August 22, 2009
The President of the United States of America
The White House
1600 Pennsylvania Avenue NW
Washington, DC 20500
Mr. President,
Contrary to what you, and your masters at the Baby Oak Tree Organization, would appear to believe, the problem with the health care system in this country is not that you are failing to extract enough money from the pockets of Americans. The problem is that with health care, and much else in our country today, far too much money is already being removed from those pockets. I guarantee that I care far more about my own finances than you ever well, and that the average ten year old is probably better at making responsible money decisions than you and your sub-breed of political elites in Washington.
So, what can you do to apply some meaningful change (like the way I worked that word in there for you?!) to the health care situation in America that will result in vast improvements?
To start, let’s impose a little bit of tort reform. Doctors around the nation are compelled to order many tests that in most cases are absolutely unnecessary, but need to be run just in case their patient is that one in one hundred million individual suffering from a disease that only has 93 recorded cases in the history of man. Why? Because if they don’t run that test and the patient dies from the most unlikely of afflictions, some lawyer will be hanging around ready to pounce on a huge malpractice and wrongful death verdict. It should be reasonably simple for a gathering of medical professionals, not beholden to government pressures, to identify what would constitute reasonable and prudent medical care in upwards of 95 percent of all medical encounters. Once doctors have met those standards, they should be considered to have met their legal obligations to the patient and be freed from the specter of lottery jackpot lawsuits.
A related matter is jury awards. Though only medical suits are addressed here, the concept truly has much broader applications. No doubt everyone loves Grampa Joe. Unquestionably he’s a swell old guy. However, he is not worth an $87 million jury award just because a doctor was slightly less successful than God at affecting a cure. No amount of money is going to bring old Grampa Joe back, and his family is not going to miss him any less from their vacation home in Tahiti than they would from their rent-controlled apartment in Queens. The same can be said of much younger workers as well. Sure, some people will grow up to be Bill Gates or Warren Buffet, but the truth is that most of us spend our lives earning a lifestyle closer to that enjoyed by Ralph Kramden. Multi-million dollar paydays for events that often fall under the heading of “sometimes (all natural organic fertilizer) happens” do not ameliorate the loss of the deceased’s loved ones nor do they serve the theoretically intended purpose of making medicine (products, services, etc.) better or safer for the general public.
The next item to be addressed in improving the cost and accessibility of medical care in the United States is creating a true free market subject to competition and the pressures of consumers willing and able to take their business elsewhere. For most people, privately purchased medical insurance is prohibitively expensive. The majority either take what is offered by their employer or take nothing at all. That can easily be addressed by changing two elements of the current system: letting individual consumers make the choice about where to spend health care dollars, and give them the opportunity to shop for plans across state lines. Just because the interstate commerce clause has been violated in the case of medical insurance for decades does not mean that it ever should have been or that the practice should continue.
In order for consumers to select their own plans, employers should pay unto a fund for their employees that would be modeled on current Flexible Spending Accounts or Health Savings Accounts. The employer pays in, each employee has the right to spend up to a defined amount per year, and whatever is left unspent at the end of the year returns to the employer. In order to ensure effective shopping and sound consumerism, employees should also be offered an incentive, such as receiving up to ten percent of their portion of the pool that is not spent – providing they do in fact obtain insurance for themselves and their families. Employees who are empowered to seek the greatest value in terms of services offered for costs paid will do so. Unlike governments, individuals need to balance budgets and generally do a pretty good job at getting as much bang as they possibly can for their buck. Or at least they do when some meddling bureaucrat isn’t getting in the way.
The consumer should also be able to compare and choose from plans offered in Detroit, and Des Moines, and Denver, and San Diego. In a world where the overwhelming majority of transactions are converted to an electronic event rather than being processed manually, and where a person calling for help is far more likely to attempt to communicate with someone in Bangalore than they are to converse with a native English speaker in Boston, there is no justification for suggesting that the insurance company writing the check to a doctor should be relatively local to the consumer.
Making the entire nation a single insurance pool spreads the risk evenly across the population, just as your plans purport to do. Making every insurance company compete with every other insurance company will offer increased services at decreased cost to the consumer. Those with good business practices will gain customers and flourish. Those who feel they should be able to continually inflate premiums and reduce services will lose customers and go out of business. Further, by switching from one job to another an employee would not lose health insurance coverage since the plan they have is a plan they shopped and paid for themselves. Thus, the problem of portability is also solved.
Does this address every issue that could be improved upon in our current health care system? Of course not. It is certainly a far superior framework than the current proposal which seeks to spend even more money that we don’t have in order to provide fewer and lower quality services to all.
I don’t think Grampa Joe is worth $87 million, but I also don’t think he should die because some government panel thinks he should toss back a few Vicodin and go gentle into that good night rather than receive a new heart, liver, or kidney.
This country is about hard work, innovation and moving forward. We are not about proving that we can screw up the great socialist experiment even better than was done by Europe and the Soviet Union. The kind of change I could believe in is where you showed leadership in solving the problems that face us rather than going out of your way to prove you can be the fountainhead for the destruction of the United States of America.
Sincerely,
Jacob D. Vreeland, Jr
Bunker Hill, WV
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