Tuesday, January 29, 2008

Presidential Healthcare

I have been watching the presidential candidates for the last couple of months. Their view on this, or that, and one view that scares the crap out of me is most candidates view on healthcare.

For instance, Senator Hillary Clinton says she "wants universal health-care coverage by the end of her second term." Not even elected and she is already planning her second term.

Now I don't want to pick on Ms. Clinton – none of the Democratic candidates get it, and most of the Republican candidates get it, either. Ron Paul gets it, well, he will do the right thing for the wrong reasons (he just wants the Government out of most things, including healthcare).

Most of the candidates want "universal healthcare." Actually, most want everybody to have health insurance, and they think this will solve the healthcare problem. When I was young and was not offered healthcare at work, I went without for a while. I was young and healthy, and I didn't go to the doctor. Also, I did not have enough money to rub together for anyone to come after, so I did the irresponsible thing. Does this describe many of the 46 million without healthcare? Oh, I did get a cheap healthcare policy after a while – it was inexpensive because it paid nothing for the first several thousand dollars. Then it paid everything (or almost everything, as I probably did not read all of the small type). I had a friend who got in a car accident – similar circumstances as me, and although she did not have insurance (or much money), it took her a while to crawl out of the paperwork associated with bankruptcy. So my $30/month was more like hassle insurance.

Enough about me.

Health insurance acts as a buffer between the producer (doctors, hospitals) and the consumer (patients). The Clintons were pointing to a Kaiser Permanente system that worked well in the 80s but was starting to crumble in the early nineties. For instance, more people died waiting for a kidney transplant than received them in one eighteen month period. Health insurance was invented not for the consumers – it was created for the employers (to keep people at work). And it sort of does that – and in some instances, keeps them employed because of the health insurance. I have met several people who work at jobs they hate because they have a special needs kid and love the insurance.

One page can't really explain my thoughts. Think of it this way – when I was involved in one accident, I took my car to a body shop, and they billed the insurance one amount. If I were just taking the car into the shop for the same stuff without insurance, it would be actually cheaper because the body shop uses market forces to set the price sans insurance. With healthcare, it is actually the opposite – they charge way more for healthcare of non-insured (or self-insured) people because they don't expect to be paid and will hound, garnish or otherwise collect some of what they are due.

Anyway, if everyone has health insurance, overall costs for health insurance will actually increase. I have heard quotes from lots of people saying, "I want to vote for this candidate or that candidate because they will give me health insurance." If you get something from the government, it is coming from somewhere. Sure, the government prints a heck of a lot of money, but the US's budget is not a Ponzi scheme. Actually, it is sort of like a Ponzi scheme in that future people are paying for what we are using today.

Oi vey. I think I am going to be sick. Good thing I have health insurance. For a $10 co-pay, I can see a doctor for just about anything. And they have to listen to me.


Sister Sassy said...

$10 co-pay, thats nice! I used to have STELLAR insurance! It was awesome, of course I paid a good amout for it- I opted to pay more for my PPO than the cheaper HMO offered and THANK GOD because suddenly I found myself pregnant, having hypertension, on bedrest and delivering a baby who stayed in the NICU (for not eating for the most part, the kids still doesn't eat!). That would have been a HUGE bill but I didn't spend one cent.

Now...my second pregnancy was with a different much crappier insurance and I'm still paying those bills 2-years later! ACK! I kept asking my husband what we were even paying for each month?

Anyway, I don't know the answer to providing heath care to the masses just thought I'd gripe about my 2 year old hosptial bill. Sorry :)

LarryLilly said...

I have spent more time at hospitals than most nurses, and I can say that it will be far cheaper to give universal healtcare than it is to treat people at ER's for things that dont need doing at ER's.

We dont have to give gold plated treatment, we can provide a semi catastrophic level of care, people pay for visits for colds, fevers etc, the health care system pays for vaccines, and hospitalizations.

I had in the past been without insurance, for 5 years, and yet I had money to buy any plan, but I could not get any plan since my wife had an illness that they did not want to cover, and I offered to remove her from being covered, so i could cover me and the three kids then, but they wouldnt do that. I knew then that any form of market based health insurance was a scam. They are in the business to make money, so it falls on the Government to cover those, at yes, the cost to others, to provide that care. If as a collective we cant as a nation do that, then we are a third world nation.

Leesa said...

sassy: ouch, 2 year old bills.

larry: by your definitions, we already have universal healthcare. Anyone can walk into an ER and get care, then walk away from the bill. And it happens all of the time. Trouble with universal healthcare - is that it would drive more people to the overcrowded ERs. Medicaid patients have no incentive to stay out of the ERs - no $100 co-pays. I am a big proponent of co-pays. And I am also a proponent of covering the uninsurables (or providing money to plans that do).

Ian Lidster said...

Your current system would terrify me. Canada's universal healthcare is not without its flaws (lots of them) but at least everybody is covered for the basics. If you come here and get in a car accident, your wants will be seen to. When I travel in the US (which I do quite often) I always take out an extensive insurance policy for my wife and myself. I'd be frightened not to.

Anonymous said...

Absolutely on all accounts. What Hillarious wants is socialized medicine. Socialism isn NOT something I want.

Insurance companies started to exist to even out health care costs. A California appendectomy cost more than a Texas appendectomy. Instead of letting the market determine the value, it was inflated in some places and deflated in others. Now doctors have to factor in how much it costs to employ people to file insurance and that raises costs. I read that a lot of doctors are going to a cash only basis or they has a cash price for their services for those who don't have insurance.

My mother is a retired nurse. Don't get either of us started on insurance. Illegal immigrants come in uninsured and can't pay the high costs of hospital visits in the U.S. so that increases the cost of services and so it's passed along to the rest of us.

In my opinion, get rid of insurance companies. The market will determine the cost of services and MAYBE just MAYBE we'll move to a society that practices preventative medicine.


seattledrizzle said...

I would rather have the government administrating my health insurance than the place I work for.

Prata said...

When is the last time you had a co-pay of 10 dollars? And I know you haven't been to the ER for less than 100 in co-pay for at least a year.

What's interesting...is that there really isn't a need for health care to be so bloody expensive. It's kind of an artificial expense, somewhat like how our money works today. As we have no more gold standard =-P

But you know...I'm a little ignorant ;)

LarryLilly said...

Leesa, when was the last time you have been to the ER?

Under our current system people with sick kids are there, adults with flu. Yes, they are sick, but they need to go to "Doc in a box" and not the ER. Provide the 24 hour "Doc in a box" for that simple stuff. But waiting in an ER when your sick, but you dont have urgent health issues isnt practical. If we provided care for the simple stuff, allow them to pay a nominal fee, then let the ER's handle the real emergencies, then the ER's can be smaller in size. Dallas has two critical care hospitals, and one just increased by 400% its ER dept, yet they arent getting the type of patients that require that level of care with associated cost. If there was a "doc in a box" next door, then the ER would be smaller, and the costs to society lower. You can get a practicing doc that deals with flu, colds, nose and ear infections for a lot cheaper cost than a staff at an ER.

It isnt Grey's Anatomy, its more like warehouse Medicine.

Prata said...

Whoops let me correct my statement...
I haven't been to the ER for less than 100 in co-pay.

Larry also has a very good point. There are _tons_ of patients with non-critical care issues sitting in the ER. Some because that's the only way they can get medicines that they need or it's the only form of medicine they know because they can't/won't/whatever go to a primary care physician.

Leesa said...

ian: our current system kills more than 100K patients per year by accident. That should scare any of us.

edge: the wrong incentives are used for current healthcare.

seattle: yeah, the government has really held down costs for the post office. And mis-directing mail is a bit more forgivable than removing the wrong limb.

prata: I don't frequent the ER. In fact, I don't think I have visited the ER for myself ever. Paid the co-pay for hubbie about 10 years ago. Yeah, we don't use the ER much.

prata: again, the incentives are all screwed up in heathcare. That is sort of the point.

Prata said...

Me and the ER are only friendly terms, that's what fighting will get you. Say if you were to be kicked in the face..yay!

Incentives though, really shouldn't even be in the health care vocabulary. Health in and of itself is incentive enough, but I think you're meaning the industry(producers) and not the consumers; because no amount of incentives is going to insure a patient that can not pay. The foreboding of recession isn't helping either.