Yet Another Health Care Law Poll

Another poll on the new health care law. People feel that it will hurt their own health care, raise costs, butg improve health care overall.

Patient Copyas and Encouraging Efficiency.

Patients who have to pay more for the doctor do visit the doctor less! They also end up in the hospital more.

So much for using patient copays to reduce patient costs.

See our four-part participatory democracy framework to reform health care. The last part is the doctors are paid on the basis of the service they provide, after they provide it.

Health Care Poll

The Associated Press polled Americans on health care. Eighty-two percent are in favor of a ban on insurance companies discriminating against those in poor health. However, when told that this ban would cause most to pay more for health insurance, 31 per cent of Americans are now against it and only 43 percent support it.

The questions should have been Would you support a ban on insurance companies not insuring those with pre-existing conditions who had an opportunity to buy health insurance, could afford same, but chose not to do so?

Would you support an insurance company not insuring someone with a pre-existing condition who lost their insurance through no fault of their own (e. g. got laid off)?

A bureaucracy might not be able to distinguish between the two but a sortition jury could have. It is also the premise of my alternative to a public insurance plan, a sortition plan. That is, there is no public "insurance" but there is a public "pool" of money to which both the person covered and the public (as part of general taxes) would pay for. When an individual got sick, they would petition for approval to have the public pool pay for this. A sortition jury would look at both the illness and treatment involved. It would also look at how much the person contributed to the public pool and their income in comparison to the contributions made. Thus, the eighty dollars that the proverbial washer-women contributed might have more weight than the eight hundred dollars that the YUPPIE contributed.

Sixty-seven percent agreed that everyone should have "at least some health insurance" with only 27 percent opposition. However, sixty-four percent are opposed to a tax penalty for not having insurance. And even half of Democrats oppose fines to enforce the requirement to get insurance.

I proposed a broader requirement of financial responsibility and this, obviously ambiguous one, be interpreted by sortition juries.

Wall Street Journal Health Care Article Response

The Wall Street Journal just had an opinion piece on health care. It has some good facts:

1. 400,000 people engaged in medical tourism here
2. Our five-year survival rate for all cancers beat those for Canada, Europe and England
3. The HR 3200 is long and has too many new taxes and penalties and mandates.

But some other facts are just plain wrong:

1. "Anyone can walk into an emergency room and receive care regardless of their ability to pay.
   That is not true. They can be treated for the emergency, but if they have cancer, a gall bladder that needs to come out, it probably is not an emergency.
   As I have argued here, we need to replace this with a plan that says that those who do not have insurance must go before a sortition jury (Unless it is truly something current like a heart attack or a car wreck) and they will decide whether the person could reasonably be expected to have health insurance or be putting money away into a health savings plan. The person making $20,000 with a family probably will be excused for not having helath insurance. Ditto for the person who was layed off. Ditto for the person who went to the health insurance companies but was turned down. The yuppie making $70,000 who went bare would not. And we would like at the amount in the health care savings care plan as compared to one's income. The proverbial washer-women who saved a few thousand dollars over her life in her health care plan would be given much more credit than the young urban professional.
   We would all serve on these committes. I know I would probably push people to go to the premier medical facilities such as John Hopkins, Hospital for Special Surgery and Memorial Sloan Kettering, just as I do for my students and family. They would all use Pubmed the wonderful free resource provided by the United States Government that indexes the medical journal literature, to research diseases, treatments and outcomes.
2. They blame "runaway lawsuits," "malpractice"premiums for the problem. Malpractice costs are only two cents of every health care dollar. They blame defensive medicine. But the CBO found many studies that show this is not a problem.

Doctors and hospitals that do provide charity care should be rewarded at tax time by sortition juries. The Wall Street Journal advocates vouchers! But I would argue that those who receive public funds for their health care should have to answer to the public for what is done with it. As mentioned above, this would be done on a one-on-one basic through sortion juries. Of course, I am not including here programs that represent earned dollars like Medicare.

I also have advocated that businesses that do provide health insurance for their workers be rewarded at tax time. This is better than mandates.