Curing the system 

The economy is booming, but why does the middle class feel so squeezed? For parents, the soaring cost of higher education is an ever-present concern, and each of us is stunned by the price at the pump. However, neither one of those problems is enough to bankrupt the average family out of the blue.


An unexpected trip to the emergency room or a regimen of chemotherapy can tax the healthiest of budgets; for Oklahomans without good health insurance, the results can be devastating, even when the physical ailment is cured.


We all know our health-care system is broken, but somewhere along the way, we got caught between the pet panaceas of socialized medicine on the left and so-called tort reform on the right. Therefore, we simply do nothing. When our economy is harmed by a grossly inefficient system and countless fellow citizens live in constant anxiety, the time for inaction is past.


Before setting a new course, we must take note of false starts in the past. A one-size-fits-all federal solution like the "HillaryCare" of old is incompatible with American values and aspirations. The problem with our current system is the layer of trial lawyers and insurance functionaries between doctor and patient; adding another layer of bureaucrats is no solution.


Speaking of unwelcome interlopers, an accident of history tethered many, if not most, health-care plans to employers. In the days of 30-years-and-then-a-pension, this system muddled along fairly well. In our present age, a dynamic economy calls for employees to take the wheel of their careers to a greater degree. It is time health policy caught up with the flexibility of the labor market rather than the former simply holding the latter back.


So, what is to be done? A first step is to create a health-insurance exchange. The idea works much like the stock exchange, where a single market would be created for every health-care plan to meet every resident of the state. Employers even can make the health-insurance exchange the plan for their employees, thereby providing them with the current system's tax benefits while opening up choice and portability.


Secondly, we must address the gap into which so many working-class families fall: between the Medicaid system designed for the poor and the insurance policies that so often can be afforded only by the more affluent classes. Choice and security can be opened up to these members of our society through refundable tax credits and other mechanisms that keep red tape to a minimum.


Finally, we must take seriously the policy of making health insurance mandatory. We require all drivers carry insurance because, in part, we do not turn anyone away from the roads. We do not live (and I shouldn't like to) in a society where we turn people away from emergency-room care. All too often, this quite expensive form of care is necessary because preventative care was unavailable.


Through the programs cited above, those who cannot afford insurance could be aided while those who can afford it would help grow the risk pool.


Such a serious issue demands serious debate; I merely have tried to present an outline of some principles and policies that can start and guide that debate. If you think about it, the same principles can be applied to education "¦

Reese is an attorney who lives with his wife and son in Oklahoma City.


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