Tuesday, July 28, 2009

Three False Assumptions in the Health Care Debate

Part of the reason we are facing such a nightmare of a health care plan is that the architects in the White House and Congress have defined the need for a new and radical system based on assumptions that simply aren't true. The media has glossed over these assumptions. And Republicans and opponents to the President's plan have concentrated their fire on the plan itself, when they should be attacking the underlying assumptions.

Once the President set up the playing field to his advantage, he thought it would be easy to score the goals. Thankfully, opposition has risen to the plan and much of what Obama and Pelosi designed may never emerge. But, if we were playing on a level field, it is likely an entirely different solution would emerge.

I want to begin by stating clearly that we all share the same goal: Universal Health Care for everyone regardless of income, economic status and health conditions. This essay is not an effort to avoid the goal, but rather to make it much easier to achieve, at a lower cost, and with much less pain.

Three False Assumptions

Number ONE: The Current Health Care System is Broken

This is simply, totally wrong. The current health care system works beautifully. It provides the most choice, the finest doctors and greatest hospitals in the world. It develops 85% of all the new drugs in the world. People live longer and have a much better survival rate in the event of catastrophic illness.

Eighty Five percent of all Americans' get exactly the health care they desire. They have a huge smorgasbord of insurance options along with medical savings accounts and extraordinary cash payment options. Every major city has clinic open at virtually all hours and trauma and emergency rooms for crisis events.

And all this costs the government NOTHING!!! No taxes, no handouts, no rationing, no boards to oversee doctor and patient relationships.

The problem we face has nothing to do with the system being broken. It is that FIFTEEN PERCENT (15%) of Americans don't have easy or affordable access to the system. The system is absolutely wonderful. We simply need to get the last 15% in the doors!

Number TWO: The Current Health Care System is Bankrupting the Country

Again, this assumption is pure rubbish. The health care options currently used by the vast majority of Americans costs the government NOTHING. The part of our system that works is, in reality, cost neutral.

What doesn't work, at all, is the part that our government mismanages to the point of absurdity: medicare, medicaid and the Veteran's Administration Health System. Medicare is totally out of control, so badly run that is it bleeding both financially and physically. Many doctors and hospitals refuse to take Medicare patients because the government allowances don't begin to cover actual costs.

Meanwhile, because of pathetic oversight and ill defined guidelines, other doctors over order tests and procedures. There is little quality and virtually no oversight. Most seniors have to purchase Medicare Supplement Insurance to get back to the level of excellence enjoyed by younger Americans.

The problem is government run health care. It is not an insurance problem, it is not a health care system problem. It is the same problem that plagues virtually all government run systems in this country, a large, ill trained, poorly supervised bureaucracy.

To keep the country from going into bankruptcy, we must fix or scrap the current Medicare System, not enlarge it to include the entire nation.

Number THREE: The Current Health Care System Can't Cover All Americans

I beginning to wonder where all this bullsh*t comes from. Actually, the current system can easily absorb all Americans and the Insurance Companies have already stepped up to the table and agreed to cover everyone. The three big players, Insurance, Doctors and Pharmaceutical Companies are all on board.

There are thorny issues that require new laws and government oversight. But every key factor to achieve Universal Care has already been agreed upon. Insurance must be transportable form state to state and company to company. The Insurance Companies agree and are actually excited about this change as it will increase their potential customer base.

Premium pools must be greatly enlarged and then all people must be insured regardless of prior conditions. Once again, insurance companies are already on board. But there is one more step.

All people must be required, by law, to obtain insurance. And all companies must be required by law to provide insurance plans. Adding the young people who purposefully avoid purchasing insurance will enlarge the premium pools and provide some coverage for the critically ill. There will be costs here, but these are small compared to government run plan projections. And frankly there are some easy ways to reduce costs.

Health insurance should operate just like automobile insurance, with dozens of providers and competition based on coverage and premiums. It can be done and insurance companies are ready to do it.

That leaves one issue, covering the poor who simply cannot afford insurance. This will cost all taxpayers money. It can be done through a voucher system with premiums based on a a sliding scale by income level.

SUMMARY: The Current Health Care System Can Work Wonderfully

I haven't the time right now to go into the amazing cost reductions now available to everyone. MRI's and CAT Scans are available now for a fraction of their costs just two years ago. Doctor's visits are available now for $15.00 to $30.00 to people WITHOUT insurance. And, if we don't screw up the system, prices will begin to drop for everyone. Competition is the solution, it is not the problem.

What is wrong with the entire debate in Washington today, is that we are determined to break the huge part of modern health care that isn't broken without even attempting to fix the small government run parts that are draining our national wealth.

7 comments:

Vigilante said...

Yeah, Wizard! Why change? The US has the 37th best health care system in the world. I'm down with that!

Unknown said...

Vigilante why not tell the full story instead of spinning a propaganda lie like this? The Who Data is 10 years old. And the WHO five performance indicators are really self serving. The premise being only government can run healthcare.

It would be much better to afix a hook rather then re-attach a hand accordingly.

Vigilante said...

Well if you don't like USA ranked at 37 by the WHO in 2000, Howabout the USA ranked 50th in life expectancy by the CIA in 2009? Looks like national health stats are trending adversely for us.

BTW, how are you coming on parsing that apology?

shoo said...

Life expectancy is an extremely poor indicator of the quality of health care. Mormons live on average 10 years longer than other Americans. Do they have access to secret Mormon health care? Life expectancy is all about culture and lifestyle, and has little to do with health care.

Wiz: great post, but I have an issue with every person being forced to buy health care. It's a lot like paying a tax for the right of existing. Something about the "land of the free" keeps bothering me. On the other hand, we already force people to put a lot of their money into an forced retirement system, so it really isn't much of a stretch. Of course, I don't think the government should be forcing people into Social Security either. That's just me being silly and wanting people to be free.

Bob Keller said...

Vigilante, There is no apology forthcoming and I certainly stand by my all comments.

What I think you glossed over in my essay is that I agree that we MUST HAVE CHANGE in our current health care system. I AM NOT defending the Status Quo.

You and I agree on the need for change. I believe we agree that there needs to be Universal Health Care. I think we agree Insurance should be portable across companies and across state lines. The poor and the infirm must be fully covered. And no one should be forced into bankruptcy because of catastrophic illness.

If we do those things life expectancy and our "international ranking" will improve. But as long as we are the most overweight country on earth (and, obviously, the least physically fit), we will not climb to the top of the charts.

You and I only disagree on whether health care should be nationalized like Medicare or, god forbid, like the VA. I believe it must not happen.

Knowing how very badly those two systems work, I'm astounded you favor nationalizing health care.

Vigilante said...

What all the lying and BS are about is protecting obscene insurance company profits; $20 million insurance co. CEO pay and lavish stock options; sky-high executive pay; layers of administrative personnel, many of whom are hired to keep claimants from costing the company money; shareholder “value”; and of course tens or maybe hundreds of millions for campaign donations and lobbying.

Government (which means 'the public') can do what the medical insurance companies do with less overhead, minimal profit and better service, minus the hassles.

Unknown said...

"Government (which means 'the public') can do what the medical insurance companies do with less overhead, minimal profit and better service, minus the hassles" Quite the leap of faith.

Americans have better survival rates than Europeans for common cancers. Americans have lower cancer mortality rates than Canadians. Americans have better access to treatment for chronic diseases than patients in other developed countries. Americans have better access to preventive cancer screening than Canadians. Lower-income Americans are in better health than comparable Canadian. Americans spend less time waiting for care than patients in Canada and the United Kingdom. People in countries with more government control of health care are highly dissatisfied and believe reform is needed. Americans are more satisfied with the care they receive than Canadians. Americans have better access to important new technologies such as medical imaging than do patients in Canada or Britain. Americans are responsible for the vast majority of all health care innovations.

Yet you would jettison that, make more people die with worse health care because someone made profit?