My Solution for the Great State of Texas

I am a native of the Lone Star State. I have lived here all my 26-and-eleven-twelfths years.

Those who really know me know that I am a Libertarian at the Federal Level, a near purist, but at the state level, I'm center left. I voted for Kinky Friedman for governor in 2006. He has some socialistic views. And that's fine. I like it. I also am a strong capitalist.

I think for a Texas health system, it could go something like this:

-- We have a mandate at the state level that everyone be insured for catastrophic loss. In Texas, car insurance is mandatory, as it is in most states. What's more important? Car related affairs or people's health? In some ways the two intertwine cuz car insurance involves a "medical payments to others" portion. So I think it's a good thing to mandate that people have at least catastrophic insurance. It's the right thing to do. It helps the hospitals for one thing. They won't take so many losses from treating people with no coverage. And it will save patients from crushingly heavy medical bills of $200K, $300K, even $900K in some cases. It's a damn shame that anybody in Texas has ever gone bankrupt over medical bills, yet I was watching a PBS documentary in which a Houston man who'd worked in Info Tech but lost his job and then had a heart attack and was left with $900,000 in medical bills. The hospital treated him even though he had no insurance, but he declared bankruptcy after the fact. That's unacceptable. That's gotta change.

-- People need to have their own individual health insurance policy, not through their job. Having said that, we need to have a program, in following Germany's model, wherein if you lose your job, your coverage remains. I think that this can be done first and foremost in the private sector, and in the insurance companies. When I used to be a Primerica agent, our life insurance policies had a provision for people under 56 called "Waiver of Premium." It wasn't much more to add it on per month, and if you became disabled and couldn't work, Primerica would pay your premiums while you were disabled. I think the health insurance companies like Blue Cross Blue Shield and Humana should offer a waiver of premium for unemployment. It could be the kind of thing where, you pay, say, an extra 5% of your premiums and then if you became involuntarily unemployed, you could keep your coverage for up to 6 months of no work. If the insurance companies are for any reason unwilling to do this (and I don't see why they wouldn't), then the state of Texas can create such a fund through fast food or tobacco tax or something like that.

-- We need to have a program where the state of Texas provides assistance to low income people who have trouble paying their premiums. You could even put this in place of Medicaid eventually. If your income is less than 3-and-a-half times the poverty rate, Texas will help you with your premiums. Same with people in the risk pools.

-- Speaking of risk pools, Texas is one of 30 states that has one. And the provider therein is Blue Cross Blue Shield of Texas. The rates are by Texas law, required to be 200% higher than standard health rates. I think bringing other insurance companies into the risk pool would create rate competition. How? Because whoever has the best standard health rates will have the best risk pool rates too. Then the people in the risk pool win. Competition in the market place lowers prices and improves the product. Look at the cell phone. Look at the television. The computer. The car. Etc, etc, etc.

-- People need to be given an education about health insurance and HSAs and how it all works. I know what I know cuz I'm into the topic, but for Joe Blow who's not like me and knows little, he needs to be provided an education and insight into it.

-- S-Chip is a great program, and I personally know mothers who are on it, and I'm happy that single moms who have 3 kids have coverage for their kids that they can afford. But $50 a year?! That's absurd. That's $4.17 a month for all your kids. It should be $50 a year for one child and then an extra $15 per child. So a mom with 4 kids would pay $95 a year. That's still dirt cheap. $95 a year is only $7.92 a month! For 4 kids! That's less than $2 per month PER CHILD!