Dreams of reform

Writing this on the eve of the inauguration of our new president, I am anxious to see what is in store for our country.

President or President Elect (depending on when you read this) Donald Trump has many claims of what he plans to change as our nation’s leader. What he can pull off and what that will look like is still a huge unknown.

One of Trump’s campaign pledges was major health care reform, first and foremost, repealing the Affordable Care Act, also known as Obamacare.

Obamacare seems to have benefited only insurance companies. For those who did not qualify for Medicaid in states that expanded it, it forced everyone to buy a product that cost individuals more each year, while for the most part providing fewer and fewer benefits.

I would like to see Health Savings Accounts pushed more. They make sense for people who are healthy and start early. Ben Carson proposed giving children a birth certificate, a Social Security number and an HSA account they carry with them their whole lives. Either their parents pay in or the state pays in. It would attach some “skin in the game” for those receiving free health care when it comes to seeking services. Obamacare sought to eliminate Medicare patients from using the ER as their general provider. I’m not sure how much success it had in doing so.

Having a high deductible insurance plan and an HSA makes people think about health care differently. It was helpful that the ACA required certain preventative care to be covered 100 percent regardless of insurance plan. I found with my high deductible insurance women’s wellness checks and vaccinations were covered with no out-of-pocket expense.

It just makes economic sense to keep healthy people healthy with basic services.

I also want to see more competition among insurance carriers. Open up the market nationwide and help people understand what they are paying for. It would be nice if employees weren’t tied to the insurance their company offers to receive the employer’s contribution. 

I also want to see more transparent and more easily accessible information on health care provider pricing for services. As a patient, it feels like we are billed at the whims of providers who arbitrarily assign costs for services. I know that’s not the case, it just feels that way, but costs of services range widely from provider to provider. Yet, it is very difficult to “shop around” for health care.

It would be an insanely difficult thing to create, but I dream (no harm in dreaming, right?) of a website that compiles detailed cost information for every provider in practice for every service they provide. Only when customers can be informed of the actual price of services can there be a free market.

And even more helpful, would be the ability to enter your insurance information into that site and find out which of those providers are preferred by your coverage and compare costs.

Throw in a Yelp-like ability to submit ratings and reviews of those providers and their services and you’ve got a serious game changer in the health care industry.

I’ve put some thought into this, down to how to create it as a business model or even as a completely non-commercial free offering through crowd input using a wiki (a type of website that allows collaborative modification).

So there’s my two cents on what I’d like to see regarding health care reform - it boils down to freer markets and greater transparency.