Wednesday, March 22, 2006

Insurance

Healthcare in this country is too expensive. Republicans know it and democrats know it. The argument here, as is any political issue, is what can be done about it. Yes, managed care (your HMOs, your PPOs, your POSs) was a Reaganistic initiative which promised lower costs (which it did) but over the years it has been bastardized by both parties who are owned by the healthcare lobbying groups. Of course this all flows back to the need for campaign finance reform, but I digress.

The democratic solution is to have someone else pay for it, their employer or the government, anyone but themselves, because every democrat knows they don't want to pay for it because it's too expensive.
Republicans know it's too expensive to and we can tell this because, if they're an employee, they're happy to have the company pay for it or, if they run a business, they're shifting some cost to employees and/or changing to cheaper plans and/or doing without. The summary is this; democrats: Who's going to pay for it? Republicans: This costs too much. Same problem, what do we do about it?

Before addressing any solution, the question that begs to be answered is why is healthcare so expensive? One large reason is we are pathetic consumers of our healthcare. Most of us know where the best place to go to buy shoes, groceries, clothing, etc is. Does anyone know who the doctor is that gives the cheapest physical is? Probably not. We don't shop around for the best deal in medical care like we shop around for everything else because we're conditioned to paying a premium plus a co-pay and we have no incentive to look for a better deal. This has led to us a system that is rife with waste and abuse. Waste in that the doctors\hospitals try to collect on everything imaginable for a hospital stay or an office visit and they charge the maximum that the insurer will allow regardless of what the actual cost of the treatment is. Abuse in that we as consumers do not take a more active role in taking care of ourselves (extra sour cream on that burrito please or I’ll exercise tomorrow) or we go to the doctor or emergency room for every scraped knee or sniffle. “Guilty!”

Lasik Eye Surgery is a medical procedure that has operated completely outside the confines of medical insurance. In its early days this procedure was about $5,000 an eye with so-so results. Currently, two eyes can be done for under $2,500 with guaranteed results. In essence, this medical procedure, subjected only to free market forces, resulted in lower costs and better results. This is much like the world of plastic surgery but since I’ve never had a boob job (at least not yet) eye surgery just seem to fit. Since there are no “deep pockets” paying the bills and cost has become the overall driving consumer factor, providers are forced to look for ways to be more competitive, i.e. lower costs or offering better technology and better results. Does anyone know of an insurance bound medical procedure that can make the same claim?

Imagine (you know I like to live in a hypothetical world) if there was no health insurance and everyone had to pay out of pocket with our meager paychecks. Would doctors still be able to charge $100 for a 10-minute office visit, or would people either stop/postpone visits or shop around for someone charging less, thus putting the $100 doctor out of business? Would hospitals be able to charge $40 for a Tylenol, or would they have to lower their costs to a realistic figure because people would demand they do so or go elsewhere? We allow these outrageous and ever growing costs because "we" think we're not really paying them, the insurance company is paying them. And whenever the providers raise their rates, as they often do, then the insurance outfits just raise their rates, and we pay it because we are too complacent to say enough is enough (where are our leaders, our rebels, our patriots!).

Am I saying the elimination of all health insurance is the answer? Absolutely not. Heck, Cooper’s surgeries and medical care was well over $500,000 to date, 99 percent of which was paid by insurance. I do think we will always need some type of catastrophic coverage for these situations. However, I do believe the costs would be significantly lower if some of the burdens imposed by insurance were removed. My point in all this is the democratic solution of getting more people health insurance coverage plays right into the hands of the medical profession and the insurance companies. Do you think the insurance companies DON’T want to collect more premiums and up their profits, do you think the doctors DON’T want more people coming in with a runny nose? I think not. Oil company executives have to be scratching their heads thinking “how can we be more like the insurance companies”?

Health insurance through my company costs $11,098 per annum. My company pays $7,800 and I pay $3,298. Pretty good deal for me when compared to what my employer pays. I like to think that if our doctor’s offices were no longer allowed to bill the insurance companies and had to answer to my wallet, costs would go down. I believe I could be a better consumer if a significant portion of that money was given back to me and the rest went to some type of catastrophic insurance policy. Maybe I’m just stuck in the hypothetical. Maybe the democrats are right; that I’m better off as an indentured servant. God, I hope not.

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