Health Care and ‘Skin in the Game’

Other countries have implemented Medicare-for-all systems that do not require “skin in the game,” and they get better health outcomes at much lower costs. In fact, “skin in the game” causes consumers to forgo necessary health care. The most common way to implement “skin in the game” is with high-deductible health plans. As one health expert stated:

The nation continues to push forward with expanding deductibles in health plans in spite of evidence that they are creating great harm by increasing financial burdens on individuals and families and by impairing access to essential health care services and products.

Meanwhile, health insurance and pharmaceutical executives have no incentive to improve the system. For too long these executives have been able to act however they want without any consequences. This has literally killed people and caused bankruptcies—all in efforts for the companies to keep their profits high and for the CEOs to keep their salaries astronomical.

It is time to force these executives to have “skin in the game.” We need to define a series of performance goals for our health care system.

The first goal should be that our health system covers everybody.

The second goal should be to eliminate financial stress from accessing health care. Eliminating copayments and deductibles can achieve this.

The third goal is that patients should have the freedom to choose any medical professional or hospital.

The fourth and fifth goals should be to have the per capita health expenditure equal to or less than $4,750 and the health expenditure as a percentage of GDP that is equal to or less than 10 percent. According to data from the Organisation for Economic Co-operation and Development, which represents 35 countries, the average per capita health expenditure is about $4,750 for developed countries, and the average expenditure as a percentage of GDP is about 10 percent.

Until all goals are met, health insurance and pharmaceutical executives are limited to compensation that does not exceed ten times the minimum wage. Profits from the companies shall be used to reduce health care costs until the goals are met. Once met the companies may use their profits and compensate their executives however they want.

These executives have perpetuated a system that requires too many patients to sacrifice their good health, their financial well-being, and/or their lives. It is only fair that we make the executives have “skin in the game.”

The Newest Banana Republic

According to one report on Dec. 19th, Kuwait switched its annual party from the Four Seasons Hotel to president-elect Donald J. Trump’s newest hotel in Washington, DC, “after members of Trump’s Organization pressured” Kuwait’s ambassador to the U.S., Salem Al-Sabah.

The next day another report claimed that there had been no pressure from the Trump Organization to switch hotels. The ambassador said, “I do not know president-elect Trump. I do not know any of his people. None of his people have contacted me. I thought would be exciting for our guests to see a new venue. It looks great. It looks cool. So let’s do it.”

Regardless of which version is true, it gives the United States the feel of a banana republic, where you try to gain favors from a country’s leader by enhancing the leader’s economic well-being. Unfortunately, “[f]oreign diplomats have openly admitted that some see staying at the Pennsylvania Avenue hotel owned by the president-elect as a chance to curry favor with Trump.

To prevent our becoming a banana republic, President Obama should issue an executive order that forbids any foreign government representative from staying in or having functions at any Trump property.

If the U.S. wants to retain it superpower status, we must not only maintain our strength, but also our moral standing. We must demonstrate that we will base our foreign policy on actual policy. Otherwise our status as a banana republic will become permanent.

Medicare-for-all—There Is No Better Solution

Republicans have been saying for many years that the Affordable Care Act, aka Obamacare, needs to be repealed and replaced with something better. Medicare-for-all is that something better.

Unfortunately for Republicans and the rest of us, after six years of complaining, they still have no idea of how to replace Obamacare. Their latest proposal is to repeal Obamacare, then delay the repeal for two to three years in the hope that they can force Democrats to negotiate a replacement.

Republicans argue falsely that the current problems in our health care system have been exacerbated by Obamacare. In fact Obamacare has mitigated some of the worst problems by reducing the number of uninsured by about 12.5 million and allowing people with pre-existing conditions to get insurance.

However, even Obamacare has not been able to fix the systemic problems that cause the United States to have the most expensive health care system in the world with some of the worst health outcomes of any developed nation. We pay for a yacht, but get a dinghy.

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Democrats Must Focus on Messaging

There is a passionate debate as to whether Democratic National Committee Chairwoman Debbie Wasserman Schultz should be replaced. This debate focuses on three main points: did Wasserman Schultz show favoritism towards Secretary Clinton, has she been biased against Senator Sanders, and can Wasserman Schultz unify the party? However, neither of the preceding points are the most important criteria for evaluating the Chairwoman’s performance as head of the DNC.

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