1) my thoughts are very fluid and rarely ever make sense at first. And since I am a doer, not a thinker, this will probably spill over into my entries.
2) my mind can be easily changed so if you make some good points, I will probably wish to subscribe to your newsletter. This also means that I'll probably post some very contradictory entries and you'll just have to deal with it.
Now, onward!
So. Apparently talking about health care is all the rage now-a-days.
The debate currently isn't about health care itself. It is about health care for everyone. (Who knew health care was written about in the Constitution, eh? See here: The American Form of Government--which makes sense...until the end because really, we go from a republic to a democracy to an oligarchy? considering how many Constitutionalists there are, I'm guessing that after the oligarchy, it will go back to a republic.) Which really just means that the debate isn't about health care, it's about health insurance. Everyone can get health care. It's called an emergency room. So, let's be frank, we are debating health insurance when we are talking about 'health care for everyone.'
And now, my view on health insurance is not that we don't have enough of it, but that we have too much. That's right, without health insurance doctors would set their own prices and it would therefore create a competitive market. Doctors that are good could set higher rates, and those that think any girl having stomach cramps needs a pelvic exam...well, they probably shouldn't be practicing. But still, you would get what you paid for. There could be different levels of laboratories set up so you would pay based on how quickly you wanted your results (like the post office!). *
The biggest problems with this plan are that insurance works like a pension plan--it covers the cost of one over the payments by many, and so big ticket items, like chemotheraphy, would probably become something only the insanely rich could afford. Plus it doesn't account for drugs. To an extent a competitive market already exists, it's just that insurance pays for a large portion of the drug...of course if they priced the drug so only a few could get it, there wouldn't be any money in making the drug, so the cost would have to come down in order for them to make any money. And, as always, the health insurance industry is a HUGE industry that employs thousands upon thousands of people, so if you got rid of the insurance industry, you'd have that many people suddenly unemployed.
Perhaps, however, this is just too much of an anarchist agenda.
* Has anyone actually looked at their health insurance pay out on an insurance claim? My yearly pelvic and health exam is billed at $112 for lab processing, preventative services for $194, and $217 for more lab fees. This comes to a grand total of $523. My insurance looked at that and said to the doctor and lab "And yet you shall only recieve $148.64". And of course, because I have insurance, I only paid the $20 copay. I forget how much my employer actually pays for my health insurance, but I think they pay close to $500 a month for me to be able to only pay $20 out of pocket. I still fail to see out it's fair that my employer pays $500 a month to some entity that refuses to pay the asking rate for services rendered, all based on the theory that I might, someday, use the money for a medical emergency...in which I'll still get screwed because the insurance will try to claim that chemotherapy is a non-standard treatment for cancer. Fucking insurance companies.
Also, in the interest of full disclosure, I feel that I should mention that 3 people in my extended family work for (or used to) for the health insurance industry.
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Unfortunately we are not debating at all. The options we have are a government option or the broke down option we currently have. There are no additional alternatives which really blows. While I am on the topic....the health care town halls have turned into a joke. Screaming crazy old people talking about death panels is laughable. If you don't have an alternative then let's try and make it better instead of just sitting around and effing around with a 1000 page document up our asses. (BTW...are we allowed to cuss? I sometimes find it difficult to express my opinions without using the f-word!) =)
ReplyDeleteAs you know I work in FP&A for a software company and we pay $525 a month for health insurance per employee to Aetna. Then the employee contributes anywhere from $40 a pay check to $150 a pay check depending on household size. Now, I could be wrong as humans have a tendency to act irrationally which is why all economists will always caveat their theories, that if companies were not allowed to offer health insurance benefits and instead had to give the employees the money on a monthly basis, employees would then drive the competition between health insurance companies simliar to how they do to the auto insurance companies. It obviously would not be that simple...and given that I tend to write in run-on sentences probably non-coherent but basic price-theory would back up my argument. The poor, very young and old would still be covered by the government but someone like me could take that money, shop for the best price and hopefully have some left over to drink with?
I was just talking to my mom last night, and she reminded me of the time when she had to tell her older brother that Medicare/Medicaid were government run programs. This is only really sad because the daughter of this man is on Medicare. He also complained about socialized healthcare not realizing that his wife, who is Cherokee and on the Native Peoples' health care plan, was using socialized health care. And this was in 1992. He still complains about Medicare/Medicaid and socialized healthcare and how they are worthless programs that should be discontinued and/or never discussed.
ReplyDeleteValid points to both of you. I don't know who GTIGuy is, though. So...who are you?
ReplyDeleteAnyway, I think the idea of giving people cash instead of paying for health insurance would work, except for that the lowest class of Americans(socioeconomically) would not use the money for health insurance. They'd use it for God only knows what kind of cheeseburgers and malt liquor and cigarettes. It's not like they became poor by being super-good at saving money and spending wisely.
Chris has a theory about how poor people will find something they can afford the very BEST of, and buy that, even though it means other areas will suffer. Take cell phones, for example. You'll see people on welfare talking on smartphones, because it makes them feel less marginalized. One step up are the people who drive Lexuses (Lexi?) but can barely afford to pay their credit card bills or rent on a shoddy apartment. It's a method of self-soothing that plays out everywhere you look. And it's not EVERYBODY, so don't think I'm being a heartless bitch. It's just fairly prevalent.
Now, applying that to healthcare--if someone is given money outright to spend on healthcare, they'll likely spend it on something that makes them feel good right away, and is a visible form of wealth (gold chain, mothafuckaaaaaas), rather than buying the best health plan they can afford, which offers them nothing immediately tangible. It's like a new heirarchy of needs, but for material things.
I'd LOVE to see people able to make doctors compete on a fee-for-service basis. When Chris opens his clinic, that's what he plans to do. No insurance, just fee-for-service. It ends up costing doctors less, and they make more money than if they went through insurance. Granted, Chris is allergy, so it's a different breed of clientele (i.e. one that can afford to seek health solutions for discomfort, rather than pain and pestilence), but I think it's probably the best way for healthcare to work.
Sadly, we as Americans need to get a lot smarter about healthcare before that can happen. It needs to be a priority over going out, buying things, eating fast food, etc, or the people who can't afford it now will be the same people who can't afford it then.