Wednesday, April 26, 2006

The Health Care Crisis

"Preserving health by too severe a rule is a worrisome malady" ~ Francois de La Rochefoucauld

Today, I am again typing this entry on the computer at the local county Library. The problem I had with my cable connection yesterday was fixed at approximately 2:50 PM yesterday and I was able to go online the remainder of the day (after I got home from work, that is). This morning, when I got out of bed, it was again down, but this time it had to be fixed by a technician actually coming out here and fixing the problem in the overhead lines. As I type, it is still not operational. I had most of this post already typed and saved to documents, but, alas, I cannot access my documents from the Library computer, so I basically had to completly re-write this.

I recently received an e-mail from Shaun Mullen, the administrator of the moderately progressive Liberal blog, kikos house, inviting me to be a guest blogger on the topic of the healthcare crisis in America. The following is part of the e-mail he sent me:

Year in and year out, reforming America's troubled health-care system is the biggest third rail issue in politics. No matter how you approach it and no matter how you want to fix it, you're going to get shocked.

I previously asked visitors to Kiko's House to guest blog on reforming the U.S. immigration system and for their comments on the third anniversary of the war in Iraq. I am now extending an invitation for you to share your views on how to fix health care.

A little background:

America spends far more for health care per capita than any other first world country.

Nearly 45 million Americans have no health-care insurance. A surprisingly large minority of this group are technically not poor.

Emergency rooms are groaning under huge loads because many patients don't have family physicians, let alone insurance.

Previous efforts at cobbling together a national health-care system have been disasters, although Massachusetts will begin experimenting with a new near-universal system beginning next year.

Pharmaceutical and insurance companies have a disproportionately powerful voice in any discussion about fixing health care.

What do you think needs to happen to fix this mess?

The following is how I responded to his query. It will be posted on his blog, I assume, somewhere around May 6:

In response to your question on how I would fix the Health care system in America:

I believe we are looking at the whole problem backwards. We are constantly trying to focus on how to pay the high costs of health care, and not on how to lower the cost of health care, which I consider more practical.

I am unashamedly Conservative, which already puts me at odds with Kiko and the majority of the readers of his blog. Be that as it may, my solution to the health care crisis in America is one which I formulated many years ago, when I considered myself a Liberal.

So it may be a Liberal solution. I don't know. Nevertheless, I still think it's a very good solution.

We regulate many types of businesses in this country. We put a ceiling on what private enterprise can charge for goods and services. The oil industry is a good example. Gas gouging is illegal. Independent oil companies are not allowed to charge more than a set amount for gasoline.

Similarly, other industries are equally regulated. Grocery stores have a ceiling on prices. As do most industries dealing with essential human needs. Telephone, gas, electric, and trash companies have to obtain permission from the government to raise prices, and then they are limited to how much of a raise they can institute.

Why not healthcare? Doctors and pharmaceutical companies currently have no restrictions on how much they can charge for their goods and services. Why not? Are they somehow better than the oil companies, and the utilities?

Here is my solution: Do not allow doctors and pharmacists to be paid more than a set figure per year. When I first entertained this idea, my original dollar figure was $50,000.00 per year, but with inflation, that is much too low in my opinion. However, I do think $100,000.00 a year is quite enough for doctors and pharmacists to live on.

Besides, a doctor who is a good manager of his money can turn a little money into riches through other means. This plan would not prevent doctors from getting rich. It merely forces them to find more inventive ways to reach a fiduciary goal. Doctors who manage their money well can still become millionaires with this plan.
This will have several related benefits.

First, and most importantly, healthcare costs will plummet, making health care much more affordable for the average American.

Second, this plan would eliminate the mercenary doctor, who only became a doctor to get rich, and couldn't care less about the welfare of his patients, as long as he gets his fee.

The only doctors and pharmacists left would be the ones that genuinely care about the patients health and will do whatever it takes, and explore every avenue to that end.

Additionally, the research scientists would have no more reason to milk the coffers of charitable organizations such as the American Cancer institute, etc., and would likely miraculously find a cure. A cure, that I am quite sure they already know about, but it is relatively inexpensive and if it was permitted to be used would seriously affect he yearly incomes of the doctors.

In short. Don't regulate the patients. Regulate the healthcare profession itself.


Erudite Redneck said...

What in the world are you talking about?


We put a ceiling on what private enterprise can charge for goods and services. The oil industry is a good example. Gas gouging is illegal. Independent oil companies are not allowed to charge more than a set amount for gasoline.


Similarly, other industries are equally regulated. Grocery stores have a ceiling on prices. WHAT? As do most industries dealing with essential human needs. Telephone, gas, electric, and trash companies have to obtain permission from the government to raise prices, and then they are limited to how much of a raise they can institute. OK, THIS ONE'S RIGHT, SINCE THEY'RE PUBLIC UTILITIES.

But otherwise, WHAT?

David M. Smith said...

Hi Mark,

Is the air in that library circulating?

Is story time distracting you?

What? What? and What?

tugboatcapn said...

Are you planning to cap Tuition for Medical Schools, or provide Grants in order to educate these doctors?

Does your plan include Eliminating the possibility of Multi-Million Dollar malpractice lawsuits?

If not, then the quality of the Medical care you recieve will not be the question.

You won't be able to FIND a doctor anywhere. They just won't do it. (Not the best and the brightest, anyway.)

You are right about one thing, though...

This is indeed a Liberal Solution.

It advocates dragging high achievers down to the level of the Mediocre, rather than allowing everyone to rise to their own personal level of success, no matter where that level might be.

You want to fix the Healthcare System?

Outlaw Health Insurance, repeal Medicare and Medicaid, stop the practice of treating everyone who walks in to an ER free of charge, and make everyone pay for their own Healthcare up front, out of their own pockets, or work out whatever payment arrangements they could with the treating Physician, and if they do not live up to the terms of the arrangement, put them in Jail for non-payment.

Same deal you get when you take your car to a Mechanic.

That would cause the cost of Healthcare to plummet.

Erudite Redneck said...

Mark, I just think your comparisons are off. The only thing keeping the grocery stores from charging what they charge -- or anybody else, except in the case of public utilities -- is the marketplace. There's no government rule, regulation or law involved. Sheesh.

And, no I don't pretend to have an answer for saving the medicine and medical treatent marketplace. It shouldn't be left to the marketplace in the first place.

Trixie said...

Mark, have you seen the numbers spinning on the gas pumps recently? The ones that indicate the price per gallon? There is no limit other than market forces at work -- supply and demand. Same at the grocery store. And even though utilities are regulated, they can get price increases (just look at my natural gas bills this past winter if you doubt it!)

Drugs are expensive because it costs a lot of money to develop new drugs. As long as people demand the drugs that are advertised, which are still under patent, drug prices will be inflated. That's why good doctors often will prescribe generics or use an older drug that doesn't have as much flash but gets the job done and saves the patient money.

I love my doctor. I don't want the government telling him he can't make a decent living. There are still a lot of doctors like him, if people are lucky enough to find them. They still care about their patients and keeping them healthy. They don't deserve to be forced out of business because of insurance companies who put unreasonable barriers between the doctor and patient care.

Too many people who would make great doctors are deciding not to go to medical school now. In Oklahoma, we already have a terrible shortage of physicians and hospitals, especially in rural areas. It seriously won't be long until the only people who can get medical care will be those living in about eight cities here. The rest will have to try to survive with a patchwork network of a few rural doctors with traveling clinics who depend on telenetworking with the metropolitan hospital networks. If you thought things were bad before, just wait until you see what concentrating that kind of business does for the corporations that own hospitals!

And those pharmaceutical companies? Pay attention to the PR circus they are creating with the programs they are touting to help provide medications to the people who can't afford them. It's like they can't even keep a straight face when they set their prices. They get seven years on each new patent to charge whatever they want. You notice you never see advertisements for Prozac any more? That's because the patent expired.

Doctors do not set their prices, insurance companies do! Have you looked at an EOB and seen what the "allowable charges" are for services? Have you seen your co-pay rise? Have you ever had reimbursement for prescription charges denied because you didn't get a generic?

It's getting harder for Americans to afford or qualify for health insurance too, especially if you leave a job at an employer which is large enough to have a group policy. COBRA will carry you for a while, and then you may be able to convert to an individual policy, but then the insurance company can drop you like a hot potato for any number of reasons (I was turned down partially because I am short and have acne. I am not kidding. I have the paperwork to prove it.)

Old Soldier said...

I don’t pretend to even be somewhat informed about healthcare costs but there are two ancillary issues that to me seem to be significant impactors on the overall costs.

Lawsuit awards and malpractice insurance costs; each causes the other to spirally increase the costs of medical care. Tort reform is a must if healthcare costs are to be brought under control. Your $100,000 salary would render a doctor in poverty after paying for malpractice insurance.

Non-paying patients are the second significant cost driver. Most states have laws prohibiting hospitals from turning patients away because of their lack of ability to pay. When the government reimburses a hospital or doctor for care of non-paying patients, it is done at a rate of pennies on the dollar. Guess who gets to make up the difference? (The well meaning social program has an impact after all, doesn’t it?) I’ve seen quite a few reports lately that contribute a significant portion of the non-paying patients to illegal aliens. It seems to me that the cost of having laborers who will take the extreme low paying jobs is becoming extremely high. And, again, we get to make up the difference.

Mark, you haven’t completed your conversion to conservativism if you still believe government control is a viable solution for healthcare costs. Keep working on it, you’ll get there.

Mark said...

The reason malpractice insurance is so high is because the level of incompetency in the medical profession is so high. This incompetency is a direct result of the doctors I mentioned in the post. the ones that are in the business strictly for the money. If you put a ceiling on what they can make, those incompetennts will find alternative ways to bilk people out of their money and only good doctors will be left, And they don't get sued. They do what they are supposed to do, and they do it right.

Therefore, no reeason to have malprqactice insurance. No malpractice.

Trixie said...

Mark, most malpractice suits have nothing to do with a doctor doing something wrong. For the most part, these suits are brought by the families of patients where there was an outcome that wasn't what they wanted. People die, things happen. It's not always the case that the physician did something wrong to "cause" that outcome.
The largest number of malpractice suits over the years has been related to ob/gyn cases -- delivering babies. Everyone expects and desires to go home with a perfect, healthy child. Nature being what it is, that doesn't always happen. And too often, the doctor is sued. Too many good ob/gyn doctors, or prospective doctors, no longer can afford the malpractice insurance that is required for an ob/gyn practice. Their insurance is not optional. Economically speaking, delivering babies is a bad investment in medicine.
If you want to point the fingers at someone when it comes to medical malpractice, point the fingers at the lawyers who have convinced the public that there's a paycheck coming if you just sue, sue, sue.
Did something bad happen in your life? Sue! The money will make everything all better.