The CEO of Whole Foods has a plan to reform health care. Not by increasing communist-style government control of healthcare OMGWTFBBQ, but instead by taking simple, common sense steps. Mainly, having every retailer on Earth become Whole Foods.
While we clearly need health-care reform, the last thing our country needs is a massive new health-care entitlement that will create hundreds of billions of dollars of new unfunded deficits and move us much closer to a government takeover of our health-care system. Instead, we should be trying to achieve reforms by moving in the opposite direction—toward less government control and more individual empowerment.
This sounds like common sense speaking, and if there's nothing that never made me pants-shittingly annoyed, it's people sharing common sense with me!
Remove the legal obstacles that slow the creation of high-deductible health insurance plans and health savings accounts (HSAs). The combination of high-deductible health insurance and HSAs is one solution that could solve many of our health-care problems. For example, Whole Foods Market pays 100% of the premiums for all our team members who work 30 hours or more per week (about 89% of all team members) for our high-deductible health-insurance plan. We also provide up to $1,800 per year in additional health-care dollars through deposits into employees' Personal Wellness Accounts to spend as they choose on their own health and wellness.
Money not spent in one year rolls over to the next and grows over time. Our team members therefore spend their own health-care dollars until the annual deductible is covered (about $2,500) and the insurance plan kicks in. This creates incentives to spend the first $2,500 more carefully. Our plan's costs are much lower than typical health insurance, while providing a very high degree of worker satisfaction.
This seems like a great, common sense reform. High deductible health insurance with a significant contribution towards the deductible. I mean, if you ignore the fact that high deductible insurance often doesn't cover common conditions like pregnancy, have incredibly strict in-network requirements, high coinsurance rates even after deductibles are paid which far outstrip an $1800-a-year contribution, place strict limits on the allowable prices for common procedures and are tied to hour-per-week work requirements that it's incredibly easy for companies to work around, it's pretty much like perfect.
I'm also not aware of this reckless pack of health care spenders, wantonly running around under a $250 deductible having their feet repeatedly examined by podiatrists and getting thryoid tests done because they slept poorly last night. What it did make me more likely to do was go to the doctor before I got pneumonia (as happened this year under a high-deductible health insurance plan that didn't cover the visit). And there was that time that my doctor found the polyps in my colon under a low-deductible plan, a visit that I likely would have delayed if I'd been earning the same amount and had to pay for a colonoscopy out of pocket. I must say, though, bleeding out of my ass and not breathing properly are small prices to play for the ineffable satisfaction of true capitalist freedom.
Equalize the tax laws so that employer-provided health insurance and individually owned health insurance have the same tax benefits. Now employer health insurance benefits are fully tax deductible, but individual health insurance is not. This is unfair.
It's unfair, but individual health insurance is also a lot more expensive than group health insurance. If the former has the same deductibility rules as the latter, it pushes more people onto the drastically more expensive individual market by making it artificially cheaper, which pretty much only serves to insure that the government loses out on more revenue in order to pad insurance companies' pockets. Or wait, no, was that the point? Did I ruin the surprise? Fuck me.
Repeal all state laws which prevent insurance companies from competing across state lines. We should all have the legal right to purchase health insurance from any insurance company in any state and we should be able use that insurance wherever we live. Health insurance should be portable.
That's sweet, look at this guy. Wants to have a national health insurance system that can be used wherever he lives, and carry it with him at all times. Through the private market. Look at the balls on this guy, big as grapefruits. Gonna start calling him Ruby Red, this guy.
Repeal government mandates regarding what insurance companies must cover. These mandates have increased the cost of health insurance by billions of dollars. What is insured and what is not insured should be determined by individual customer preferences and not through special-interest lobbying.
Oh, right, because health insurance companies are going to give you comprehensive coverage nationwide out of the kindness of their hearts. So far, I'm supposed to be buying individual, high-deductible health insurance that's good nationwide wherever and whenever I want, which is at the fairie doctor who makes cancer into lollipops, because that makes as much sense as this plan. I also appreciate the idea that customers will decide what they do and don't want covered (which is everything but abortions and abortions, respectively). I'm 27 years old. I don't want to pay for cancer coverage. I don't have cancer, for one, and I want to smoke it up with the extra cash, two.
The one way to make health insurance and health care more expensive is to set up the system we use to insure against medical risk and have each person craft their own policy towards what they feel their most likely unforeseeable risks are. (Or better yet, to craft their policy based on the description of the coverage and costs they're given, which is almost certain to be different in practice than on paper.) Take pregnancy, for instance. If you're not planning to get pregnant, there's absolutely no reason for you to be paying for maternity coverage. However, if you decide you want to get pregnant, and go to your insurance company to tack on maternity coverage, there's no reason for them to not charge you an arm and a leg for that coverage, since they absolutely know you're going to need it. God forbid you have an unplanned pregnancy and can't postpone your plans until you can afford the coverage. High-deductible insurance on an individual level is pretty much asking for hyper-expensive add-ons as your life situation changes.
It's also a wee bit hypocritical for a guy who offers group insurance through his business to advocate for individual negotiations of health insurance. The reason that group insurance works is because it allows people to pool resources to mitigate risk for the entire group. You give up some degree of choice, but with the caveat that you pay less overall to get what you wanted plus extra stuff than you would have to just get the stuff you wanted on your own. You cannot get more economically efficient results as an individual than you can as a group in health insurance. If you don't believe me, try to buy a single candy bar for the same unit price you'd pay for a box of them. And then buy the box and eat them, confident in the fact that you're sending a message to the CEO of Whole Foods covered in low-grade chocolate and filled with nougat.
Enact tort reform to end the ruinous lawsuits that force doctors to pay insurance costs of hundreds of thousands of dollars per year. These costs are passed back to us through much higher prices for health care.
Except that they have virtually no impact on medical costs, and are growing far slower than medical inflation. There is that.
Make costs transparent so that consumers understand what health-care treatments cost. How many people know the total cost of their last doctor's visit and how that total breaks down? What other goods or services do we buy without knowing how much they will cost us?
You know, he's right. Penicillin costs a lot less than chemo. Treat my pancreatic cancer with that, you con artist. Oh, and I want the generic antibiotics for all the herpes I have. Thanks. Why didn't I get the cheap spinal surgery? I'd sue the fucking pants off of you, but I can't because of the tort reform.
Enact Medicare reform. We need to face up to the actuarial fact that Medicare is heading towards bankruptcy and enact reforms that create greater patient empowerment, choice and responsibility.
In other words, pays for less. Got it.
Finally, revise tax forms to make it easier for individuals to make a voluntary, tax-deductible donation to help the millions of people who have no insurance and aren't covered by Medicare, Medicaid or the State Children's Health Insurance Program.
We can't get people to donate $3 to the Presidential Election Fund. You think we're going to get people to voluntarily donate enough money on their tax returns to help uninsured adults? Does Whole Foods sell black tar heroin? Is that why you're saying this? Is it covered by your health plan? May I have some, sir?
This is about as close as anyone's yet come to articulating a plan which would end all government involvement in health insurance, make insurance into a truly free market and allow all people the opportunity to have health insurance. This is also the closest anyone has ever come to proposing an idea as stupid as the idea I had in college to rename the penny as "the orgasm", so that people would gladly exchange valuable orgasms with each other all the time. Mainly with me. I like pennies.
Health care is a service that we all need, but just like food and shelter it is best provided through voluntary and mutually beneficial market exchanges. A careful reading of both the Declaration of Independence and the Constitution will not reveal any intrinsic right to health care, food or shelter. That's because there isn't any.
Here's the problem. You have alternatives when it comes to food and shelter. You can go to different doctors, but you're seeking the same thing with the same rough cost no matter where you go - it's just a matter of who you get it from. If I want food and have money, I can eat many different types of food at many different prices from many different places. I can eat steak or I can eat zucchini, I can make a sandwich myself or buy one from a shop. Same goes for shelter - I can live in an apartment or a home, in any of a number of areas around town. If I have a broken leg, I need it set and put in a cast. I have no choice except to do it or not do it, regardless of how much money I have. I don't have a lot of time to research, call around or bargain, I can't wait for Sunday and see if there are broken leg coupons, I can't be lazy and drive over to the place that fixes broken legs worse, but does it faster. Even where there are multiple treatments available, you're still looking at a very narrow range of solutions to the problem. An apple, a cupcake and a bowl of cereal all solve hunger to a certain degree, but the vast majority of medical remedies simply will not work when something's wrong.
The piece eventually lapses into an ad for Whole Foods, because what's an admonition to pay more for your healthcare without an admonition to pay more for your produce? That aside, I'm still trying to decide what choices it is that this plan actually expands. You get to pay more for worse insurance, you get substantial pressure put on you to not seek medical care, you're placed in a situation where unexpected medical problems are almost certainly ruinous and you have no regulation guaranteeing you even minimum coverage from whatever it is you're paying hundreds of dollars a month for.
Choosing who is going to eventually fuck you over and ruin your life is not liberty. It's abject stupidity.