A Step Back In Time Might Fix Our Health Care / Insurance Mess

[Jerry Cohen]

Let me start by saying right up front – for the last 20+ years I have earned a good portion of my income guiding health insurance selections made by sole proprietors and businesses. I also live on Long Island with my wife and kids ages 18 and 17. Each of us has had ample reason to use our health insurance coverage so I have a strong interest on a personal and professional level.

I also find it pretty bizarre that the people making the most noise about the cost of health insurance are the politicians since they are the ones that got us in to this mess to begin with. When health insurance first started in the 1920’s medical science was not nearly as advanced as it is today and therefore health insurance was designed to replace income someone lost as a result of a medical problem. With the advances that occurred in medical science after World War II there were many more medicines and procedures insurance was asked to cover. The 1960’s were a major turning point for medical science – consider the first heart transplant which happened in 1967 – for example. What really helped insurance costs escalate out of control was government adding mandate after mandate requiring more and more items to be covered without asking “ how much will this add to the cost of coverage?” I should add that many of the mandated items are things which – on an individual basis a person may have no interest in having covered.

That being said, I believe I can offer a suggestion that could help all of us solve the problems with health insurance in a much more efficient manner than the ideas I have heard coming out of Washington lately. And it is important to understand that Health Insurance is different than Health Care. Over the last year these two terms have been used interchangeably and have confused the conversation more than you may imagine.

Healthcare concerns itself with the maintenance of a state of basic well being. Health Insurance is designed to pay for substantial bills that arise out of treating a medical problem. Our current health insurance model provides very little incentive for individuals for maintaining a healthy lifestyle. My solution returns to a time when a basic chassis could be purchased whether you were buying a car; a house; or insurance. It would be up to the buyer to enhance the purchase when and if their budget permitted. My plan would call for a return to a basic health insurance chassis. This chassis would have enough protection built into it to cover an unforeseen catastrophe and not a runny nose or a splinter. This model was used during the 1930’s; 40’’s; 50’s and 60’s by the Blue Cross / Blue Shield association and started to disappear by the 1970’s as government mandates and consumer demand for more benefit rich products made these plans unattractive . My chassis plan would provide basic coverage for a hospital stay – let’s say 10 days. The plan would also cover surgical costs according to a printed table of reimbursement. If an individual used up all the benefits provided under this basic plan then they would have recourse ( subject to a means tested ) assistance from the Federal government either in the form of an interest free loan or a very low interest monthly reimbursement arrangement. I would also offer riders which could be added at additional cost by the purchaser to cover only those items they felt important: vision care; chiropractic care; prescription drugs; mental health; domestic partner coverage; coverage for children beyond a certain age etc.

Let me know what you think.