What conservatives need to address on health care

Most of the conservatives thought pieces this week have been ranting on health the President's inaugural speech was a liberal manifesto.  Specifically, his defense of Social Security, Medicare and a belief in Global Warming.

As usual for this blog, I wish to comment on health care; the cost of which is bankrupting the nation as the baby boomers retire and high cost life extending procedures will be demanded by almost anyone in need of such procedures.  Not everyone, though.  I think some cancer patients will prefer an end with dignity rather than subject themselves to endless brutal chemo-therapy.  But some will want that in the hope there is a worthwhile life after chemo.  And most people want to decide this for themselves and do not want an insurance company or government panel to decide that for them.

So the two issues that the conservatives need to address in their plan, for holding down the cost of health care for the taxpayers, are: (i) how do you make health insurance a group cost for individuals and (ii) how do you manage end of life care?

Just turning the whole thing over the private sector insurance companies that have failed on both of these issues is not a believable answer.

My answer is to separate health insurance from employment.  I am now part of a small business group, thank god, and my cost of health insurance went from $36,000 a year in the individual market to $20,000 in the group market, which is what it was when I was employed by a real company.  (All those values include premiums, deductibles and co-pay estimates.)  We are the same two people and the only difference in the concept of group membership.  It is not right that being employed is the only path to group discounts.  Individuals add up to a lot of people which would constitute a group.  The GOP ignores this issue and most people who think about this in the center and on the left want a single payer health insurance plan.  If the GOP wants to win on this issue, this needs to be addressed because you will never get people to give up their Medicare without convincing them they will be in a group and get credit for the money they paid in over the years.

As for end of life care, the GOP made death panels an evil concept when the Affordable Health Care Act only called for counseling.  I read a book written by a Dr in charge of end of life care at Dartmouth Hitchcock where he described how such Doctors do their job and encourage people to find the path that is best for their care without spending needless amounts on treatments that will end with a death anyway.  Part and parcel of this is ending fee for service.  There is nothing in the GOP plan addressing this except to turn it over to Insurance Companies that created the fee for service concept and have a bad reputation for denial of treatments.

These issues need to be addressed if the GOP is to win over the citizens of this country.