To continue with ‘real health care reform’, Incentives are the best thing we can do to begin to change people’s behavior. There was a financial incentive for people to engage in behavior resulting in poor health and there must also be an incentive to change, or it will not happen. Many of us will not change unless we have to so there does need to be government mandated, positive incentives to change. We must reward healthy behavior and lifestyle as well as productivity resulting from proper behavior. On the other hand, those who chose to lead lifestyles that promote the current ‘disease care’ system, must be motivated to change by negative means.

If I must pay health insurance rates to care for the chronically ill who are so because of lifestyle choices, then I want them to pay a whole lot more. While we cannot eliminate interdependency, we can punish those who refuse to participate in the greater good, as though they were tax evaders.

One company has, in the last five years, had zero increase in healthcare costs while the national cost is three times the rate of inflation. They have incentives that include healthy options such as gym memberships, and subsidies for healthy options at the company cafeteria. In addition this same company offers discounts on health insurance for those with low BMI’s and non smokers.

One additional reform whose design is to move government out of the role of elder care is an incentive to pay more for coverage while in our working years. This is in order to have care as we move into an age when we can no longer work. Changing the current tax and spend to a collection and investment system designed to cover costs of healthcare when we are old. To eliminate Medicare and the intrusive and inefficient nature of government by replacing the way money collected for eldercare is used. No longer using the funds from young people to fund a government payor system, we save the money to pay for those who are yet to enter the system, reversing the ‘great society’ of LBJ.

I have a dream too, a nation with much less government control. One nation, of the people, by the people, and for the people. What a concept!