Awaiting creative answers for health care costs

Brian Brown, ReporterFor decades, there has been wide disagreement over what national health care should look like. The result of that disagreement is a disjointed, mismatch of those with Medicare, Medicaid, private insurance and no insurance. Meanwhile, health care costs seem to be forever rising in spite of the reforms (Affordable Care Act, aka Obamacare) designed to make care more affordable.

While the economic recovery appears to be slowing the increases in health care expenditures – now roughly 4 percent per year since 2009, according to nonprofit health education organization Kaiser Family Foundation – the trajectory is still upward.

From a broader perspective, health care spending in the U.S. exceeded $2.6 trillion in 2010, more than 10 times expenditures in 1980, far outpacing inflation, according to the Kaiser Foundation.

During a recent trip to urgent care, I had a few minutes in the waiting room to contemplate the innovative actions Americans could take to stop health care costs from rising, and I remembered one of those fleeting ideas that occurred to me a couple of years ago. What if individual communities managed their own single-payer systems? In recent years, we have seen a local foods trend gain traction; perhaps a local health care trend is possible.

Many countries have universal coverage, and their citizens spend less on average for their care, but most people, according to Gallup, are against a federal plan. So, what if cities did it themselves?

Let me be clear, as a reporter, I’m not advocating for such a system, just brainstorming. Having researched and studied the ACA a handful of times as part of my job since 2009, I’m not aware of any provisions in the law that would prevent such an idea from coming to fruition. At the state level, I know reforms are designed to allow individual states to determine for themselves what they would require of insurance providers, assuming minimum national requirements are met.

Imagine if, for example, a city sales tax of 8 to 10 cents on the dollar paid for the health care needs of all its residents.

It could be done through property taxes, as well, but a sales tax could have residents and nonresidents both paying for local health care. How would that impact businesses within its city limits? My guess is that could attract a lot of people to the city who would want to be residents for the “free” care, and at the same time push businesses that don’t want to compete against lower area sales taxes outside the city limits.

On the flip side of things, what if consumers had more flexibility to eliminate insurance for all but the most major health care expenses?

In 2009, consumer reporter and libertarian columnist John Stossel argued that insurance on common care needs is  driving our costs up. Stossel pointed out that everyone knows what the price of items are at the grocery store, but few know what they’re paying at the doctor’s office. Admittedly, I don’t have a clue what I’m going to have to pay for my recent urgent care trip.

During the next year, many businesses are going to have to navigate a complicated health care landscape as key ACA rules take effect in 2014 and state exchanges are put into place. I don’t have the answers, but I am hopeful that as these changes occur businesses, insurers, health care providers and government officials can come up with innovate ways to work within our legal framework to turn a disjointed system into something that looks and feels, well, healthier.

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