flowing. Between us all we can do this.

Please.

I did want to answer one question before I go. A reader asked me what in the world I could do to top being invited to The White House.

The answer is easy.

Work to get invited back.

:)

~Loralee

P.S. If you could spread the word that this post is up on the internet, I would be grateful. I think I will be too busy trying to keep the pestilence and plague of locusts that are probably going to descend next at bay. At least the Four Horsemen of the Apocalypse that are parked on my lawn have been watered.

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Imagine that you are at work, just going about your day and your wife calls and blurts out, “The White House will be calling you on Monday.”

That’s just another day of life being married to Loralee.

Apparently I was a rather integral part of the conversation during a luncheon held half way across the country with a room full of people I have never met. Loralee was given an amazing opportunity to speak with Valerie Jarrett about health care reform and she spoke a lot about myself and our frequent disagreements on it.

We have both lived through the same experiences and have come out of it with some different views regarding this hot button issue. While we agree on some things, we have many views that completely differ from one another about what should be done.  At the end of the luncheon, Ms. Jarrett announced that she would like a chance to speak with me to hear my ideas for solutions on health care reform. You can read Loralee’s view on the entire thing here.

I spent considerable time contemplating what I would talk about.  For those who are not aware, I am very conservative individual. I am not a Republican, and have not supported either of the major candidates in at least the last 3 presidential elections.  I am libertarian/constitutional in my views. I have a philosophy on what I believe is the role of government, and so far neither of the 2 major parties has represented those beliefs adequately.

I oppose most of the policies that the current administration has proposed.  However, even though I oppose the policies, I do not believe that the president or his advisers are bad people.  I think they wholeheartedly believe that what they are trying to accomplish is the right thing for the country.  I just disagree with the methods.  And that is why they wanted to talk to me, a network engineer from little old Logan, Utah.  They wanted to talk to a regular everyday conservative and see how he feels about the health care debate, and for that I give them huge amounts of credit.

True to her word, I received a call from Senior White House Adviser, Valerie Jarrett, the following Monday afternoon.

She is a delightful person.  We spoke for roughly 30 minutes, a significant amount of time for someone with her responsibilities. We had a good conversation about her experience meeting my wife and about health care reform.  We covered several topics including tort reform, regulatory reform, and methods for improving efficiency in the health care system.  Like many political topics, we agreed on several points of view, especially what the problems with the current system are. Due to time constraints there were many parts to the debate that we were unable to address, so I told her I would put my thoughts on a guest post on Loralee’s blog.

I’d like to address what I feel are the real underlying problems with the health care system.  It is NOT a problem with health care, and my wife agrees with this. Our family has a wonderful physician. He is a General Practitioner and he has done a wonderful job treating my wife and children. We like him very much. My wife also had an outstanding high-risk OB/GYN and Perinatologist that saw her though her pregnancy. I deeply appreciate the care my wife and baby received during those 9 trying months.

The care of our providers is not in question as far as I am concerned. It is a problem with cost and availability.  Despite a lack of emphasis of preventative care (which should be the responsibility of the individual, not the government), the US has the best system for actually dealing with health problems.  We should be fixing the underlying problems in the current system, not just shifting who pays for what. We need to address lowering the actual cost of health care and here are a few ideas on how to do that. These have been brought up by other people in other places, but this is just my opinion of them.

Tort Reform – This phrase is bandied about by a lot of people who don’t even know what tort is.  “Tort is a system for compensating wrongs and harm done by one party to another’s person, property or other protected interests (e.g. reputation, under libel and slander”[from Wikipedia].

Doctors need to have malpractice insurance in order to protect themselves from malpractice suits. Most of the insurance regulation occurs at the state level, so there is little that the federal government can do in regards to that.

However, as some states have done, they can establish caps on certain types of claims in order to help stem the rising cost or malpractice insurance.  This would directly affect the premiums that doctors pay, therefore lowering the overall cost of the services provided.  By doing this, this may also affect so called “defensive medicine”.  That is when additional tests or procedures are performed on a patient solely for the purpose of protecting the doctor or institution from malpractice liability. As far as I can find, no one has been able to successfully quantify how much waste defensive medicine is causing, but anecdotal evidence suggests that it is significant enough to make in impact.

Another option is to move medical litigation to a special court (much like taxes are) that is designed to deal with medical issues.  Having a medically trained judge making the ruling would simplify the process and severely curtail frivolous claims as they would have to sell the story to a medical professional rather than a jury. This would only be for civil suits, not when there is criminal action brought.

Regulatory Reform – The regulatory burden that has been put on many aspects of the health care industry is very significant.  I am not saying that some regulation is not needed, but come on people, some of the hoops health care providers have to jump through to provide us services are down right draconian.  This applies not just to doctors and hospitals, but to the peripheral industries that support them.  A good example of this is HIPAA.  While I applaud the effort and good intent to try to protect patient’s privacy, the lengths that doctors and hospitals are forced to go through for compliance with this law are absurd.  I know, as I have done some consulting for network and computer security for doctors and hospitals.  A review of these restrictions by people in those industries (not a politician or bureaucrat) would find thousands upon thousands of useless efficiency draining regulations that could be removed, or revised.

Regulatory reform especially applies to health insurance.  One of the major problems with the availability of insurance is that you cannot bring your insurance across state lines. There are many complications regarding this. I generally prefer  states to be as independent of the federal government as possible. Limiting the sale of a product (which is what health insurance is when you get down to it) across state lines is rather silly. We certainly don’t do that with any other products except alcohol, drugs, and firearms.  And those are generally restricted by the states themselves, rather than by the federal government.  I don’t think insurance belongs in the same category.

Tort reform and regulatory reform are changes that the federal government could make fairly easily and quickly. However, these are only things the federal government can do directly.  There are many other reforms that could be made to the basic structure of how we access and think about health care that would fundamentally change the system in a positive way. These are things that must be done in collaboration with industry and states because while the government must be involved it cannot accomplish these things by itself.

Make insurance coverage independent of employers.  What used to be a way for a company to offer an incentive to attract and keep good employees has become a requirement for any company employing more than 50 people. That has become a MAJOR burden upon businesses.  It also makes it so there is no choice for the individual. With most companies paying a portion of the care as a benefit, the employee doesn’t see the complete spectrum of cost increases. If individuals had to obtain their own health insurance, it would allow them to have real choice, rather than being forced to take whatever plan their employer provides.  

The increase in individuals seeking insurance would allow a new market of co-ops and other voluntary groups plans. If we take away the unnecessary regulations they would be able to operate for more efficiently. The money saved by employers on insurance and Human Resource costs could go directly in their employees pocket.

Making a profit is not a sin. Lately, I have heard from several sources that we need a public option because “there would be no profit motive”.  Guess what folks? PROFIT IS NOT A BAD THING.  

Now, if you are making your money through unethical or criminal means that is a different thing.  But if a company does not make a profit, they go out of business.  This is true for insurance companies as well.  It is the profit motive that spurs innovation and efficiency.  If there is no profit, there is no benefit for risk.  Why would a pharmaceutical company invest hundreds of millions of dollars to possibly develop a new drug to treat a disease if there is no benefit if they succeed? 

I hate to say this to our Canadian and European neighbors, but for your own self interest you should be fighting additional government involvement in the US health care system as the rest of the world benefits from the innovations the United States produces from…. you guessed it, profit.

I do not want you to think that I support the practice by some insurers of denying any questionable or expensive claim until action is taken and they are forced to cover it.  If you have contractually obligated yourself to provide a service, you better do it.  Since most individuals have no direct choice about their own coverage and that our system has become so bloated, the market is not working. If I have a plan in my name, and I am unsatisfied with the service I will go somewhere else.  If I have no choice other than what my employer or government has chosen to provide to me, all I can do when the service is bad is to bitch about it on the Internet.  Companies that offer poor service and have bad policies will go out of business because they won’t have any customers.  Before we abandon market principals… let’s try using them.

I began this ever increasingly long post saying that I have a specific philosophy on what is the proper role of government.  There have been thousands of volumes written on that topic, so I won’t expound too much on it, but having the federal government competing directly with private industry is not one of the things that I believe is their role.

I believe in limited government, especially at the federal level.  Government is necessary so that we are not in anarchy.  But any power that we give the government is power we as individuals no longer have.  Government by its very nature wants to grow.  That is why our constitution enumerated and limited powers of the federal government and split the powers among different branches with checks and balances with the hope that they would keep each other from growing.  If a state wants to try to offer a universal system then that plan can be debated among the residents of that state, as they do not have the same constitutional restrictions that the federal government does.  Does that mean I would support a socialized state system?  No, because I believe socialism is morally wrong and, to be blunt, destroys individual initiative and responsibility.  But that is for the individual states to decide.

If you managed to make it this far, you get a cookie.

I have not addressed one of the major issues facing many people (including my wife) and that is being “un-insurable”.  I don’t have a good answer for that.  You can’t force a private insurer to provide services to some one, and I don’t support having the services directly provided by the government.  

I think that we might already have the best solution in place now.  In Utah at least, there is a program that is partially paid for by the individual (quite expensive, but no absolutely astronomical), and part by fund that all insurers in the state are required to pay into (kind of like Workman’s Comp).  The fund is administered by a private insurer that is contracted to the state.  This is only offered to those who are unable to obtain insurance though a private insurer.  However, if we keep a system like that please for the love of all that is good, remove the stupid requirement that you must exhaust Cobra before you can join. That one bit us in the ass. We weren’t aware of us, the accepted us (when they should not), we verified coverage for our pregnancy and were told we were fine. We have learned the hard way to double and triple check everything.

In summary, I realize that the steps that I have outlined will not solve every problem we have.  There is no magic band-aid that will make it all better.  But these are steps that I think can significantly improve access, cost and availability.  There is also one thing that I think we can all agree on.  Our government cannot afford the plan that is currently proposed.  The CBO has estimated that is will cost us a trillion dollars over the next 10 years.

Remember, Conservatives want change too.  But let’s be certain that we are actually changing things for the better.

I would like to end by thanking you all for listening and my wife for giving me the chance to post this.  She did not have to do it.  I have not been the most supportive person in the world about her blogging, but am proud of what Loralee has been able to accomplish with her blog.  While I do not particularly like the massive amount of time and energy it takes, she is doing a great job.