Here are some things we might consider, if we ever do want to give this healthcare reform thing another try:

Medical liability reform. A small percentage of medical practitioners commit about half of all medical malpractice. Meanwhile malpractice insurance is driving specialty physicians out of practice. What about some kind of liability benchmarks for medical malpractice, where liability cannot exceed a certain ratio of actual damage inflicted? And what if the criteria for damages were reviewed and scaled downward?
Instead of mandating health insurance, try incentivizing it, instead. There would not have been a peep from either side of the aisle, if in the name of personal responsibility, and in an effort to get more people to actually pay something for the health services they use, there was a big tax credit for those who had health insurance in force for the previous year. Lost your coverage 11 months in? Then only get 11/12 of the tax credit. Simple. Carrots work better than sticks in this case. Plus, everyone knows carrots are good for you. Lots of vitamin A.
Stop demonizing insurance. Insurers are not the enemy here. You know what the enemy is, here? CANCER. Insurance gets in the way sometimes, because it's a funding mechanism, and an imperfect one at that. But I am willing to bet that health insurance has saved and improved many, many more lives than it has harmed. It sure saved my own father's life on three different occasions, and one of my brothers would never have made it out of the hospital after his premature birth without it, either. So some perspective is in order.
Have insurers do some serious work on linking positive health behaviors to premium incentives. Not all health problems can be avoided. But when you've got policyholders who are clearly abusing their bodies through food, tobacco or alcohol, they should be paying more for their health coverage. Likewise, policyholders who hit certain fitness brackets should receive preferential pricing. Insurance is all about discriminating against risk. So find ways to discriminate that help the insurer and insured alike, already. We already see it in life pricing, so health pricing should be no different.
Revisit pre-existing conditions and policy dropping. A big part of what drove health care reform as public outrage over how pre-existing conditions and dropped coverage were handled. In other words, the industry's efforts to control its own costs, though not necessarily to the benefit of the policyholder, broke that fundamental trust that makes insurance work. The policyholders felt that when it came to health insurance, the insurer was not really interested in living up to its part of the bargain. It was looking for reasons to cite a pre-existing condition to deny a claim, or it was looking for reasons to drop you from coverage if your claims history got too expensive. What we got was a weird solution, which was no ability to cite pre-existing conditions whatsoever, which makes no underwriting sense. What might work better is if insurers were able to cite pre-existing conditions under very strict and clear circumstances, to be identified at the inception of the policy – anything determined afterward is an unfortunate reality for the insurer to live with, but anything discovered during pre-screening is actionable. On the flipside, if you've got a health plan you like, you get to keep it for as long as you keep paying for it. If the insurer feels it's too rich for their blood and they want to discontinue, too bad. They should have done their homework on Round One. Now, it's like a rent-controlled apartment, and it's on the policyholder to not let the policy lapse. This kind of solution is at the heart of good negotiations, because neither side walks away entirely happy.
Remove the political spectacle from it all. Health care got thirty million times more complicated than it needed to be when decided to legislate it. The system still works best as a private solution, so let's have the private players craft a solution that actually works best for the most amount of people. Another driver of the reform effort was the feeling in the public that for the most part, the system did not work very well, but those who profited most from it seemed awfully content to let the system run as it had. There was a feeling that nobody was working within the system to improve it, when it was clearly in need of improving. I think it's safe to say that the private side of things has been spurred and shown that the government can and will get involved when given enough provocation. So quit provoking it, already. For as much as we like to note how capitalism is the greatest system there is for product development, the way to exemplify that is not take something as bloated and inefficient as pre-reform health care and pretend that it is as good as it gets. When a country like Canada can provide the level of free healthcare it provides to its people, there is clearly a better mousetrap to be made. So let's make it, people. And in so doing, let's give the folks in Washington some other industry to mess up. They've done enough with this one to last a lifetime.

Instant Insights /

6 feverish notions for fixing health care reform

More From HR Executive

Related Stories

Recommended For You