Wednesday, March 17, 2004

It's big, complicated and scary, but we need to do something about health insurance in the USA. I'm not saying this for my own benefit, I've always worked for employers that provided nice PPO health plans. But the system seems really broken to me.

First off, having employers as the primary providers of health insurance seems weird. You don't get your auto insurance from your employer... Having the insurance provided by your empolyer means you have to change plans, and frequently doctors as well, whenever you change jobs. I want to be able to shop for my own health insurance plan just like I can shop for my own auto, boat and life insurance. At the same time I think there is a real benefit to society of providing some basic health insurance for everyone.

So I think the federal government should ensure that everyone has basic health coverage. Nothing fancy, no transplants or super expensive drugs, but if you break your arm or whatever you should be able to get that taken care of. I'm on the fence as to whether the government should administer such a program or let various private insurance companies vie for your business. There are pros and cons either way.

But then I think individuals or employers should be able to supplement the basic government program with more full-featured plans from private insurance companies. Employers would certainly want to use this as a recruiting tool as they do now. And many people would want more complete coverage. In order to avoid payment disputes between the basic carrier and the employer/citizen funded carrier I would have the government program function as a voucher system, like some folks want to do with public schools. I.e. you would buy a higher-grade plan from Medical Insurance, Inc. or whoever and the goverment would kick in whatever they consider to be your share of the basic government plan and you and/or your employer would cover the rest. I also think that any employer contributions should also come in the form of a voucher so that you aren't locked into the Plan X that your employer has chosen like you are now, but rather can go out into the market and pick the one that works best for you.