K.I.S.S. Me You Fool

This post is the sixth in a series called “500 Words To Save The World.” Each day I will use just 500 words to address a problem that has been bugging you or me. If you want to get in on the conversation, tell me the problem you’d like discussed in the comments section of this post, or email me directly at steve@stevenazarian.com. You may start counting words… now!

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Years ago I received a Lego set for Christmas. I wrote about it in a piece called Why Legos Matter. This set included gears and axles. One day my Dad and I were playing with the Legos, and he taught me how to make a speed multiplier gearbox. When you mesh small and large gears in an alternating pattern, turning the input end produces a substantially greater rotation at the output end. It seemed like magic… I set out to build a bigger one using all the gears in the set.

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Our nation has a crisis with healthcare. The problem is not in our ability to treat symptoms, cure disease and in general support a healthier populace; no, our entire problem is centered on how to pay for it.

There is no argument that the United States has the finest healthcare delivery system in the world, unfortunately the access to that system is a mess.

I am not here to bash the ACA, its creators or supporters; but rather to point out that everything we have tried to date has not worked.

So, here is my answer. Keep It Simple Stupid

As I stated, it is a money problem, yet we keep trying to solve it with process, rules and behavior shaping regulation; wrong answer. Here are the right ones:

  • Leave the parts of the system that are working alone – If you have insurance you like (by whatever means) it should be allowed to continue unabated
  • Create a sliding scale, (Health Savings Account) HSA policy based system for everyone who wants insurance, but does not have it
  • These policies would be offered nationally by any interested company. The price would be the same for all policies, differing only in features.
  • For the most needy, the monthly deductible and HSA funding would be completely covered. As income increased, the subsidies would decrease until the subscriber was paying the full price

But wait a minute… if someone is receiving a fully funded HSA for free, what’s to keep them from overwhelming the system?

For anyone receiving a subsidy, 50% of the money in the HSA not spent in a given year would be placed in a 401K or 529 account, where it becomes the property of the subscriber, with the other 50% being returned to the system.

If you truly need healthcare, you’d have it. If you don’t, your judiciousness would be rewarded with an investment in your future. I’ve done quick math on this and it would be much less expensive than the complex road we are currently walking down. Better access for fewer dollars, simple.

Oh, I built that gearbox using all the gears in the Lego set. Guess what, it was so complex and encumbered by friction it wouldn’t turn, and when I tried really hard I broke it.

It reminds me of a picture I saw once:

obamacare-chart-big

Simplicity is all we really need to take care of each other. We’ve proven that every other approach simply doesn’t work.

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I am working on a much longer more detailed document to explain and support this idea. I welcome your input, really I do. We do not need to accept poor execution, no matter how good the intentions and if we don’t do something, we’re going to end up with nothing, and that would be simply a shame.  When you stop thinking like a Democrat or a Republican, and start thinking like a person, the simple solutions appear quite clearly.

 

Copyright © 2015 – Stephen S. Nazarian – All rights reserved.(K.I.S.S. Me You Fool)

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3 thoughts on “K.I.S.S. Me You Fool

  • Sometimes, complicated is better. Complicated can also be made reliable by refining the product.
    As examples, I suggest you consider automobiles. Today’s cars are a marvel of engineering. But they also self-diagnose problems when they do occur, by the universal standard of obd-ii. Today’s cars are not simple. They are complex, but they are also superior to their predecessors in almost every way.
    Likewise, today’s computers are very sophisticated, employing millions of transistors. We send electrons over thousands of miles to post responses to blogs. And every time we use these complex things, we expect them to work.
    So while your Lego anecdote is amusing, it is also the type of wishful thinking that conservative minds always employ. They think that if things were just kept simple, everything would be better. Fortunately for me, not everyone thinks that way. So when I went out to start my car in subfreezing temperatures this morning, it started thanks to fuel injection. I drove through ice and snow safely thanks to all-wheel-drive, traction control, and anti-lock brakes.
    And I am also able to respond to your blog without leaving my sofa, thanks to the very complex multi-million-transistor technology that now fits in our pockets.
    Sometimes, simple is good. But we should not fear complexity itself. Healthcare problems are like anything else. You have inputs and outputs. You design a system to reliably get the desired outputs for the specified inputs, and no one should have to care how simple or complex the system is. To the layman, it should appear to work as if by magic. But how you make the magic happen should not be philosophical or political. You do whatever it takes!
    There is no magic in our current system. You have a single health problem for which you dial 911, and two days later, you have a half dozen different bills from various entities that capitalize on illness. Ambulance, emergency room, physicians group, specialists, etc. Then you battle with your insurance company to see what they will cover. No, there is no magic in the current system, and you are 100% right that the problem is how you pay for it.

    • Joe,

      I agree, but sometimes it all comes full circle. My car does not have all of the complex wiring harnesses typical of a modern vehicle. There are two redundant fiber optic loops that manage information from the audio system to the engine computer to the turn signals. Yes the system is complex in design, but the implementation is simple, elegant.

      So I guess I’d say that things can increase in complexity to a point, but all systems reach the limit of their scalability at which point a paradigm shift much take place.

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