How to Pay for Healthcare

As the Obama administration continues with its push to "change" for "change's" sake, health care reform has been placed on the front burner. Congress is currently debating the nuances of such a deal. The Obama administration is seeking more federal control over the industry to reduce insurance premiums and costs. But the President has refused to accept a tax increase on individuals and businesses who currently have insurance. Economists believe that this type of tax would cause the subscribers to use their insurance more wisely, thus driving down costs, while the tax on their plans would support those who currently have no insurance.

Pay now or pay later. Sometimes we have to shake our heads at what is happening in Washington. What are they thinking? If we run out of money, we can't just go and print some more like the U.S. Treasury did this past spring. When we have to cut back so that we can afford to pay the bills, we just do it. There is no choice. So, why is the government waffling?

Our Congress and President are in the middle of a political tug-of-war. Both sides are pulling as hard as they can so that as much of the rope (money) as possible remains under their control. President Obama and the Democrats want to pay for insurance but have no money at their disposal, and they refuse to enact a tax. Republicans in Congress want to help too, but they want it to work and don't see how it can. They refer to the CBO's (Congressional Budget Office, a bipartisan agency) Director Elmendorf who said that Obama's plan was underfunded and would not stop the rise in insurance costs. Regardless of what we think we know or what we see, if we truly trust in our government, and in our elected officials, we have to believe that they are making the best decisions possible at this time.

So, what is the solution? Pay for it. If people are going to use insurance, they need to be able to pay for it, possibly without full monetary reimbursement to the provider. They should be subjected to a quick governmental assessment carried out by a local social worker, and placed on a "Pay For It" scale. They will pay as much money as they can at the moment of service, and have one year to pay back the rest in one of two ways: Either monetarily, or from a list of corresponding service hours to the community. This is a bartering program of services for services.

I remember my dad telling me stories of my Uncle Roy Ingalls. In the 1920's and 30's he was a town selectman in Orleans, Vermont. He did this for free...Part of his job was to take town monies collected from taxes, and disperse them to the poor. There were no "poor houses" at this time, although the popular Katherine Patterson "Jip" book alludes to it. He was called the "Overseer to the Poor" which meant that he oversaw assistance.

Yet, it wasn't always monetary assistance. Part of his job was money, yes, but more of it was to check in on their general wellness (welfare). He would observe them, chat, and check on the kids, the plumbing, etc. He would be a local contact for them and let them know from his "gossip" or "town knowledge" what jobs may be available, or which farmer had some extra foods, etc. He was one of the first social workers of the past century. He had unlimited powers and met the people where they lived.

What do our social workers of today have? Paperwork. I personally am aware that in Northern VA, more than half of their time is spent on paperwork. They must document every word they or a client says, every phone call, visit, etc., with minute detail. The purpose is to avoid legal issues down the road and for accountability. Well, the social welfare departments are effectively cut off at the knees!

Here is another solution to our healthcare crisis: re-empower the local social worker. Take power away from the federal government and place it back in the local overseer's hands. Trust them. Give the job to those in the community who can be vouched for. Draw local communities together, instead of apart with "federal funds." A return to this type of "welfare" will release money into the system as nurses, medics, doctors, secretaries, and human service workers of all types have more money to spend where they know it needs to be spent, and have the time to observe their patients or clients.