“If anyone has a better approach that will bring down premiums, bring down the deficit, cover the uninsured, strengthen Medicare for seniors, and stop insurance company abuses, let me know. Let me know. Let me know.”

I’m glad you want to know, and I’m happy to help.

You definitely need a better approach. The recent proposals in Congress, including guaranteed issue plans and strict limits on how much rates can vary based on age, sex, and smoking status, would do the exact opposite. Rates would go up on almost everyone, and would at least double on young people. And there are of course many other concerns about this much government involvement in health care. There is definitely a better approach you can take.

The most important thing to do is to get the consumer more involved. With our current system, doctors and hospitals don’t even post prices, and in fact its hard to get a price even when you ask. High deductible plans that work with health savings accounts (HSAs) have already been set up by millions of Americans. These plans provide a tax incentive for people to save money to pay their own medical expenses, and it gets them more involved in shopping for the best value. This places competitive other health care providers to lower their prices, and increase quality and convenience.

The next step is to let insurance companies offer whatever type of coverage they wish to offer, and let consumers purchase whatever they want to purchase. This is a voluntary transaction between two parties, and there is no need for the government to interfere with it. Get rid of government mandates forcing insurance companies to pay for certain things.

It is true that in some states there is not enough competition among health insurance companies. Remove restrictions on competition by letting any American buy health insurance from any insurance company, even if the plan is based in another state. This will open the market wide open, and increased competition means lower prices.

Structure things so people purchase and own their own health insurance, and get rid of the perverse tax incentives that cause most people to have health insurance that is connected to their employment. That way people don’t lose their coverage when they change jobs. This will also increase competition as individual consumers make the choices that will give them the best value.

Make it possible for good physicians to practice good medicine without worrying about multimillion dollar lawsuits. Not only does this directly increase the cost of medical care, but it causes doctors to order unneeded tests to protect themselves, further increasing medical costs.

Start there. Prices will plummet. Then help out those who cannot afford health insurance with vouchers that will enable them to shop among the plans and find the best value for their needs.

Let people protect their insurability, and help the uninsurable. We are a wealthy and compassionate nation, and we can afford to take care of those who cannot take care of themselves. But first encourage personal responsibility, not dependency. Encourage people to save for the future, to shop for the best value, and to take care of their own health so the money in their HSAs grow.

Do this, and you will not only get wide support, but you will radically improve the way health care works in this country. If you would like to discuss these ideas further, just give me a call, I’d love to talk.

We now have a tremendous opportunity to start over, and reform our health insurance system in a way that will really work. The seven factors below will increase consumer involvement and lower costs – and should be a core part of the next health care bill.

1. Promote HSA plans for everyone. Health insurance should be like car insurance. You insure for the wrecks. You pay for your own oil changes and tires. When everyone has a high-deductible plan (including those on Medicare), they’ll all be looking for value when they go to the doctor. And the market will respond.

Tax-deductible HSA accounts will also encourage everyone to save money for medical expenses they’ll have in the future. And those who stay healthy will further benefit, with a nice additional retirement account.

2. Encourage competition. The solution to not enough competition is not to create a government competitor – it is to free the market to compete. Let insurance companies offer whatever coverage they want to offer (and consumers want to buy), within or across state lines. In many areas prices will plummet.

3. Let people be responsible for their own health insurance. Currently if you buy your own health insurance, you pay extra taxes that your employer does not have to pay when they buy health insurance, and you can’t take it with you if you leave the company.

4. End all government mandates. Let people buy the kind of health insurance they want to buy, instead of letting special interest lobbying groups dictate the coverage. Again, prices will plummet.

5. Enact tort reform now. The costs of multi-million dollar lawsuits are ultimately passed down to the consumer. Tort reform is a no-brainer.

6. Encourage price transparency. People argue about why health care costs go up, and yet no one ever mentions that you never see prices posted at the hospital or doctor’s office. (Now that CVS and Wal-mart get into the mini-clinic business, that is changing and we’re already seeing dropping prices.) Involved consumers will drive down prices.

7. Let consumers insure their insurability. To encourage a free market, people should be able to switch coverage to a new insurance company any time. But health problems can currently prevent someone from switching, leaving them basically stuck. Insurance exist to protect against risk, and a market could easily be formed to insure against that risk.

Enacting these changes would not help just a “little”. Instead, they would completely transform the marketplace, and more people than ever would be able to afford health insurance and medical care.

(This time, Congress, please get it right!)

This has renewed my faith in the intelligence of the American public, and in the power of our system of government. In voting Scott Brown into Congress, a serious disaster may have been avoided. The proposed plan would have caused insurance rates to skyrocket, and would have no-doubt been MUCH more expensive than proposed. Quality of care would have declined, and health costs would have continued to grow.

But now, we have an opportunity to start over. Not to “fix” the proposed bills, not to pass them piece-meal, but to actually start fresh, with an entirely different approach that will actually work.

To create a system that cuts cost and improves quality, convenience, and innovation, we need less government involvement, and more consumer involvement. HSA plans should be expanded, tax code that favors employer provided coverage over individual coverage should be eliminated, and rules that prohibit competition among insurance plans in different states should be eliminated. Tort reform should be enacted, of course.

It should go without saying that whatever bills pass should benefit all Americans. We don’t need back-room deals to give favoritism to union members over non-union members; tax-payers should not be paying the costs for citizens in one particular state; and all bills should be posted online for at least 72 hours before a vote, so we the public can see what is being voted on.

We definitely need health insurance reform in this country. But passing “anything” is not better than passing nothing. We have great opportunity now, to get this right.

The public has been saying this pretty loud and clear for a while now. It looks like Congress may finally be listening.

Health care in this country certainly needs reforming. It needs more price transparency, more competition, individually owned health insurance, more consumer involvement and personal responsibility. Basically, the opposite of what is currently being considered.

Succeed at unleashing competition, and we’ll see prices dropping, and innovation soaring. This has already happened in the lasik eye surgery business, which has plenty of price transparency and competition. The future looks bright, if we look in the right direction.

As I’ve discussed previously, Medicare is already on course towards bankruptcy. Medicare already pays less to doctors and hospitals than private insurance, thus transferring costs to those of us not on Medicare. So the idea here is that this would enable people to buy into Medicare to pay lower premiums than if they purchased private coverage.

The Mayo Clinic, which has been praised by the Obama administration, blasted this proposal in their Health Policy Blog. They report that an expansion of Medicare will not solve the nation’s health care crisis, but would actually compound it. The main reason is that most Medicare providers lose money.

If providers are paid less by Medicare, there will certainly be a response on their part. One is that they will continue to transfer costs to private insurers. Another is that, as many doctors already do, they will quit accepting Medicare patients. And it is inevitable that tax payers will ultimately be subsidizing the costs for the 55 year-olds who do sign up.

So the net result will be increased government spending, access problems for those already on Medicare, and cost shifting that will raise premiums for those that are privately insured.

But… the fact that this dramatic proposal was laid out just days before Reid wants to have a final bill indicates that the Democrats are scrambling, and that the likelihood of any of this passing are falling quickly.

It’s high time our government considers a market based solution like Health Savings Accounts. These HSA plans would do far more to reduce healthcare costs than what is currently going through congress.

Keep in mind that as the government spends all this money, it will also be requiring you to purchase more expensive health insurance, with your money.

Here’s where some of the money is hidden:

- $200 billion was going to be cut from physicians under the Medicare program. This is being stopped under the “Doctor Fix bill (H.R. 3962), but the Senate bill ignores the cost.

- A new government health care program for long-term health insursance, the CLASS Act, will, according to the CBO, eventually lead to costs exceeding incoming premiums.

- Revenue will be taken in from the get-go, but expenses are four years. So the 2010-2019 budget estimates do not really account for the cost of fully implementing everything.

- The cuts to Medicare, ultimately, won’t be found and won’t stick. This includes $118 billion in cuts to Medicare Advantage.

- Unfunded mandates to states to increase Medicaid spending will cost billions – an estimated $2.8 billion in extra state spending in Texas, $1.5 billion in Pennsylvania, $1.4 billion in California.

Accompanying all this spending will be, of course, increased taxes – at the federal, and probably the state level as well. There are even new taxes on consumer-directed plans like HSA plans.

Under proposed legislation, Congress is exempt from the healthcare plan that they will possibly be imposing on the rest of us. Congressman John Fleming, from Louisiana, has proposed an amendment that would require congressmen and senators to take the same healthcare plan the rest of us get.

Congressman Fleming is encouraging people to go on his Website and sign his petition.

http://fleming.house.gov/index.html

We are at a defining moment in our country’s history. If a bill similar to that passed by the House and proposed in the Senate passes, it will mean a shift in power that may have profound implications on your ability to control your own health care.

This is because the more control is taken away from you and given to government bureaucrats (to approve health insurance plans, to approve procedures, approve practitioner categories, determine required vaccines, etc.), the more powerful those with money and existing power, become.

The current healthcare reform plans will appoint an “expert panel” to determine what kind of treatment Americans can get. We can be fairly certain that those industries with plenty of lobbying money (pharmaceutical, surgical, hospitals) will make out ok, but those without (chiropractors, acupuncturists, nutritionists) will be left out of the game.

There may not be out-and-out conspiracy, but it is interesting to watch the money flow. For example, our tax dollars subsidize corn, one result being super-cheap high-fructose corn syrup is in almost any food you can buy. And a followup result is a surge in obesity and obesity-related diseases like diabetes.

The government My Pyramid that guides Americans in the healthy way to eat is of course highly influenced by farm industry lobbyists. So dairy and whole grains are well represented, but the fruit and vegetable producers don’t quite have the money to play this game.

But the real questions is how will the lobbying game affect what kind of healthcare you can (or must) receive. What if your government-paid doctor tells you you must get a vaccine that you do not want. Will you be allowed to refuse? What if your doctor, on the other hand, wants to give you a treatment that is not “approved”. Will he or she be allowed to do that?

Under a centralized healthcare plan, control of the U.S. medical system will be in the hands of several powerful groups, including the FDA, the pharmaceutical industry, and the AMA. How much freedom and control you and I would have remains to be seen.

Friend—

Michael F. Bennet

So I went to his site. He forgot to tell us that insurance rates will be going up. He forgot to tell us that the numbers are cooked, and that this bill really costs way more than advertised. He forgot to tell us that most people are not really going to be able to keep the coverage they have now… especially if you own a Health Savings Account.

Here’s what needs to happen before anything becomes law:

• First, the bill must pass through the Senate
• Then the House and Senate proposals must be reconciled
• Third, the reconciled bill must pass through the House
• Last, the reconciled bill must pas through the Senate

The CBO ranks the cost of this bill at a whopping $848 billion over 10 years. But as you would suspect, this is not really the true cost of the bill. The bill states that Medicare participating providers will get a 21% payment cut in 2011, which would then carry forward to subsequent years. Politics make this very unlikely to happen, and so you can add another $247 billion to the cost.

To pay for this bill, congress is pretending that they will cut $464 billion from Medicare spending. This, too, is politically unlikely, as Medicare is already struggling to keep participating providers.

The rest of the money will come from taxes on insurance companies (who will pass those cost on to customers), and wealthier Americans (raising the top tax bracket to 45%).

There are $25 billion in unfunded mandates for the state to pay.

As with the House bill, this one has meager penalties for those who don’t carry health insurance, which is the only way the proposed system for guaranteed issued coverage will work, without premiums going up. ($95 starting in 2014, eventually reaching $750).

It is likely the premiums will increase by at least 50%, on average. If the bill is not changed to allow plans like the current HAS-qualified plans held by millions of Americans, then premiums will also go up when people are forced to change to a more benefit-rich qualifying health insurance plan.

There are so many problems it is amazing to think that this bill has a chance of passing. There is nothing to control medical spending; premiums will increase; government debt will increase; the economy will suffer massively, and we will be taking the first steps towards a total government takeover of healthcare.

Debate in the Senate begins November 30.

Happy Thanksgiving.