Health Care Sound Bites

In my prior bog, I talked about the irresponsibility we have seen from many of those fueling and participating in today’s health care argument. As the negative mythology continues to be spun, let us try to separate out some of the real substance of this discussion.

“Death panels will determine which old people will be treated or let die” is the worst distortion, courtesy of Sarah Palin’s unilateral and unproven/unfounded declaration. Except it ain’t so. A Republican congressman (who has denounced Sarah and her distortion) sponsored a measure to simply ensure that Medicare would pay for doctors to spend time helping patients and their families determine IN ADVANCE what care THEY want at end of life. Such conversations thankfully help people avoid making bad decisions in times of crisis. It is no more than encouraging the Living Will that I have and all others should. So no more talk about death panels killing grandma. And no more listening to Sarah Palin about anything.

“Canada and England’s single-payer government-run health system does not work and people do not get adequate or timely care.” Sorry, no. All polls of those citizens continually report back a preponderance of high satisfaction with their system, and everyone in the country has access to it regardless of their ability to pay or their current physical condition. Unlike us. Waiting for services are no worse than we have here (e.g. my recent 1-month wait for a simple dental cleaning appointment).

“We don’t want a government bureaucrat between the doctor and patient.” As opposed to the administrative staffer/clerk in the insurance company who now already decides what treatments I will get or not, and is rewarded for cutting costs by refusing benefit claims? When my doctor prescribed three pills for me for a recent condition, it was the insurance clerk that said, “No, only two allowed.” I prefer to think my doctor knows more about what I really needed. I would prefer a government bureaucrat not to be in the middle, but frankly I trust the company clerk even less.

“75% of the American public likes their current health plan.” I suspect that 75% of the public likes their current doctor/provider! But have you ever tried to read and comprehend what your health insurance policy says? I contend that 90% of those 75% satisfied people have no idea what their policy really says or will cover or for how much. And they won’t know until they file a claim after an illness. Then that same company clerk will explain to them why they will get reimbursed a smaller percent than expected, or they were only covered for one day in the hospital, or were not covered at all for a “pre-existing condition.” Before I filed a recent claim, I was told that my plan covered 80% of the cost after a $150 deductible. It actually turned out to be 50% after all the exclusions / limits / caveats kicked in.

“If there is a public plan that is inherently cheaper to offer, employers will simply drop their programs and force people onto the public plan.” Well, employers are already dropping employee health plans. They have been for years. According to one report, 64% of Americans were in employer plans in 2000; only 59% are now. Health plans are a moving cost – always up! So businesses, especially small ones, cannot pay that cost and compete with the afore-mentioned Canada and England (or Europe), much less Mexico, China and Asia. Employers have to stay in business by being competitive. So higher health costs = less employer plans. Except now they are forced to dump people out to NO health care, with no public or other option available to people to fall back on. A recent study found that 73% of people who tried to buy individual insurance coverage over the past three years gave up. A vicious cycle repeats.

“A public plan will drive private insurance companies out of business.” Frankly, it is difficult for me to be too sympathetic to these companies. That said, I suspect they will do just fine, thank you. The problem now is that these companies cherry-pick to get the healthiest customers to insure (read: less payouts). Or they drive down costs to the company by limiting sick people’s expected benefits by imposing such things as “maximum limits,” “pre-existing conditions,” “limitations of treatments,” and other tricks. The “Fedex versus Post Office” analogy is a correct one. The government operates with a moral/legal imperative to support out-of-the-way cost-in-effective branch offices to meet the service demands of the entire public, while Fedex/UPS make no such commitment. They provide only profitable services primarily to corporate accounts. Truth is that private insurance is already making nice bundles of profits supplementing government Medicare coverage. They will do exactly the same with heath insurance, providing “bonus services & privilege benefits” to the wealthy who can afford it. The doctors will do the same thing – tiered services for those who can afford it, like Congressmen and corporate executives. That is OK. American capitalism and entrepreneurship are not dead; they will just work a new angle, because Americans are great at finding a need and filling it. But at least everyone will get a base level of care that cannot be pulled out from under them during the emergency times. It will be just like our current public-for-everyone versus private-for-who-can-afford-it school system of choices. And if the key to successfully providing insurance is to “spread the risk across the biggest base as possible,” then is not the biggest pool of all the entire American public, and therefore the most successful risk pool, one which no single private company can afford to take on?

“We have to help small businesses be able to provide health insurance to their employees.” No, we need to get ALL businesses OUT of health care responsibility. Employers do not pay my mandated auto insurance so I can drive a car; they do not pay my life insurance which I should have for my family for when I die. So why provide health insurance – the least controllable cost they have? Employers are retailers, builders, manufacturers, service and entertainment providers, not health care deliverers. Employer-based insurance is no help to the unemployed, unemployable, or self-employed. And with the “some employers do / some employers don’t” system we have now, a very large unreported percentage of our population is being held hostage to their job, a job they want to leave but cannot because their medical insurance will not travel with them. What toll of stress and unfulfilling lives is that causing?

Lastly, “America has the best health care in the world.” No, America has the best health care skills in the world, hands down. But “care” is only if you have the money, or position, or home asset, or savings account to afford all those high end medical gizmos. And most people cannot. A gourmet meal is not very tasty to those standing outside the restaurant peering through the window. Almost every developed country in Europe outranks us in terms of health care outcomes and successes.
Medical competency is not the issue in America. Access to that competency is. As we baby boomers start flooding into the system demanding high-quality highly-sophisticated care, and more of the population becomes under-/un-employed and on their own for benefits, it will not be Medicare that collapses. It will be the whole medical care system brought to its knees, and with it our economic future. That will be the true doomsday from our non-action.