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BS ‘n’ About…
Individual Entitlement Accounts
Compromise is the art of reaching an agreement whereby no one gets what they want. With the insulting exceptions of the insurance companies, the trial lawyers, the hospital conglomerates, and Big Pharma, the 2010 healthcare reform bill has to stand as one of the most divisive compromises ever enacted by those who supposedly represent us, the American people.
The Republicans hate the bill because it dares to restrain the ability of a handful of us to amass Gilded Age fortunes at the expense of the rest of us. The Democrats hate the bill because not enough of our hard-earned dollars will flow through their greedy little government fingers. The young hate it because they don’t want to be forced to buy insurance for the sole purpose of subsidizing the old. The old hate it because they fear it will screw up a Medicare system that for the most part works. The states hate it because they see it as a boondoggle of a bill that will leave them holding the bag.
The only thing certain is that, far from being resolved, the issue of healthcare will continue to be bloviated about by self-serving politicians for years, if not decades, to come. How can it not be when the bill did virtually nothing to address any of the underlying time bombs that threaten to collapse the entire industry?
The bill did virtually nothing to address our sedentary, pill-popping, unhealthy lifestyles, nor the rapacious, fee-per-procedure, medical billing system, nor the ambulance-chasing malpractice lawyers who hold the industry hostage. For the most part, the bill addressed wrongs inflicted upon the other guy: pre-existing conditions, those dropped after diagnosis, the impoverished uninsured.The ‘average’ employer-insured person will see little or no benefit from the passage of this bill. The ‘average’ uninsured person is probably twenty-three and didn’t want health insurance in the first place. Aspirin will still cost eighty bucks in the emergency room. Malpractice lawyers will still own private jets. Doctors will still pump us full of drugs we don’t need. Politicians will still bloviate. Business as usual.
As the bill stands now, each and every one of us, starting at birth, would be required, under penalty of law, to shell out an average of three hundred bucks a month to an insurance company for coverage of an average of 70% of our healthcare bills. Do the math. It means that every single one of us will have to spend more than $5100 each and every year just to break even! Yet with only 70% coverage, cancer or diabetes would still be, for most of us, a financial death sentence. The rest of us would be running to the doctor with every little ache and pain trying to get our money’s worth. Yet emergency room aspirin will still cost eighty bucks, doctors will still buy Van Goghs with their prescription drug kickbacks, and a sizeable proportion of our healthcare dollar will still end up in the pockets of the trial lawyers. Healthcare Reform 2010.
The fact that healthcare needs reformed is obvious to all of us. But a system that effectively penalizes us for staying healthy can’t be the answer. Nor can one that takes enough money out of our wallets to guarantee that we’ll continue to spend a minimum of one-sixth, yep one-sixth, of every dollar spent in America on healthcare. The fact that we spend one-sixth of our GNP on healthcare is not only ridiculous, it is downright criminal.
In the year that it took Congress to reach a compromise that pretty much pissed everybody off, We, the People made a pretty strong Tea Party statement that we didn’t want government in charge of our healthcare. But nowhere in that protest was it implied that we wanted to pay the insurance companies to run it for us either. The truth is we want to be free to make our own healthcare choices, thank you very much! And being forced to shell out $3600 a year to the insurance companies is no one’s definition of free to do anything!
We need to find a way of removing all the middlemen and layers of bureaucracy that stand between us and the healthcare we truly need. We need to start getting a dollar’s worth of healthcare for every healthcare dollar we spend. An aspirin is an aspirin and it should cost the same in Detroit as it does in Toronto, the same in Cedars-Sinai as it does in Walgreens. For a country that professes to worship at the alter of capitalism and free trade, our healthcare industry, especially Big Pharma, have lobbied for what amounts to a set of tariffs that stand between the American people and fairly-priced medicines and medical care. When our favorite, if for different reasons, vice-presidential candidate tells of her family slipping across the border into Canada for healthcare, we ought to be asking ourselves…
Is there a better way? Damn straight there is, and the answer is right in front of us. There is a solution that is simple, elegant, and easily implementable. If the politicians had actually been trying to find a solution that was in our, their constituents, best interests, rather than their own, they probably would have stumbled upon it long ago. For, not only does it address the issue of healthcare, it is a step in the right direction toward fixing the impending crises facing education, unemployment, and social security. The solution is Individual Entitlement Accounts.
At birth, rather than writing monthly $300 checks to the insurance company, have those checks deposited into an individual IEA savings account. Funds from this “IEA” would be deducted throughout childhood to pay for medical expenses. What was left over when the child graduated from high school could be used for college or other post-secondary career education. Even at the most conservative compound interest, barring catastrophic health issues, that would be a college fund somewhere north of $100,000!
The incentives inherent in such a system would completely change the society in which we live. We might actually start taking an active role in our own health, questioning unnecessary procedures, choosing lifestyle changes over popping pills, maybe even, (God forbid!), getting a second opinion every once in a while. We might even quit running to the doctor for every little sniffle or boo-boo.
And, knowing that there would be enough money there for college would change, not only a parent’s expectations for their child, but their child’s expectations of themselves. Knowing that tuition was coming out of a fund with their own name on it, we’d probably have a much lower college dropout rate and a lot fewer students majoring in beer. We might actually learn a little bit of financial responsibility at a heretofore unheard of early age.
Not all of us need college, and a system such as this might ensure that only those who need it get it. For those who don’t, their IEA could be structured to provide a one-time opportunity to get jump-started in life. It could be used for a down payment, a car, and a modest savings account, perhaps triggered upon marriage. Military service, the Peace Corps, and similar types of service could be used to augment this total.
The childhood IEA could be a way of providing incentive to steer our young onto pathways that serve the needs of the country. Financial incentives could be given for green careers, nurses, or buying a car when Detroit is having a bad year. If we take our politicians’ self-interest out of the equation, the possibilities are virtually unlimited.
Once we’ve entered the workforce, we would continue to deposit our monthly three hundred bucks into our IEA. Since our early adult years are generally our healthiest, we ought to be able to get well ahead of the game before we start racking up the doctor bills. Since what was left of our IEA would eventually form the basis for our Social Security allotment upon retirement, we would again have incentive to lead healthy lives, question unnecessary procedures, and seek healthcare only when we really need it. We would have strong incentive to exercise, eat less, stress less, and quit smoking.
A special fund could be set up to augment those individuals who come down with catastrophic illness, needs a transplant, or suffer a debilitating accident.
Unlike any other healthcare proposal out there, IEAs would provide financial incentive to lead a healthy lifestyle, stay out of the doctor’s office, and stay involved in your own healthcare. Less than two long lifetimes ago, doctors were still bleeding people and prescribing cocaine and strychnine. Throughout most of human history we’ve survived without cat scans, colonoscopies, or Cialis. These days we want to make it all better with the latest wonder drug so that we don’t have to address the all-too-real lifestyle problems facing us. We’re fat. We’re stressed out. We smoke too much. We’re getting old. Pills aren’t going to fix all that. All they are going to do is give us an excuse to not address the real issues. All they are going to do is see to it that we continue to waste one-sixth of our GNP to stay sick! Skinny people don’t need diet pills. Calm people don’t need Valium. . Healthy people don’t need healthcare.
With enough painkillers, you can dance on a broken leg, but that doesn’t make it a good idea. Everything about healthcare in America is about masking the problems rather than fixing them. Everything is about keeping you coming back. For all the trillions spent by Big Pharma, not one major disease has been cured since polio. ‘But taking this pill will mask…’
Our grandparents would probably be appalled by our weakness and herd mentality, not to mention our excesses and waste. They were people who were bound and determined to get ‘their money’s worth’. When’s the last time you heard that phrase uttered in America? It’s been a while.
The Individual Entitlement Account would be the basis for a complete change in how we interact with our government, not to mention how they interact with us. It would make each and every one of us a vested participant in this great democracy of ours. IEAs could fund healthcare, education, unemployment, and social security, leaving us, America’s citizens, secure for the first time in a generation. Washington would be working for us instead of the other way around.
Read between the lines. If employers were required to pay unemployment insurance into an employee’s individual IEA for, let’s say, the first three or five years of their employment, wouldn’t that provide incentive to hold onto employees long term, rather than turning them over? If we were given options with what remained of our IEAs upon death, might that not affect our end-of-life decisions? If unemployment and social security deductions were held in these individual accounts, might it not prevent Congress from running up trillion dollar deficits?
Might not having such an account make each of us a participant in this great democracy of ours, rather than a spectator? One thing is for certain. It would be the biggest change in the way We, the People were governed since we gathered on the Lexington Green and fired our muskets at the British.
No one is careful or responsible when they are spending other peoples’ money. It is why we aren’t outraged by the eighty-dollar aspirin or million-dollar malpractice settlements. It is why government can’t efficiently administrate anything. It is why we shouldn’t allow the insurance conglomerates control of our health care expenditures.
Americans spend more money for less healthcare than anywhere else in the world. There are so many greedy intermediaries between us and the actual healthcare we need that we’re lucky if we’re getting twenty-five cents worth of value for every dollar we spend.
The 2010 healthcare bill may have been borne out of good intentions. It has managed to right some of the most grievous wrongs of the old system. But the compromises that were made to right those wrongs just created a whole new set of wrongs that will be with us for decades to come. We shouldn’t be insulting the landmark social legislation passed by FDR and LBJ by including this compromised mess in the same sentence with them.
The fact that the Tea Partiers are protesting so vociferously ought to tell us something. The fact that the insurance companies, hospital conglomerates, malpractice lawyers, and Big Pharma aren’t, ought to tell us something else. This is their bill, not ours. The only thing that has really changed is that 32 million more of us are being forced into being ripped-off by the system. Aspirin still costs eighty bucks. The 2010 Healthcare Reform Bill. Business as usual.
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