Aug 12, 2009

Health Care

Okay, you want to talk about Health Care. Hey, you clowns in the back with the Swastikas, quiet down a minute - holster that weapon! Let's all look at what it is going to take to bring some real solutions to the Health Care problem.

First, let's all agree what we're doing now is not only unsustainable, it doesn't make a lot of sense. We're all going to agree that there is a NEED for a change in to the mishmash of policies and practices we're doing now. We also need to agree that we are already paying for the folks who aren't participating, which is why the prices are so high. Okay, can we get that groundwork down?

Okay, now let's tackle how the government and private insurers can come together. We can all do this together.

Blasphemes mentioned earlier this week that tort reform should be the first plan to cut costs in health care. I will repeat it. Tort reform or caps on bad outcomes would keep malpractice premiums and lawyers fees fixed. We also need the loser to pay the court costs. If tort reform isn't part of the package - I don't care who's paying for it, all the money still goes to the lawyers and the insurance companies. In tort reform, we also have to tell people you can't sue because your Doctor didn't run eighteen million and one tests on you to cover his ass, legally. If your Doctor offers the best care, and if it doesn't work out, sorry, he gave it his best shot. YOU CAN’T SUE! That’s the rule, just like the rest of the world. Yes, a system for legit redress of grievances must stay in place if he amputates the wrong foot. But with tort reform there's a price tag on that foot depending on your age. If you are 25, that sucker's going to be, oh, 5 million. If you're 69, here’s twenty bucks and a free prosthetic.

With all that testing that Doctors do to cover their ass from getting sued - let's also stop firing up the six thousand dollar MRI to look at a hairline bone fracture. We can do that with a three hundred dollar X-Ray. The old Radiation King can easily diagnose your problem. But the MRI costs money, looks cool and we need to charge you for it. Today if you already spent that $500 deductible - who cares, right? You’re not paying for it. Guess what, somebody is paying for it. And that somebody is everyone else. So lets all knock that off, okay?

Since we're talking about technology - why don't we trim all that administrative crap out too? How? Well, the medical field is notoriously full of luddites especially in automation and record keeping. Hardly anything is electronic. Have you looked behind the window at your Doctor's office? It's all paper files. But that's to protect your privacy. Uh, yeah, great - but if you have to visit another Doctor, say in an Emergency - that piece of paper has to be sorted, shipped, looked at - and oops you're dead because no one knew you were on ABC medication with XYZ condition.

Also, a database for efficacy in treatments, outcomes and drug testing plus interactions might inject a little extra science into the whole 'practice' of medicine. Perhaps an attempt to make paying quicker and more efficient would help too. Now I see three ‘this is not a bill’ notices from the hospital, and a year after treatment I’m being served by a credit collection agency and then trying to figure out who didn’t pay and why – a whole year later. That system not only is strange and inefficient, it’s also silly. No one wins.

So we modernize the records and bill paying. Now think of what we can do with all that data. We’ll be keeping track of which Doctors are doing a good job, and we can put them on some sort of list? We could create a Best Doctor list –a Zagat-ish Guide to help patients make better choices based on what ‘good’ or ‘exceptional’ care actually is? Maybe those Doctors could teach other Doctors what they’re doing right – and the best practices so that everyone will have better outcomes?

What about primary care and promoting health, rather than just treating a chronic ailment? You know? Actual Health Care? Doctors can keep a person alive for years with modern medicine. Heart disease, kidney failure, diabetes and a slew of other chronic 'conditions' used to kill you. Now we can pump you full of meds and tubes to keep you alive for - hell - forever. You can live with a condition that doesn't kill – but that’s expensive and who wants to live that way?

Maybe we all need to agree to PREVENT those 'conditions' from occurring in the first place? That's part of the 'Social' in Socialized Medicine. I don't hear many folks on either side of this debate talking about this aspect of the deal either. It's up to ALL of us to eat right, exercise, take care of your self and get off the booze, smoke and loose sex. If you want the 'European' way, this is the social contract you must agree upon to participate. It's on YOU, and on ME, and your Neighbor to not get fat, sick and... well… American.

Changing everyone's attitude about taking responsibility for his or her personal wellbeing? That's nothing short of a Herculean task. But it must be done. Because, I'll tell you, WorldofWarcraft182, I'm not going to be too happy about paying for your fourth bypass surgery.

Which leads me to another issue - everyone must participate. Everyone must buy insurance. Everyone in the pool. You know the claim of 49 million uninsured you keep reading about? It is a little misleading. About 12 million of them are illegal aliens. You're already paying for their healthcare even if you don't have insurance. That's why a wad of gauze costs you over $50.00 in the E.D. Actually, that’s why gauze costs private insurers fifty bucks. Anyhow, that’s 12 minus 49 so that leaves 37 million uninsured.

Who are they? I’ll assume the self employed, twenty year-olds, the Unibomber, the homeless and shut-ins. What if one of these shut-ins, WorldofWarcraft182, decides he doesn’t need insurance? He has a heart attack – THEN he magically decides he needs that product? I can’t drive my car around and call up GIECO to get insurance after I crash into a school bus… but WorldofWarcraft182 and millions more do this with health insurance all the time. They simply ‘opt out’ until it’s convenient. Meanwhile, everyone else is on the hook for this dope that never contributed a dime into the collective pool. Convenient for him - not so much the rest of us. This is why Hillary Clinton and McCain’s plans were to mandate everyone must buy health insurance. It is necessary to offset costs. It’s more fair – (however, the costs will still go up – look at the last three years in Massachusetts) – and some still fall through the cracks – but we can’t keep letting WoW182 keep jumping in and out of the pool and taking a bucket of water out when he feels it suits him.

Also the argument that buying health insurance is so unacceptable really needs to re-evaluate their debate cards. States mandate insurance for your cars, and no one pickets. Your mortgage provider also requires you to buy home insurance for their house. That’s right – the mortgage company (the good ones anyway) require you to buy insurance for the house they own while you slowly pay rent-to-own. Moving on.

We also need the government to quit paying only 30% of the bill. Somebody has to pick up the tab after the government orders the bottle of wine and lobster and only leaves $30 at the table - then runs out the door to make a phone call, leaving everyone else with the $70.00 difference. Oh, you only had a glass of water? Too bad. That's how it is now. Public programs typically underpay everyone. Doctors and hospitals hate Medicare. Ask ‘em. To top it off, they have so much paperwork just to get the 30%, many would rather not participate… if they had a choice. So who really pays for that other 70%? You do, your employer, private insurers and the folks who have to pay out of pocket. But Nancy Pelosi needs a villain – and she picked private insurance. Considering they’re picking up your tab for Medicaid, Mrs. Speaker, perhaps you should pick on the folks who don’t want to participate instead? Oh, you called them Nazis? Great work there.

That’s why health insurance and service cost what they do now, plus add in inflation – and that’s why it keeps going up.

Take my suggestions: Tort reform, everyone has to play – and everyone has to be good and the prices should go down and service should also improve. With the savings, we can subsidize the folks who slip through the current system with a sensible government plan. Simple stuff, really. We just have to roll up our sleeves and do it… before the government steps in and makes it all worse than what we’re doing now.


Hans-Hermann Hoppe said...

To cure the problem requires not different or more government regulations and bureaucracies, as self-serving politicians want us to believe, but the elimination of all existing government controls.

It's time to get serious about health-care reform. Tax credits, vouchers, and privatization will go a long way toward decentralizing the system and removing unnecessary burdens from business. But four additional steps must also be taken:

Eliminate all licensing requirements for medical schools, hospitals, pharmacies, and medical doctors and other health-care personnel. Their supply would almost instantly increase, prices would fall, and a greater variety of health-care services would appear on the market.

Competing voluntary accreditation agencies would take the place of compulsory government licensing — if health-care providers believe that such accreditation would enhance their own reputation, and that their consumers care about reputation, and are willing to pay for it.

Eliminate all government restrictions on the production and sale of pharmaceutical products and medical devices. This means no more Food and Drug Administration, which presently hinders innovation and increases costs.

Deregulate the health-insurance industry. Private enterprise can offer insurance against events over whose outcome the insured possesses no control. One cannot insure oneself against suicide or bankruptcy, for example, because it is in one's own hands to bring these events about.

Because a person's health, or lack of it, lies increasingly within his own control, many, if not most health risks, are actually uninsurable. "Insurance" against risks whose likelihood an individual can systematically influence falls within that person's own responsibility.

All insurance, moreover, involves the pooling of individual risks.

Because of legal restrictions on the health insurers' right of refusal — to exclude any individual risk as uninsurable — the present health-insurance system is only partly concerned with insurance. The industry cannot discriminate freely among different groups' risks.

To deregulate the industry means to restore it to unrestricted freedom of contract: to allow a health insurer to offer any contract whatsoever, to include or exclude any risk, and to discriminate among any groups of individuals.Uninsurable risks would lose coverage, the variety of insurance policies for the remaining coverage would increase, and price differentials would reflect genuine insurance risks. On average, prices would drastically fall. And the reform would restore individual responsibility in health care.

Eliminate all subsidies to the sick or unhealthy. Subsidies create more of whatever is being subsidized. Subsidies for the ill and diseased promote carelessness, indigence, and dependency. If we eliminate such subsidies, we would strengthen the will to live healthy lives and to work for a living. In the first instance, that means abolishing Medicare and Medicaid.

Only these four steps, although drastic, will restore a fully free market in medical provision. Until they are adopted, the industry will have serious problems, and so will we, its consumers.

RushSays said...

Obama's health care plan will be written by a committee whose head, John Conyers, says he doesn't understand it. It'll be passed by Congress that has not read it, signed by a president who smokes, funded by a Treasury chief who didn't pay his taxes, overseen by a Surgeon General who is obese, and financed by a country that's nearly broke. What could possibly go wrong????