Tie coverage to lifestyle choices

My daughter is a director at a small faith-based hospital dedicated to helping its community. It serves several Medicaid and Medicare patience as well as those with private insurance. Its leaders keep expenses down by job consolidation and using primary-care doctors. Cutting payments to those doctors would damage their goal to provide essential services to promote a healthy community.

A group of 22 hospitals has a no-deductible plan for their employees and they can earn premium credits by following healthy-living goals. Perhaps premiums for medical insurance including Medicare and Medicaid should have similar standards.

A large number of Medicaid patients smoke. Maybe a premium should be paid if they refuse to enroll in a paid no-smoking program. Give rewards for healthy living. Getting people to stop smoking, eating healthy, and into drug rehab will lower costs. Not addressing these issues will increase costs for all.

Insurance companies also need to be heard. It is impossible to be financially sound if they have to insure bad risks at the same rates. Most states have a risk pool for problem drivers. The federal government subsidizes flood insurance. Insurance is for unexpected losses. Health insurance as we know it is more of a maintenance policy. Obviously, some subsidies are needed for the chronically ill and lower-income people.

Everyone should be able to have basic medical needs provided. Getting it right will take time. Don’t rush without considering all factors. The Affordable Care Act did just that. Some of its provisions are good. Some are a disaster.

Muerl Liddell Powell