Why we don't want a safety net.

Healthcare reform is all the rage here in the US. However, people keep talking about it in the wrong terms. There's talk of building a "safety net". We actually already have a safety net - they're called emergency rooms. However, a safety net is like the airbag in your car - it's there for when things go very wrong, and ideally, you want to never, ever use it. I will be extremely happy if I never find out what an airbag deployment feels like.

So no, we don't want a safety net. What we want is something like a balance pole or a set of anti-lock brakes. We want something that will keep us from having to use the "gone-to-hell" option. Here's my suggestion:

Part 1: all healthcare funding providers (insurance, public option, whatever) must offer a physical exam at no cost, a minimum of once a year. No cost means no cost; no deductible, no copay, no "after repayment"; NO cost. The moment this becomes a cost, people will decide not to do it. We're trying to get people to look after themselves better; the less it costs, the more likely they are to do it. So, zero-cost physicals every year. Please note that this is only a "must offer" - there should be no compulsion for anyone to go if they prefer not to.

Part 2: no healthcare provider may deny coverage of anything coming up in the free physical. Let's not provide a "free gift" and then use it to punish people. If something shows up in the annual exam, then it shows up early, while it's still cheap to manage, and it can be prevented from turning into a huge problem that lands the person in a hospital. Yes, this will result in more paying for medication to manage conditions - but that's still a better deal than paying a huge sum for hospital treatment of something that could have been managed if only it had been detected earlier.

Part 3: let's incentivise. Healthcare providers may reduce premiums (if any are payable) for anyone taking advantage of the regular checkups. Let's face it, by taking some responsibility for keeping themselves healthy, they're reducing costs overall. Let's reward them. We need to recognise that healthcare provision is about making sure people who need healthcare get healthcare - it's not supposed to be about maximising shareholder return. I wish the markets would recognise this and value good healthcare outcomes highly - if the best way to maximise shareholder return is to do the right thing for the guy who needs a doctor, then everyone's interests align. As things stand, that's not the case, and so greed pulls the providers in the direction of denying healthcare.

And for those concerned about "bureaucrats deciding what I can be treated for" - would you please explain how that isn't happening right now - except with the bureaucrats being given large bonuses for finding ways to deny you healthcare, with absolutely no accountability, and with no standards for minimal acceptable care? I can't guarantee that government bureaucrats will be any better, but I will state that there is no prospect for there not being a minimum standard if the government takes over. That in itself will be an improvement.

I don't have a perfect plan. Nobody does. However, we need to start fixing what we can, and doing it now. If NASA had waited until they had a perfect plan, we would never have gotten men to the Moon. Let's shoot for the Moon on healthcare.