8/10/2009 -  TM, Chester, NJ writes ...
How to Fix the Health-Care 'Wedge'       Post to Main Thread   Reply to TM

Yes, thank-you!

As a small business employer, I know first hand the true costs of our typical HMO health plans. They are the adverse of insurance - they do not hedge against a serious incident but aim for paying for everything. This certainly leads to abuse by the insured.

Because of this, the premiums no longer reflect covering the risk of a person getting sick, but have to cover every cost, thus it is almost a one-for-one relationship.

Most vision plans charge as much in premiums that they offer in coverage. Most dental plans charge about 80-90% in premiums that they afford in coverage. And most small businesses have started to adopt medical plans that have huge deductibles, in the 1500-3000 range, because this cuts premiums by up to 70%. Then they simply pay directly what the plan does not cover, saving the business a huge amount. But then that is how insurance should work - it should cover the risk of a serious illness or injury, not every visit for a ear ache.

To gain control over insurance costs, make insurance what it should be - coverage for risk. Get rid of the trial lawyers getting rich by suing doctors and medical institutions to get access to their insurance coverage. End the practice of allowing the uninsured to use emergency rooms as their local doctor (I am an EMT and see an astounding amount of this, and it costs a fortune!). And get control of drug costs. There is no reason that an individual should have to pay thousands a month for drugs.

The one thing that will never work - just what the Obama administration is offering: have the government pay for everything. It will just lead to massive abuse of the system because people will be completely disconnected from the transaction. If your local car wash was free, I would bet most would get their car washed every day rather than just once in a while.

8/13/2009 -  PKT, Los Angeles, CA replies to TM 8/10/2009 ...
How to Fix the Health-Care 'Wedge'       Post to Main Thread   Reply to PKT

The health care debate is confusing. I read the World Health Organization report and it says the US ranks 37th worldwide for public health based on a variety factors including infant mortality and life expectancy. The Cato Institute and the Right to Life League say the report is biased and politically motivated. However, since both these groups are inherently biased and politically motivated their criticism has to be taken a bit more than a grain of salt. Forbes, which is the probably one of the more balanced sources with a slight tilt right, places the US 15th on the list. That in itself should be a warning light since we are number one on health spending and number one in terms of cutting edge medicine and research but can only rank 15th behind countries like France, Germany, Iceland and Switzerland.

Forgetting the competing health care plans out there right now I would really be interested to know if the debate is one over the quality of health care or the health of insurance companies and hospitals. If a plan could be developed that didn’t increase government spending or the deficit, ensured quality health care, covered the 47 million or so without insurance but was single-payer and eliminated the insurance companies would the protests be so strident?

One of the major burdens on health care providers now is the onerous paperwork and administrative costs associated with private insurance. As single tax advocates like to point out billions is spent each year on tax accountants and tax preparers because of the complexity of the tax system. The same is true of private health insurance. Billions go into to paperwork requirements and because the companies are for profit billions more go to the corporations’ bottom lines. Eliminate private insurance and you immediately save billions of dollars that could be spent directly on patient care.

As for the argument that the government can’t run an efficient health care system we already have single-payer systems in the form of the VA and Medicare both of which seem to be dong an adequate job. As proof look at the angry seniors at the town hall meetings who are there because they don’t want a change in Medicare. That’s an astonishing degree of loyalty for a supposedly inefficient government run health care program. Admittedly Medicare is facing a financial crisis but that is due more to legislative failure than a failure of the system itself.

Most civilized countries have had public health options for many years. Americans can certainly look at other models and take the best from them to come up with a system that fits our needs and delivers care on a more equitable and efficient basis. The argument that reform isn’t needed is ridiculous. Emergency rooms are being overrun because the uninsured are using them as de facto clinics at a cost two to five times non-emergency care would cost. Companies who provide health insurance as a benefit are cutting back more and more as costs go up to record highs. One personal anecdote my wife’s company was scheduled to merge with a Canadian firm that backed out at the last minute as due diligence revealed the cost of health insurance to the company. The bottom line was affected enough to make the merger unprofitable to the Canadians. We talk about the free market and fair competition but American based companies have an added expense Europeans for the most part don’t; therefore, more money is available for capital expenditures and development. The cost of private health care in America is in reality an economic anchor dragging us down.

The fear of health care rationing that the organized mobs at the town hall meetings are so vocal about is also a straw man. Insurance companies ration treatment right now and the stories of individuals who have been cut off because their care is too expensive are well-known and documented. In fact for every horror story about Britons or Canadians facing illness or death because of delayed or postponed treatment critics of the current American health system can counter with stories about people facing bankruptcy or death because of private insurance company decisions. I find it amazing those free marketers who see competition as sacred are yelling the loudest about a competitive government insurance option because more people might be attracted to it.

I could go on but sufficed to say that to me the current debate is less about health care reform and is instead becoming a symbol for all the right hates about Obama and the government in general. Rather than address the legitimate concerns about a burdensome system that even by the most generous benchmarks is falling behind the rest of the world while costs are increasing the lunatic fringe represented by the tea baggers and talk show rabble rousers doing their best to stifle any reforms at any level -- much to the delight of the insurance and pharmaceutical companies who have a vested in keeping the status quo.