I am not an expert on Health Care, but I believe most things can be solved with a healthy dose of common sense. My family is not a stranger to large hospital bills. My oldest brother passed away from complications of Cystic Fibrosis (CF) four years ago. My sister had scarlet fever as a child, so she has heart damage and has had three open heart surgeries three years ago. Another brother has both CF and Phenylketonuria (PKU.) In addition, we also have run into more common ailments associated with aging.

This being said, I understand that pre-existing conditions need to be covered in any “universal” system, but any coverage that does not produce incentives for people to retain coverage when then are well will fail to spread risk and expense over the masses. For instance, if people can buy insurance only when they need it, they will only pay premiums for the months when their health expenses out way premium expenses. As soon as the cost for premiums out way health expenses, they would then drop it until the next time they “need” it.

I am also a proponent of individual choice when it comes to health care. When presented with a complicated or life threatening ailment, a patient needs to have trust and confidence in his or her physicians. They need to be free to seek other physicians’ advice or counsel.

My proposal is as follows.

1. Disassociate health care coverage from employment. 

      Why should an employee keep his or her job if they are unhappy only because of the health benefits? Why should government force a business to have fiduciary duty to provide health care for their employees? Currently, this is a benefit to employees so companies can entice better and brighter employees. But if mandated it will become only another hurdle to new entries into the business place and it will become an obstacle to entrepreneurship which in turn may stifle innovation.

1A. Instead of giving a tax deduction to businesses, give a tax credit to individuals. The tax credit would be based on age. Someone 0-17 would get a tax credit of X. Someone 18-30 would get X + 500. Someone 31-40 would get X + 1000. Someone 40- 50 would get X + 1500. Etc.  

1B. This tax credit would be an “up to” amount. Therefore, if an individual premium for a 31 year old non-smoker is 3600 a year and he or she can only get a credit of 3500 a year, he or she would have out-of-pocket of 100 once the credit is taken. If he or she only paid 3000, they would get a credit of 3000 on their taxes.

2. Pre-Existing Conditions must be covered.

      However, in order to prevent people from ‘jumping’ in and out of the coverage when it suites them financially, pre-existing conditions would not be covered until 3 years into the coverage, unless coverage starts within (3) three years of passage of the bill or coverage is transferred from one insurance company to another.

3. Expand coverage options not but mandated coverage.

      Insurance coverage should be allowed to be sold across state line. Insurance companies would be able to sell ‘a la carte’ so one could buy just catastrophic coverage, all inclusive coverage, or policies that lay in between. If one is against abortion, euthanasia, etc, as I am, then you could tailor your policy to exempt those items from the premium. It would allow new companies to spring up that  may cater to Evangelists, conservative Catholics, Progressives, etc.

4. Insurers would issue a 1099-“H.”

      Insurers would issue a 1099 that would show months covered, people covered, and total cost of months purchased. If one moved to a new insurer, you would get  two. This would be used on the IRS Individual income tax form to substantiate credit taken. If a person was born, died, or entered a new age category, they would get the higher of the two credits steps.

5. Create subsidized hospital/clinic system.

      Not everyone may purchase insurance so how should these people get help when they need it? They could go to a public hospital and the emergency rooms would be separated into divisions for non-emergency sick, injured or wounded, and then critical emergency for true emergencies. The person would receive the same credit on their taxes as they would with insurance, but they would be liable for expenses up until $25,000 per person, per year. Expenses after $25,000 would be covered by government. This would allow for a small punitive cost because they did not have insurance, but it would give people a way out of catastrophic bills.

6. Doctors must “work-off” student loans.

      Doctors who take student loans would be required to work 3 years in these public Hospitals/Clinics before they could open a private practice or move on to a fellowship for more specialized fields.

7. Tort Reform.

7A.Recovery Caps.

      One of the biggest driving forces of health care costs is medical insurance for doctors and medical facilities. Doctors order extensive tests for usually simple diagnoses because they need to do everything to prevent a lawsuit in case the      most common diagnosis for the symptoms turns out be incorrect. This is called defensive medicine and increases the cost of care. Doctors need to be protected when making educated diagnosis even if it turns out to be wrong. Limitations on “pain and suffering” need to be capped.

7B.Public option for Medical Insurance.

      Since Congress seems so intent on entering a public option for insurance right now, why don’t they have a public option for medical insurance? They could  undercut the “evil” insurance companies and lower costs for doctors and correspondingly their patients while letting insurance companies compete for individuals.

In the end, I think this would do more to fix the bad and keep the good in our current medical systems than most of the ideas floating around Congress at this time.

Over the past two weeks, we have been witness to one of the finest examples of "punch-counter-punch" that I have seen in the last decade.  Barack Obama rallied and John McCain counter-rallied.  Central to these rallies were each candidate's picks for VP.  Pundits have been examining the "meaning" of the picks but I believe they have fallen short.  Regardless of the success or failure of these picks, they provide a window into the candidates' shortcomings as they see it.  They chose like-minded juxtapositions to their own selves.

Obama picked Joe Biden.  Why?  Obama is bright, young, inexperienced and possibly scared at his own success.  He is, more than anything, liberal.  As such, he chose a fellow liberal who is slower, older, more experienced (although to me his experience leaves me wanting,) solid, and stable.  If Obama is what Joe Biden isn't, we will have a very malleable and untested person at the helm of the world's largest power.

McCain chose Sarah Palin. Why?  McCain is headstrong, aging, experienced, independent, and possibly scared of "his" conservative base.  He is, more than anything, a maverick.  Conservatism is not his calling card although it does significantly influence his opinion.  As such, he chose a fellow maverick who is more conservative, younger, less experienced (although to me her experience has been overstated,) solid and unknown. (And yes, she is a she and she has "the looks" McCain is lacking.)  If McCain is what Sarah Palin isn't, we will have a very independent and headstrong person at the helm of world's largest power.

Independent or malleable?  Experienced or Inexperienced? McCain or Obama?  That is the question.  America will answer and we will all need to support the choice by loyal opposition when necessary.