Healthcare as politics

 

 

The only word for the current crop of Democratic Presidential candidates – pandering.

Why?  Among other things, they are almost all promising voters universal healthcare.  People understand that healthcare is not cheap.  It can bankrupt a family in a flash.  A simple appendectomy can be $10,000 in an afternoon.  To those not well off, this can be a very powerful message – something for nothing – I wonder if it hits them that someone ALWAYS has to pay.

For the socialists in our society, this is just another nail in the coffin, enforcing a ‘we are in this all together’ mentality.  What they forget is that while groups of people have historically banded together in this country for specific problems, those collective acts generally do not last for long.  After all, this nation was not built on a collective idealism but on individuals acting to better themselves and their families – hardly socialistic tendancies to be claimed. 

And even if universal healthcare is put into practice, it will be a losing proposition – the only question is how long will it take before it fails AFTER it becomes a money pit.  All one has to do is look at Canada and the UK to see how that model performs.  At its best, it can be described as "rationed healthcare" where patients, even those critically ill, can wait months for necessary procedures and the most advanced technologies and medications are not available at any price. Why?  When something is touted as "free" (when it really is not), demand for it goes up – why not, it doesn’t cost ME anything!.  At some point, those in charge realize that the real costs cannot be contained and there are few options available – raise the "income" of the program via fees and taxes or cut the benefits (which causes howls from the "deprived").

Once again, government distorts (or further distorts) the marketplace.  Once that happens, competition is stifled and innovation dries up.  Result?  Things get worse.

Here in the States, we only have to look at what Tennessee did with what was TennCare – basically universal care for its older and poorer citizens.  While it ran well in the beginning, the typical things happened – costs spiraled, the managed providers started to fail, the lawyers got into the act, and so on.  While it still exists, it started to fail badly enough that it became the focus of the governor’s campaign race.  Even now, efforts are on-going to salvage things and to save face.

The problem now is that Colorado and California political and advocacy elites are trying to push this collective answer to what should be a free market and individual choice.  However, being what they are, politicians are going to show that they are "concerned" and have "good ideas" and that they will "solve" the problem.  As with many things of this nature, they would be wrong.

At least the Dems are being honest – we will tax everyone to give a little to all.  Make no mistake, it may sound good, it may look great in the beginning, but it will be a slow motion disaster.  No, the current level of care (and we can argue all day long about the quality of it) will go down if these are put into place.

More insidious are those Republicans that are touting programs that provide "private insurance for all" as an alternative to universal healthcare.  I include both the Governator Arnold and Governor Romney in this category. 

In my opinion, when something is made mandatory by government that has an identifiable cost associated with it, it is a tax from a philosophical standpoint (albeit, perhaps not a legal one as the money does not go to government coffers).  Certainly car insurance lies in this category – in most states this is mandatory and is punishable for its lack with fines and/or jail time.  It therefore is money that must be spent by individuals that might not ordinarily be spent.  Foolishly if not, but it is no longer an individual’s decision.

Governor Romney’s stab at this, sometimes referred to as MassCare or RomneyCare, incorporates this notion of mandated expenditures by individuals upon pain of legal retribution. It mandates that all people be covered by medical insurance. 

If you are financially capable, you are legally responsible to have a policy and can only use an HMO plan. This could cost you up to $3,600 / year if you earn $29,000.  And a high deductible no-frills policy can only be obtained by those 27 years old and younger – older than than, fork it over.  Those that are 300% of the poverty level or below will be subsidized by everyone else.

It is even rougher on businesses – all employers with 10 or more employees have to provide financial coverage.  If they do not offer insurance, they will have to pay a fee of $299 / employee / year to the State.  That might sound like a great deal until you consider that these same businesses will then be responsible for ALL financial obligations of its employees and their families with no caps. 

Talk about a business killer!  Why in the world would a small to mid sized company want to put themselves at so much risk?  As a former business owner in a business with extremely low margins (day care), I would have closed up shop immediately as I could neither afford health insurance for my employees (go ahead, double or triple the cost to your customers and see what happens!) or afford that kind of financial risk 

Now that it has started, the obvious has started to become obvious!  What was touted as being low cost is rapidly turning out to much higher – try doubling or tripling the early estimates that were used to sell it (gee, what a surprise!).

When it all comes down to it, RomneyCare, CoCare, and GovernatorCare (which I believe will kill off small buisnesses in CA), are universal healthcare dressed up in other garb.  The Dem versions of universal healthcare will be even worse – instead of universal healthcare, I predict that long term, it will bring the same universal misery that we now see in scloretic Europe and that did hardly anything in the Communists regimes except keep the appararatchiks well.

That’s the problem.  What’s the solution?  In the grand scheme of things, make people more responsible for their own healthcare costs.  The main thing that most people worry about are the big high ticket items that people believe that are necessary – that’s what insurance should be.  More minor things – out of pocket (trust me, my family’s on-going medical costs would cost a pretty penny every month) expenses should be taken care of at the individual basis.

This is what Health Savings Accounts with high deductible insurance plans can do.  The next part is where the two things have to intersect – the Internet and the publishing of health costs.  The first is easy and I bet there are people chomping at the bit to provide sites to for the next bit – the costs.

The philosophy among healthcare providers, in general, is not to make well known their costs.  This will need to change in order for patients to be good consumers. And that, in a free marketplace, will bring down the constant rise in medical costs. 

But getting to that point, publicly available costs and consumers making decisions with that information, will take time and take a lot of arm twisting.  The current environment is not conducive to this new way of approaching care, thus the problem of change management on a massive scale will be needed.  Newt is leaning in this direction and I believe that it will, if accomplished, will make for higher quality care at lower cost. 

After all, competition (what Republicans should always be trumpeting!) is good – more competition is even better for consumers.

Not universal healthcare – or it’s shame work-a-likes.