My question is regarding your proposal to remove routine office visits from the list of "covered expenses" under health insurance plans. I understand (and agree with) the logic behind this for adults, but my concern is that many parents will opt to forgo well-baby checkups and immunizations as a result of the change. I know there are quite a few parents out there who won't even spend money on food for their children. I wouldn't expect them to make medical care a priority if the expense was not completely covered. What are your thoughts on this potential problem?
As I already mentioned, I think you have solutions that will work and I wish more of the people running the country thought along the same lines as you do. Best of luck in the election!
Answer: In the 1980’s, 75% of Americans were covered by health care. Business owners were the distribution outlet of health care. Health care at that time was 100 % paid for by the employer. We would like to head back in that direction, but we will never again see 100% employer paid health care again.
Having routine care and well-care eligible for insurance reimbursement has and will continue to drive premiums up. Due to the cost we are now covering less than ½ of our population. So the first question is what percentage of our population do we want to be covered under health insurance?
Second, the administrative charge for any health care provider is approximately 25% and the physician’s office also has an administrative cost. By eliminating this line of coverage we have significantly reduced the role of the insurance companies (significantly reducing premiums) and you are now working directly with the doctors. (It is important to make this change universal or doctors will cater to those who have insurance). The first result will be a decrease in well care visits; however doctors will address this issue by decreasing the cost of an office visit. If a physician has no malpractice premiums and sees 5 patients per hour, how much does an office visit need to cost?
In the health care plan that I proposed, I strongly urge a combination of tort reform (for all outpatient procedures which I expect to reduce physician overhead drastically) and the elimination of coverage for routeine care.
We need to make available to all Americans a health care program that is guaranteed issue (with no medical underwriting), this program needs to have a commercial takeover provision, which eliminates repeating a pre-existing condition clause (thus eliminating the need for portability). In addition we need community rating which means that it doesn’t matter if you are single and age 65 or single and age 25; you pay the same rate. Currently, our rating system contains age discrimination factors (in other words, in most states, small employers will not hire people in their 50's or 60’s).
Thanks for the question.
Mike V.