Wednesday, August 12, 2009

Cash for Non-Clunkers Cafeteria Health Care

My health care plan, a COBRA by default, is one of those Cadillacs that covers all sorts of things I know I will never use, and many I hope to avoid. Maternity care and family planning - I'm almost 55, and so far, childless, by choice...and not a man. Contraceptive drugs and devices - I'm post menopausal. Ditto for infertility services. Smoking cessation - I've gone this far without a puff. A boatload of mental health and substance abuse benefits - I went through a very contentious divorce five years ago and yet the strongest thing I've ever imbibed is a couple of cups of morning joe and I'm probably one of the few Baby Boomers who's never inhaled. The plan is also light to non existent on such services that I actually do use, such as dental care and massage therapy. For almost $500/mo, I get far more than I will ever utilize and am clearly subsidizing other enrollees and the insurance company. With all the talk about health care reform swirling around these days, I've heard virtually nothing in the discourse about a "cafeteria" plan, where one would be required to pay for coverage for "basics" such as hospitalization and office visits, but could opt out of services that were clearly irrelevant to lower the premium. While this might have been difficult back in the day when our current "system" was in its infancy and record keeping was by hand, it could be easily implemented now in the age of computer technology, pricing customized plans...the way auto insurers do! Not only would it lower my premiums, but it would also allow many who only need and can afford a skeleton plan the opportunity for real coverage versus doing without altogether or because of a high deductible, and misusing our emergency rooms for care for free. The insurance companies shouldn't balk; in return for minimal extra effort, they could increase their subscriber base. The policies would be self limiting, cost containing and somewhat behavior modifying by their very nature, keeping access to and abuse of the system in check. You get what you pay for...act responsibly.
All the current proposals seem to be doing is generating class warfare. The ironically pro choice, and largely conservative and working "haves" don't seem to realize that their employer based plans cost them higher salaries and the rest of US jobs. The "have nots" are loaded with time on their hands and heart wrenching stories, loudly vocal, but with little to no agreement as to what "change" to do.
I'm not obese, I have no expensive chronic illnesses, and I watch my diet and exercise daily. I'd like to see some cash in the health care plan as a reward for not being a "clunker" and would gladly downsize to a Chevy and nibble at the "cafeteria." How about you?

Karen Ann DeLuca

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