Thursday, July 28, 2011

Defining the Exception Before the Rule

The Sutherland Institute wrote a pamphlet on the importance of Charitable Care. The article laments that their suggest fell on deaf ears.

"Once again, the call for input fell on deaf ears – none of
Utah’s health care stakeholders seriously considered the request."

I am not a "stakeholder." I was dissatisfied with the article because I believe that the article started at the wrong point.

It is true that charity is an important element in a free society. Through charity, free people express their most cherished values. In health care, a well honed system of charity provides care for the people who are underserved by the primary medical system.

Charity is important, but charity is the exceptions and not the rule.

Because the Sutherland Institute sought to address the exception before the rule, the institute ended up penning a proposal that does not resonate with either the "stakeholders" or the public.

The Sutherland plan creates a new state-owned charity called the "Community Health Foundation" that runs free clinics and coordinates charitable care. The program assumes doctors will line up to volunteer time at a state run clinic, and that people are super eager to donate to state agencies.

To me, the CHF appears to be just another top heavy political structure in a world dominated by top heavy political solutions for health care. The "stakeholders" in health care probably just see the CHF as another player in the grub for power.

I believe Sutherland would have better success in promoting free market health care if they start with the rule before trying to define the exception.

This is the approach of the The Medical Savings and Loan.

The mantra of the Medical Savings and Loan is "Those who can pay for their health care should pay for their health care."

The MS&L creates a structured savings program to help people self fund their care. The program records in minute detail a person's health care spending, income and overall wealth.

When a person has abnormally high medical expenses or abnormally low income then they need charitable assistance.

Because the Medical Savings and Loan records people's care, we can identity those who need additional assistance.

Conversely, when a person has abnormally good health or abnormally high income, the MS&L points this out and encourages the lucky ones to donate to the unfortunate.

A well crafted tool that helps people self-fund their care will identify those who cannot.

As such, The Medical Savings and Loan will work elegantly with charitable and public health efforts. Were we to adopt the paradigm of the medical savings and loan for health care, we would find that can provide generous grants without a top heavy structure like the CHF.

While the Medical Savings and Loan works elegantly with public health agencies, insurance does not.

As insurance companies are eager to dump sick people onto the public health system, insurance makes public health care problematic.

Were the Sutherland Institute to look at the rule and not the exception, they would realize that we need to change the primary mechanism for funding health care from an insurance model to the Medical Savings and Loan Model.

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