The Health Care Debate Continues

As time moves on, the health care debate does too. And all we see is the passionate debate for or against it, with no real discussion of what's broke about the system and what specific aspects that need fixing. It seems that there are 2 schools of thought; Government run health care or increase insurance competition without the government entering the business. HR 3400 is the Republican solution to health care which simply put, has tax credit provisions for maintaining health insurance, and allows for small businesses to pool into groups to purchase insurance for their employees at large group rates, and more blah blah blah about fraud waste and abuse and so on.

Let me tell you something, when you have a middle man administrating the care whether it's the government, in the case of Medicare and Medicaid, or the private sector in the case of all other insurance, rates are predetermined/negotiated. Which means the insurance company or the government tells the provider how much they will pay them for a certain service or procedure regardless of cost. A set up like this encourages fraud waste and abuse on so many levels. Meaning a doctor sees a patient and takes the opportunity to run all sorts of tests and procedures, ordinarily unnecessary but particularly if it is of no harm to the patient in order to increase their reimbursement. All they have to do is justify it medically, and when you are an expert in the game you can justify anything. This is especially easy to do and difficult to prove on older patients or if the patient makes any comment that could be construed to justify ordering this or that, which is another billable item.

What I am trying to say is that as long as there is a intermediary that must employ doctors, nurses and administrative personnel to administer payment on behalf of the patient, fraud waste and abuse will continue. Do you not find it fraudulent that insurance companies can deny coverage on the basis of a preexisting condition? But they can. This is the issue I think Americans can agree on and where we ought to start. That doesn't mean these patients might not have to pay higher premiums or higher deductibles or co-insurance.

Let's be honest, the fact that we pay premiums just means that insurance is just a payment plan for our routine medical care that is expected to even out over time. How else is an insurance company going to make money? For example. My parents were without health insurance when they first got married, by choice. They could have paid for it, but money was tight and it was a risk they chose to take since they are both very healthy. About a year later, dad went to the ER for kidney stones. They paid the discount they were offered to pay in full at the time of service. (All facilities offer this probably doctors too, some just make you ask for it) Calculated out, it cost about what insurance premiums and a deductible would have cost them for the time period of being uninsured. Had they put that money in savings every month, they would have had that money at the time of service instead of having to put it on a credit card.

I will say it again, if doctors and patients ban together to cut out the middle man, whether the government or insurance companies and take back personal responsibility for our health care, (dare I say live healthy lives?) I bet the cost of care would drop dramatically because doctors wouldn't have to employ staff or pay agencies to bill and collect from insurance companies. They could just collect the full amount up front at the time of service and I bet it would be lower than the "negotiated rates" they get from insurance companies or Medicare because Doctors and facilities would truly have to compete for your business. See my previous post about this issue on July 12. But I know 90% or you or more will likely disagree with me on this issue just like 90% of America is going to disagree with me about privatizing social security.

My point of this post is rather than each side insisting on their solution and their solution only, both of which only treats the symptoms, how about we think outside the box and treat the problem. At the very least, let's focus on 1 part of the system that we can all likely agree on (preexisting denial, or perhaps something else) and start there if the majority don't really want to treat the problem. As it is it just seems like a political power grab taking freedom from you and me the consumers.

Are Politics More Polarizing Now than 20-30 Years Ago?

I was watching a stand-up comedy routine from the early 80's and it was filmed in Washington D.C. So a brief comment was made about Reaganomics and the crowed booed. They didn't stay on it long but enough was said that the predominate feeling in the room was that Reaganomics was bad. Now I know Ronald Reagan wasn't a perfect president and no president is. However the conservative (not Republican) belief is that Reaganomics was really good for this country. His economic policies stimulated the economy that many say Carter and whoever sent spiraling downward.

I wasn't alive back then, so I don't know what the general political feeling was. Was it really all that different than today? Did people pick their side and no matter what the other side did, it was disastrous, or wrong, or sending the country to hell in a hand basket? All I hear from the other side, no matter who's in power, is doom and gloom. And you find yourself starting to buy into the hype of doom and gloom.

That said, there are some dangerous policies being discussed and voted on, i.e. cap and trade and government run health-care that disturb me greatly. But what disturbs me even more, is that either people are laissez-faire when it comes to voicing their opinion about politics and policies to their representatives, or that our representatives just aren't listening. I happen to think it's a combination of both. If everyone in this country took 10 minutes on each major issue to contemplate how it will affect them and their family, maybe more people would take another 10 minutes to call or email the government to let them know how they want their representative to vote on certain issues. Instead it seems like people can't be bothered with this as they are too busy enjoying their lives.

Reality Check!! The reason we have the freedom to enjoy our lives is because people stood up and voiced their opinions!! And fought for freedom. But slowly over the years, our freedoms have been encroached upon and we let it happen in the name of safety and compassion or charity (no matter how mismanaged), among other things. Before you know it the government will be telling all of you what you are allowed to buy to feed your family while taking 50-75% of your check each month. But you'll be so dependant upon their "free" health care, "free" food, and "free" housing, that you won't be able to see how much better quality lives you could have if only you could make your own decisions. They want everyone to become so dependant on them that we do their bidding. When the government is in charge, quality and efficiency are drastically reduced. But sheep don't know the difference. Sheep will be convinced it's wonderful because they have food to eat and a place to sleep.

Let's not become a mass of sheep being herded by wolves!! Fight back, get involve, voice your opinion!!! Don't become complacent. The more that happens the more powerful they get. Please care enough to not let this happen!

Back to the 2010 Budget - Department of Health and Human Services

Here's the link to the part of the budget specific to Health and Human Services. It's only 4 pages so I think it's worth a read.

http://www.whitehouse.gov/omb/assets/fy2010_new_era/Department_of_Health_and_Human_Services1.pdf

But if you can't bring yourself to read 4 pages, here are the highlights provided on page 1.
Funding Highlights:
• Accelerates the adoption of health information technology and utilization of electronic health
records.
• Expands research comparing the effectiveness of medical treatments to give patients and
physicians better information on what works best.
• Invests over $6 billion for cancer research at the National Institutes of Health as part of the
Administration’s multi-year commitment to double cancer research funding.
• Strengthens the Indian health system with sustained investments in health care services for
American Indians and Alaska Natives to address persistent health disparities and foster healthy
Indian communities.
• Invests $330 million to increase the number of doctors, nurses, and dentists practicing in areas
of the country experiencing shortages of health professionals.
• Supports families by providing additional funding for affordable, high-quality child care,
expanding Early Head Start and Head Start, and creating the Nurse Home Visitation program
to support first-time mothers.
• Strengthens the Medicare program by encouraging high quality and efficient care, and improving
program integrity.
• Invests over $1 billion for Food and Drug Administration food safety efforts to increase and
improve inspections, domestic surveillance, laboratory capacity and domestic response to
prevent and control food borne illness.

First of all, I don't support government funded research of diseases. People don't need to be compelled to give to research, they will do it as they see a need. I highly encourage private efforts to raise funds for research. Look at how successful St. Jude's is at raising money for research and treatment of kids with cancer. But I shouldn't jump on this one since it's unpopular to oppose government funding of diseases.

Here's what the highlights don't tell you but the website does. The budget establishes a reserve fund of $630 Billion over the next 10 years to "finance fundamental reform of our health care system that will bring down costs and expand coverage." If you think $630 Billion over 10 years is enough to provide universal health care, you're crazy. It will cost more than that a year most likely. And that creates health care rationing. Ask Canada or England or any other country with it. It might not be too bad for routine care, but what are you going to do if you get a life threatening disease or a pain causing condition or need a knee or hip replacement. Do you want the government telling you when you can get it taken care of? How would you like to have to live with pain unnecessarily for years before it gets treated? The older you are the further down on the list you go because you're expendable. How's that for a violation of your civil rights?

Pharmacy's have already started a solution to the problem with their generic drug programs thanks to the leading of the oh so evil Walmart. And I thought Walmart only hurt people. Now for doctors and hospitals to follow suit. Actually in essence they do. If you go to a hospital most if not all of them will offer you a self pay discount to pay up front if you don't have insurance, which is equal to or greater than the discount provided by membership to an insurance network. (The discounts very by negotiated rates with various insurance providers). If you don't choose this option and you go through the emergency room, they will set up a payment plan. Many doctors will also negotiate with you if you ask them.

Do you want to know what's driving up the cost of health care other than uncompensated care? I'm going to tell you whether you want to or not. Insurance companies have become the middle man between patients and providers. They are not non profit companies. They are for profit. So now two entities are trying to make a profit from providing you a service. Since you are the only one paying money, who do you think is paying for the profit to the insurance company and the doctor? You are, or your company is. The insurance company has to pay people to process and pay your claims and the doctors and facilities have to pay people to file claims to insurance companies including Medicare and Medicaid offered by the supposed cost saving government. What if patients and providers got together to eliminate the middle man for routine care? You wouldn't have to pay insurance premiums which you could now save to pay cash for your health care. Providers would now be competing for your business on price and quality of care. Perhaps they could create their own premium based care where you pay them $X/month and they agree to see you and treat you as needed. They could tailor levels of care/cost to your age, family history, or desires.

Step two is encourage health savings though health savings accounts like are available now. I hate to use the term "mandate," but this would be an acceptable alternative in my mind. Only rather than losing any unspent money, it should be able to roll over to the next year in an effort to save for additional unexpected medical emergencies that can arise in our lifetime that may fall outside of routine care. If a balance gets to a point where it exceeds a certain cushion amount, a person can take that money out tax free for educational use, or be rolled over to a 401k or traditional IRA. (This is working under the assumption that the Fair Tax isn't implemented)

This may not be a perfect plan but it's a start and it's a better and more cost effective alternative to government run health care.

Here's a reminder/plea for you to write your congressmen and let them know what you think about the budget. I believe they are supposed to vote on it later this week. Email them, Call them!!! Do it now!!!

Socialized Healthcare

I wonder how many of you out there really think that national health care is the answer to our health care needs. My follow up question to those of you that think it's a fabulous idea is "have you been to the emergency room lately for stitches, whiplash, sprained ankle or anything of the likes?" Depending on the area you live in, you probably had to wait a long time just to go back to see a doctor. And then once you got back there you probably had to wait some more. The reason being, the ER is filled with people that should be going to a doctor, but the reason they go to the ER is because;

1. The ER cannot turn them away by law
2. Many of them have no intentions of paying their bill hence why they go to the ER rather than a doctor. Because a doctor can ask for payment up front and refuse to see a patient if they haven't paid.

Ladies and Gentlemen, this is a socialized as you want your medicine to get. And I question the logic in allowing people to get away with not paying their ER bills because they don't care about their credit or they give a false social security number. I question the logic in telling ERs that they must treat everyone that comes into the ER regardless. They ought to be able to tell people with colds to go see their doctor along with other ailments.

But I'm sure those of you for socialized medicine think that doctors should have to treat everyone that comes to them regardless of their ability to pay. Let me tell you what happens under this system. More and more people refuse to pay which means more and more accounts go to collections, many of which are deemed noncollectable, and doctors no longer find it worth their while to stay in business. So they retire earlier, find other lines of work and advise kids not to bother going to medical school because the risks now outweigh the reward. So there are fewer and fewer professionals to treat more and more patients. But now these professionals are also employees of the government. And as the government realizes there are fewer professionals to meet the demand of the health care needs and wants, they start rationing health care.

So that elective radical mastectomy you want to prevent breast cancer because it runs rampant in your family will have to wait until it becomes cancer. Anything now considered elective, will no longer be an option until it threatens your life. So you will have to learn to live with the pain, discomfort, and even embarrassment your condition causes you. And if it does turn life threatening and you are over the age of 55, good luck on getting moved up on the priority list. The reasoning; you've lived a decent long life and are close to retirement so it's better for the government if you die before retirement so they don't have to take care of you after you stop work. They need the younger viable workers with 20-30 years of work left in them to keep working to pay taxes, so they'll take priority over an older person.

But this is what you all want. Because you naively think it's free. Nothing is free. it's only free to the person that refuses to pay taxes. But then again if you don't work to pay into their tax system, I'm sure you'll be moved down on the priority list for care as well. Because what good are you if you refuse to work so the government can take all your money to give you "free" nationalized health care?