Health Insurance: Want Fries With That?

THE HEALTHCARE DEBATE is everywhere, but it has become increasingly confusing. Trillions of dollars. More taxes on the rich. Increased employer taxes. Health-providers promising cost cutting. The result: health care that is timely, superb, and free.

I'm not buying it. The same guys who run the Post Office now want to run healthcare. Government runs only one thing well -- the military -- and no one on earth believes they do so efficiently. Remember $40 screwdrivers?

So what is the solution? Make the evil rich pay? Okay, let's say we do. But evil rich people know how how to read the bottom line, and when something costs more than it's worth, they will stop paying for it and start living off clipping bond coupons. So there will be fewer evil rich to tax, not to mention the fact that the rest of us will be out of work because the evil rich guy will close his factory. If anything, we should lower his taxes. "If you tax something, you get less of it." Fact: tax revenues exploded under Kennedy and Reagan, when rates were lowered.

What about cost-cutting in the medical industry? Sure, let's do that. In a competitive economy, there is always an incentive to cut costs, but what do you think will happen when the government horns in? Does anyone compete with Medicare? Government-run health care ("single payor") quickly runs everyone else out of the business. So be careful when you pit the government against private enterprise, while hamstringing private enterprise with endless rules, regulations, and taxes. Government will win and private enterprise will lose. And so will you, because choice is the key to competition. No choice, no competition, no half-off Big Macs.

So what is the answer? My suggestion is so simple and so well-proven I cannot believe it is not being shouted from every rooftop in D.C: treat health insurance like car insurance!

To begin with, it must be lifestyle-tested. Your car insurance rates are dependent upon your driving. If you avoid accidents entirely (or pay for fender-benders out of your own pocket), or if the accident is not your fault, your insurance premiums stay low. In healthcare, this means that you must live a healthy life. Maybe twice a year, you go in for a check-up. They look at your triglycerides and lipids, your waist-to-height ratio, check to see if you smoke or drink or do drugs. Based on the results, your health insurance premiums are set. Live well, pay little. Live badly, pay lots.

But what about the unforseeable? If my car's steering goes out suddenly and I get in an accident, I am not held liable -- the car company is. Likewise, if I am born with a congenital defect, my insurance premiums would not be raised. It's just bad luck and would be paid for out of profits. But if I'm a hundred pounds overweight, my premium would go through the roof. Go to the mall these days and see where your health insurance dollar is being spent: at Sbarro pizza by the obscenely obese guy in sweat pants and the "What me worry?" tee shirt. Why shouldn't he pay more for his health insurance? Likewise, why should Lance Armstrong pay for his testicular cancer? Was there anything in his lifestyle that contributed to it? If not, then Lance's health insurance premiums should be the lowest on earth. I'm glad to chip in to help him because he is the textbook example of an innocent victim. But not the Sbarro guy. He deserves to pay for his own heart bypass surgery.

In keeping with personal responsibility, why should an employer pay for your health insurance? He doesn't pay to insure your car, does he? It should be your responsibility and yours alone. That way, you'll be encouraged to shop around (like you do with Geico and Allstate) to find the best deal. Stripped of the obligation to pay for your health costs, your employer might choose to pay you more, hire another worker (end of the recession, kids!), pay higher dividends to shareholders, or pocket the money himself. In any case, more money would be loosed in the economy, more goods and services would be sold, and everyone would benefit. "A rising tide lifts all boats."

Under my proposal, the government doesn't need to get into healthcare at all. Evil corporations, seeking profit, would do so, just like the dozens of evil car companies worldwide who compete to sell me an evil Honda or an evil Hundai. Evil hospitals would be more efficient, more responsive to virtuous consumer demands ("I want seatbelts with my colonoscopy, please!"), and evil investors would reap evil rewards, which they would then reinvest into the evil economy. If my evil healthcare company failed to provide me with virtuous service, I would go elsewhere. And if, by malfeasance, the evil bastards killed me, my estate would have the right to sue the stethoscope off them, just like we can do with the evil auto insurance companies.

Automobile insurance works well in America. The government isn't in it (though I'm sure they'd love to be). Using the same model, our healthcare can only improve. (Indeed, let's go one step further and privatize the post office, divvy it up between FedEx and others, and get a letter back down to a reasonable cost.)

Note the image of the cadeuses, above. Can you make out the dollar sign in the twining serpents? Doctors don't go to medical school solely to be good Samaritans -- they also go to make a good living. The result for me is good health, if I do my part. I have a high-deductible insurance plan, which gives me incentives to live a healthy life and forego skydiving. The result is my health care costs are minimal and my health is . . . well . . . maximal! And it doesn't cost you one red cent!

The only one I worry about is Ronald McDonald. He's going to have to find another line of work.

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