Lancaster County, South Carolina

On September 7^th, 2009, in a speech to the AFL-CIO, President Obama challenged opponents to the Democratic health care reform proposals set forth in H.R. 3200 to come up with their own proposals.

Then on September 9th, 2009, in a speech to a Joint Session of Congress, President Obama again challenged opponents to come up with their own proposals.

Of course, as became apparent during the sometimes raucous town hall meetings held during the August recess, many, and likely a majority, of us feel that the Democratic proposals offer nothing more than the nationalization of our health care system, which will ultimately result in health care rationing, likely based upon an individual’s potential contribution to society, an idea advocated by some of President Obama’s closest advisors.  Massive tax increases and unsustainable deficits will ultimately force the United States into bankruptcy and economic ruin.

I will take up President Obama on his challenge by laying out specific reform proposals.  However, unlike the Democratic proposals, for the most part, these reforms operate within the private sector.

The health care system is in need of reform. I don’t think that any of us disagree with that assertion. Where we disagree is in what kind of reform we need.

I see changes to the following areas as the best approach to health care reform:

• Coverage Requirement
  • Congress should not mandate health insurance coverage.
  • However, in return, Congress should enact legislation providing that uninsured persons who incur medical expenses that are not otherwise paid shall be subject to a federal tax lien to recover the unpaid expenses.
• Fraud
  • Any medical practitioner who knowingly files a fraudulent Medicaid, Medicare, or private insurance claim should be subject to both civil and criminal penalties, and should have his license to practice medicine suspended.
• Government Employees
  • Government employees should be subject to the same health insurance regulatory requirements as private sector employees.
  • Government employees should not have access to taxpayer funded health insurance benefits not otherwise available to private sector employees.
• Government Politicians (Elected Officials)
  • Government politicians should be subject to the same health insurance regulatory requirements as private sector employees.
  • Government politicians should not have access to taxpayer funded heath insurance benefits not otherwise available to private sector employees.
• Pre-Existing Conditions
  • Insurance companies should no longer be permitted to deny coverage due to a pre-existing condition. Congress should enact legislation providing that insurance companies must issue policies to applicants having pre-existing conditions without the incorporation of exclusionary provisions.
  • However, in return, Congress should enact legislation providing for the establishment of a premium adjustment pool paid into by all health insurance policy holders from which health insurance companies can draw supplemental monies, limited both in amount and duration according to the type of pre-existing condition and the long term expected outlays.
  • As we all know, Congress has repeatedly borrowed from (i.e., raided) the Social Security Trust Fund.  Therefore, the premium adjustment pool must be constitutionally protected from borrowing and other encumbrances (i.e., raids) by Congress.
• Pricing
  • Congress should enact legislation requiring that medical equipment providers make their fees available to the public for comparison shopping.
  • Congress should enact legislation requiring that medical practitioners make their fees available to the public for comparison shopping.
  • Congress should enact legislation requiring that medical service facilities make their fees available to the public for comparison shopping.
• Regulatory Reform
  • Agencies which both promote and regulate can neither effectively promote nor effectively regulate. Congress should enact legislation prohibiting the consolidation of promotional and regulatory functions within a single agency.
  • Consumer choices are limited by State governments who are either interested in protecting local monopolies, or who insist upon specific types of coverage in order to satisfy local political advocacy groups.  Congress should enact legislation requiring States to open up their health insurance markets to competition.
  • Lawyers are constantly soliciting for plaintiffs for this lawsuit or for that lawsuit. Congress should enact legislation limiting such advertising.
  • Pharmaceutical manufacturers are constantly advertising this drug or that drug as the solution to this ailment or to that ailment. Congress should enact legislation limiting such advertising.
  • Medical practitioners convicted of malpractice often just move to another state, where they continue their butchery of unsuspecting patients. Congress should enact legislation requiring federal licensing of all medical practitioners.
  • Congress should enact legislation requiring that insurance company employee salaries and stock dividends be paid out of investment income as opposed to premium income.
  • Regulatory paperwork requirements should consume no more than 5% of total health care expenditures.
• Taxation
  • Health care premiums should be nontaxable up to 15% of the average annual gross income in the United States, with the top 10% and the bottom 10% of income earners excluded from the calculation.
• Tort Reform
  • Juries are all too often awarding massive and unjustified damages to plaintiffs and their attorneys. Congress should enact legislation limiting punitive damages.
  • It is often the case that most of the damages awarded by a jury are allocated to the attorneys. Congress should enact legislation limiting attorneys’ fees.
  • Congress should enact legislation providing that if a jury finds for a defendant, then the jury should be required to further consider whether the filing of the lawsuit was warranted, and if the jury finds that the filing of the lawsuit was unwarranted, then require the plaintiff to pay court costs and legal fees.
  • Congress should enact legislation providing that if a jury finds for a plaintiff, then the jury should be required to further consider whether the defendant’s actions were knowingly and willfully reckless, and if the jury finds that the defendant’s actions were knowingly and willfully reckless, then require the defendant to forfeit any ill-gotten profits to the premium adjustment pool.
• Unemployment
  • Congress should enact legislation providing for the establishment of a coverage retention pool paid into by all health insurance policy holders from which health insurance companies can draw monies, limited in both amount and duration, for the sole purpose of continuing health insurance coverage for the temporarily unemployed while they are drawing unemployment income.
  • As we all know, Congress has repeatedly borrowed from (i.e., raided) the Social Security Trust Fund.  Therefore, the coverage retention pool must be constitutionally protected from borrowing and other encumbrances (i.e., raids) by Congress.

These changes will make the health care system more responsible to the needs of the people, while addressing major problems, in the health insurance industry, in the health care delivery system, in the legal profession, and in government regulatory oversight.

Commentary

Some people have expressed the concern that the requirement that the plaintiff pay court costs and legal fees if a jury finds that a lawsuit was unwarranted will discourage legitimate filings.  I disagree.  This provision is targeted at otherwise egregious cases where the intent of the plaintiff is to extort money from the defendant, who in the current environment may be encouraged to accept an otherwise unjust settlement, reasoning that it is cheaper to settle than to win a Pyrrhic victory.

Revision History

• On October 10th, 2009, I added a “Pricing” section, where I propose that medical equipment providers, medical practitioners, and medical service facilities be required to make their fees public.
• On October 3rd, 2009, I added a “Commentary” section, where in response to readers’ commentary and questions I explain some of my reasoning.
• On October 3rd, 2009, I added a “Fraud” section.
• On October 3rd, 2009, I added a “Government Employees” section.  Government employees should be subject to the same health insurance regulatory requirements as private sector employees, and should not have access to taxpayer funded health insurance benefits not otherwise available to private sector employees.
• On October 3rd, 2009, I added a “Government Politicians” section.  Government politicians should be subject to the same health insurance regulatory requirements as private sector employees, and should not have access to taxpayer funded health insurance benefits not otherwise available to private sector employees.
• On September 19th, 2009, I made various minor text corrections.
• On September 19th, 2009, I added a “Coverage Requirement” section.  I oppose mandatory coverage, but I do advocate federal tax liens to recover expenses incurred by hospitals and physicians in treating the willfully uninsured.
• On September 19th, 2009, I revised the “Regulatory Reform” section by adding a requirement that regulatory paperwork be limited to no more than 5% of total health care expenditures.
• On September 19th, 2009, I added a “Taxation” section.  I oppose generally oppose taxing health insurance premiums, but I do advocate taxing excessive health insurance premiums.

# posted by John P. Baker @ 8:15 AM