Turning the System Around

David Gratzer suggests that the direction of healthcare in this country may be turning:

Given Maryland's tight budget situation, though, Sabatini needed to be imaginative — and frugal. First and foremost, Sabatini wanted to encourage businesses to buy insurance, making the option more attractive by making it more affordable. At the heart of his reform package was a simple idea: cut regulations. Insurance companies, he reasoned, ought to be able to offer small employers an inexpensive, no-frills health policy. Small business may fret the price of a Cadillac plan, but what about a Honda? Add to the mix malpractice reform and a crackdown on fraud, and he believes that more Marylanders will be insured. It's a bold agenda, and just last month Sabatini's efforts bore fruit when both chambers of the legislature approved a bill allowing no-frills insurance.

One can only hope that what we're seeing is the beginning of a shake-up of thinking, of some new ideas being put into play. Local AM talk host Dan Yorke was just talking about a new tax break suggested by the governor of Rhode Island, Don Carceiri that would introduce tax breaks whereby families earning less than $75,000 per year could deduct a certain amount of medical expenses that aren't covered by insurance, such as co-pays.

Yorke was focusing on the income cap (which apparently rules him out), and the governor has phrased the proposal in terms of helping people. But I wonder if the strategy mightn't count as a small side-door reform. Mostly the shift is psychological, putting the focus on healthcare as a personal expense, giving a relatively high limit for which to shoot ($1,500), considering the specific expenses included. Again, as a reform, it's miniscule, but it could betoken a change in attitude.

In fact, these two reforms made me realize that I haven't really been thinking about my contribution to the healthcare that I get through my part-time employer. This month, I started attempting to track every penny that we spend, but somehow, it hadn't even occurred to me to include taxes and healthcare in my pie graph. Now that I've done so, I see that health insurance, alone, amounts to about 10%, which, for a two-income family, is almost a full week of work for one person.

Short of finding an employer with a better program, there's not much I can reasonably do to minimize this deducted wedge from my wages. If healthcare were akin to every other cost of living, I could decide that the vision care program, for example, isn't worth the expense. If consumers were granted the ability to make such decisions more easily and directly, providers would have reason to price for incentive.

Granted, I'm predisposed to make these connections, and other people, upon making them, will conclude that somebody else ought to pick up the tab, but one oughtn't underestimate the power of new perspective.