First, let me state why I am writing on this topic. I normally write about the Episcopal Church or about faith in general. As a Deacon in the Episcopal Church, I am charged with making known to the Church "the needs, concerns, and hopes of the world." In the United States, health care is a big concern and as I stated earlier, I am employed in the healthcare IT world.
In the part I, I discussed Health Care as a scarese resource, the purpose of insurance to indemnify against unexpected and catastrophic loss, and the modern use of health insurance to pay for routine care. In this post, I will discuss some possible solutions for health insurance and some ways we can increase the efficiency of delivering health care in the United States.
First, we should not be using insurance to pay for routine medical care. Doctor's visits, well baby care, eye exams, and the like should not be covered by health insurance. To reduce transaction costs, these should not even be submitted to the insurance company, but should be paid out of pocket by the patients. We should reserve insurance for things like surgery, cancer, true emergency room visits and other unplanned events where the cost is prohibitive for most people. We can do this be limiting the procedures and services covered by insurance.
Next, we need a way to make insurance more portable. HIPAA (the Healthcare Insurance Portability and Accountability Act) went a long way towards doing this. One of the problems with changing health insurance is the coverage of "pre-existing conditions." If we chance health insurance to cover only catastrophic items, it would bring down the cost of insurance (as well as the cost of delivering care) and people would be more able and willing to carry personal insurance. Because insurance covers so much today bridging the gap between jobs is very expensive. Five years ago, I took a leave of absence for 7 weeks to take a unit of CPE. My cost for insurance duing that 7 weeks was over $2400. I believe that we can get a catastrophic policy for significantly less.
Finally, we need to find ways to cover the uninsured for and to pay for those who cannot afford healthcare. That will be the subject of part III.