Saturday, March 24, 2012

Alternatives to Obamacare

What is freedom? Freedom is the right to choose; the right to create for oneself the alternatives of choice.

Archibald McLeish (1892-1982)

March 24, 2012 - However the Supreme Court rules on Obamacare and however Americans vote in November, alternatives to the health reform law are underway.

It is clear to everyone that something must be done about soaring health costs, and something is being done. For thoughtful Americans, it is a Life or Debt decision, as the national debt nears $16 trillion and as health costs become a leading cause of personal bankruptcies.

Alternatives to the present health system are cropping up across the healthcare landscape,. And why not? People want choice and alternatives. Besides, as George Burns said of what he thought about becoming 100, “It’s better than the alternative.”

Although many of these alternatives are occurring right under our noses, we tend to ignore them because they are incremental and segmental.

Alternatives include:

• Employers offering wellness programs.

• Employer giving bonuses to employees who stay healthy.

• Health plans lowering premiums on wellness stats.

• Over 30% of employers offering health savings accounts tied to high deductible plans.

• Insurers covering retail clinic expenses.

• Growing numbers of worksite clinics among employers with 100 or more employees and among coalitions of small employers.

• Sweeping decentralization of care with more care being offered in less expensive home care and out-of-hospitals and out-of-physician office settings.

• More emphasis on self-care, enhanced by new technologies and new products allowing patients to diagnose themselves and to monitor their own care.

• More awareness of what constitutes healthy foods.

• More fitness centers in more communities.

• A new breed of physicians saying, “ Your health is what you do for yourself, not what I can do for you.”

• An older breed of physicians who are dropping out of 3rd party insurance arrangements and offering cheaper, more convenient care in concierge and direct pay practices.

• Websites offering fitness and caloric advice and data on how to stay healthy on your own without visiting health care professionals.

• Medical tourism whereby patients are going outside the U.S. to seek cheaper alternatives for high cost medical and dental procedures.

Taken together, these various developments given patients the freedom to opt out the present setting.

So Much for Bottom-up Changes

This blog would not be complete if I did not mention top-down suggestions for alternatives to Obamacare, should it collapse .

The principle alternatives most often mentioned are:

• Shopping across state lines for insurance coverage.

• Tax-credits for all individuals, rather than just for corporations and employers.

• Tort reform.

Some business leaders, like John Mackey, CEO of Health Foods, are quite specific in recommending alternatives.

• Remove the legal obstacles that slow the creation of high-deductible health insurance plans and health savings accounts (HSAs).

• Money not spent in one year rolls over to the next and grows over time/

•  Equalize the tax laws so that employer-provided health insurance and individually owned health insurance have the same tax benefits.

•  Repeal all state laws which prevent insurance companies from competing across state lines

•  Repeal government mandates regarding what insurance companies must cover.

•  Enact tort reform to end the ruinous lawsuits that force doctors to pay insurance costs of hundreds of thousands of dollars per year.

• 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?

• 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.

•  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.

Tweet: Employers and individuals are reacting to high health costs by developing a series of alternatives and choices that lower costs.

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