Health care is not a right. Health care is a need, like water or food. And like water or food, it isn’t free.

Everybody should have health coverage, and each individual should have the opportunity to choose the health care they want from the provider they want.

Every individual needs to be responsible for purchasing their own health care and making sure their children are covered.

What follows is what I would consider a “best case scenario”. I don’t have all the answers and I may border on living in La-La land but this is what I would like to see.

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What should a Health Care Insurance company be required to offer in their plans in return for premiums?

• Full coverage for “Well Care” without deductibles

• Yearly physical, well-baby checks and immunizations
• Screening tests (mammograms, PSA levels)
• Labs (liver function testing for statin use, A1C levels for diabetes)
• Classes for patient education: smoking cessation, hypertension information, diabetes, diet and nutrition

• Medications without a co-pay and without restrictions to a “formulary”.

• Mental health care covered - including counseling and hospitalization as necessary.

• Emergency and Hospital Care

• Here is where any deductibles would come into play

• The individual can choose the amount of their deductible for emergency care.

• The individual can choose the amount of their deductible for hospital care.

The amount of the premium would be based on the number of people covered and the deductibles chosen. The maximum amount of the hospital deductible would be $10,000.

There should be no exclusion of pre-existing conditions and no lifetime maximum, thereby protecting people from catastrophic illness. Cosmetic surgery would not be covered unless required as the result of accident.

Each person is able to pick their own provider of health services, be it physician, nurse practitioner, chiropractor.

Health care decisions are made by the patient and their health care provider, free of outside influence.

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Okay, there’s the foundation.

Now we need to pay for it.

I do not believe it is the government’s responsibility to actually purchase and provide health care, but there are things them government can do to facilitate the ability of individuals to do so.

In fact, I thought the recent proposals in the State of the Union message were a definite step in the right direction (hang in there with me, readers of the Democratic persuasion!). As I understood it:

• Tax breaks for both individual and families to purchase health insurance offset by

• Actually taxing employer-sponsored health benefits as income

Personally, I want the government involved as minimally as possible in my health care decisions. However, there are some situations where the government may be able to provide a “safety net” by providing a system of basic care, including mental health coverage to:

• Those who are unable to work due to disability and therefore unable to receive the tax breaks, including children of the family affected.

• The elderly who are unemployed or disabled.

• Not every elderly person is poor or needs to have government health care, especially if they are receiving tax benefits that allow them to purchase private plans.

• Not every older adult aged 65 needs Medicare, again if they are receiving tax breaks to purchase private plans.

• Health care should be provided to all Veterans through the VA system as a benefit for having served their country in the armed forces.

I’m talking citizens of the United States, by the way. Children should never suffer, even if their parents are illegal aliens and should have access to immunization and health care. If you are an adult from another country in the US illegally, you shouldn’t be receiving one dime in benefits from this country. Access to health care, yes. But you pay for it.

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This all means the health care insurance industry will now have to compete for the health care dollar.

If an individual has the ability the choose their health plan, the industry will have to become competitive. People will spend their health care dollars where the plans are competitive and the premiums reasonable.

Individuals can decide the amount of coverage they want and how much to spend on it. Younger people may choose a higher deductible as they are relatively healthier. They can add coverage as they get older and depend more on the health care system.

Individuals who (irresponsibly)choose not to have health insurance of any kind will pay the price in the form of what is popularly known as ” a bill” from the provider of the service.

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In terms of how to spend the money obtained, I’ve said it before and I’ll say it again: the majority of the money should be spent at the level of primary care: Family practitioners, Internists, Pediatricians. Think prevention. Think basic care. Deal with potential health care problems BEFORE they become problems and money will be saved in the long run.

Make private practice attractive again by making it feasible to run a practice by paying what the service is worth and not a portion of what some bureaucrat thinks it is worth. Enact legislation to stop exorbant/frivolous lawsuits so malpractice premiums will drop.

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As you have probably ascertained, I am not for a single-payer health plan. Frankly, I’ve never seen one that works. There’s the NHS in Great Britian, but I direct you to the NHS Blog Doctor for a good look at how THAT system works. Canada has national health care, but if I’m not mistaken there are waiting lists for procedures and surgeries.

Can’t imagine that would go over big here in the US, where people get upset if they have to wait an hour in the ER.

We have universal access. All you have to do is go into an ER and you MUST be treated whether you have insurance or not or whether you can pay or not. You cannot be turned away.

Most of the nursing organizations (and most of the readings in my Leadership and Management class) all promote the idea of a single payer system.

I don’t think it’s the government’s responsibility to care for a citizen from cradle to grave. I believe it is the government’s responsibility to help facilitate the individual citizen in obtaining needed services.

I believe that individuals citizens and their respective states need to take on at least some of the onus of paying for and maintaining a viable health care system that assists citizens with purchasing the health care of their choice.

Maybe someday it will be possible to do away with the employer-paid health care altogether. I’d rather have the money and be able to choose my own plan with my own provider.

Minimal government interference and individual responsibility.

That’s what I believe is the way to address health care in this country.

Because health care is not an entitlement.

(Let the bashing begin………)