Posted by
Mark S. Rader on Tuesday, June 09, 2009 12:00:00 AM
The political elites in this nation have been pushing this idea that there are 50 million Americans who do not have access to health care. As usual you have to focus hard on the words that are being used to try and understand what they mean when they say that. Are there really 50 million Americans who do not have access to health care? No... every person in the United States has access to health care today...what they are saying is that there are 50 million Americans who do not have health insurance. Anyone who can walk into a hospital emergency room has almost immediate access to health-care. So why would we be told otherwise when the reality is that we in the United States have better access to health care than any industrialized nation.
In order to highlight my point I will refer to a posting on the whitehouse.gov website. The Obama administration refers to "coverage" as the goal not actual health care.
The Administration believes that comprehensive health reform should:
- Reduce long-term growth of health care costs for businesses and government
- Protect families from bankruptcy or debt because of health care costs
- Guarantee choice of doctors and health plans
- Invest in prevention and wellness
- Improve patient safety and quality of care
- Assure affordable, quality health coverage for all Americans
- Maintain coverage when you change or lose your job
- End barriers to coverage for people with pre-existing medical conditions
This point is important because under any plan that uses "insurance" as the solution for the so-called health care crisis is doomed and actually unethical. This is exactly what the current Senate (Dodd/Kennedy Health Care) and the House (Tri-Committee Health Reform) bills do. They are both focused on getting you covered... care is less the concern. Insurance exists not to give you health care but only coverage. Insurance works best when you only get coverage and don't use that coverage. The reality is that even today where insurance is involved, health care is completely socialized. That is, it is designed to get those who do not use the coverage to pay for the health care of those who do use the coverage. Now they toss you bones, a doctors visit here or a physical exam, but even then they set deductibles and co-pays so high that most people rarely ever get insurance to cover much of anything.
According to Consumer Reports.org the health insurance industry makes over $11 billion dollars in profits a year. Now as a Conservative I do not have a problem with any company making profits and doing everything it can to make those profits. The problem I do have is our politicians treating us like we are stupid. Health care in this nation is already socialized... perhaps I should say it is a privately-socialized system. The skyrocketing increase in health care costs is because of the private-socialized system built by the government and insurance companies and any involvement of insurance companies in a solutions will be its doom.
The insurance companies have used the so-called "reasonable and customary" costing system. This is a system that has forced the cost of health care up over 6.9% a year for the last 30 years. You see, reasonable and customary charges are what insurance pays. Who sets reasonable and customary? The medical industry... today's price increase is tomorrows reasonable and customary charge. The medical industry can raise their rates knowing full well that next year insurance will pay that amount. This causes systemic increases every year with no impact from the free market. By allowing this system to exist the insurance companies have shot themselves in the foot and in a short 30 years have destroyed market forces in health care.
The insurance companies have responded to this failed system by using so-called negotiated rates. Negotiated rates have further destroyed the free market system because no one knows what things really cost anymore. One person may pay $2000 for an MRI while another may pay $250. This is due to a negotiated rates. The problem is... the one person who pays $2000 is only paying that because the person with the negotiated rate only payed $250 and must be subsadized. So what is the real cost of an MRI?
It is these forces and the removal of the free market that have created the system we have today. A system where Doctors coming to your home to examine you in the 1950's was traded for today where you are pulled together with other sick people in a waiting room for an hour, exposed to who knows what while getting to see your DR for about 4.5 minutes. Why did Doctors stop coming to our homes? Because we stopped paying the bills... they didn't have to please us anymore only the insurance company and now they will only have to please Uncle Sam. I am not attacking the Doctors here anyone with a 3rd grade understanding of business should know that profits will drive actions. Its not the Doctors fault.
According to the National Coalition on Health Care, the industry as a whole cost us over $2.4 trillion dollars in 2008. The insurance premiums payed alot of that, much was payed by co-pays and deductables but when it was all said and done the insurance companies had over $11 billion left over. The question becomes... how much health care could have that $11 billion bought us? Like I said before, the insurance companies deserve to make as much money as they can... the problem is the system. Any so-called solution to this crisis that includes the insurance industry is no worse than the worst socialized system imagined by every conservative talk-show host. If the government is running it or if an insurance company is running it "coverage" is not health care and it will equally and continually break the free market in the health industry.
Don't forget that even if your employer pays for your health premiums, $6,000 to 12,000 a year, its money that would be in your weekly paycheck otherwise. What would happen if your local Doctors and Hospitals suddenly realized that you were paying the bills and that you were the one truly deciding who you would see and what you would pay for? I venture to say that not only would prices fall, Doctors would be providing services like home visits very quickly and those 4.5 minute face-to-face encounters would become more relational and life-long. Hospitals would get far more creative in their offerings to you and your family when half the beds are empty because you are the one calling the shots.
There is a solution to this problem but I must warn you, it will never happen. If the government really wanted to help "we the people" the first thing they would do is get the health insurance companies out of the equation. If employers really wanted to help their employees they would take those premiums and put them back in our pockets.
I am not advocating a system that has no governmental involvement. There is a role for government in health care. That role is to provide the ability for the citizens of this nation to save money to be used for real health care, tax-free. Additionally the government should create health savings accounts that are not tied to insurance coverage as they are today. Further those health savings accounts should role over year to year gaining value if not used and then passed to heirs upon death. These health care savings account would be required to invest in an insured stable instrument. The poor would get deposits from the government made directly into their heath savings accounts based on their income, so they too would have money for care. Remember, these monies could only be used for a qualified medical, assisted living, or nursing home provider. The bottom-line is: a system must exist that puts the spending in the hands of the patient and it must not be setup in a way that compels people to spend-it or lose-it, like reimbursement accounts are today. Over the years and decades these accounts would build in value and the majority of people would be solely self-insured.
There are many details to be worked out... such as catastrophic care would have to be subsidized by the government somehow for the short-term. The money of people who die without heirs would be reclaimed and distributed into the system to cover the poor and visitors. Other pieces of this puzzle would be to either subsidize or eliminate the need for liability (malpractice insurance) for Doctors and Hospitals. Also to further reduce the cost of health care for the poor, allow Doctors and Hospitals to write-off, dollar for dollar, care given to the poor against their incomes. The ideal situation would be Doctors and Hospitals paying not income taxes at all. This would give the poor the best health care available. Taxes payed by the health care industry should go directly back into the system to fund health saving accounts ... not the general fund.
It doesn't take a mathematician to see the power of the bell curve here and how it would eventually create a "free-market" centergy that would make health care worries a thing of the past.