BUD BREWER
One Man's Opinion
LIGISLATING HEALTHCARE
November 6,2009: I have been listening to the politicians, media pundits and many individuals talk about healthcare and the notion that everyone has a right to receive medical care for any illness or other adverse physical condition that they suffer from. For decades, a number of Congressmen, Senators and even Presidents have argued that one of, if not the most important, planks in their campaign platform is to create legislation that guarantees healthcare to every citizen in this country. It’s a persuasive argument. No one I know would want to purposely withhold some readily available form of treatment for a fellow citizen to aleve if not cure a malady they suffer. I know the reader has seen the hundreds and thousands of pictures submitted by one or more charitable organizations attempting to assist children and adults in some part of this country who are afflicted with a serious disease or that live in an area where there are few or limited affordable medical services available. It tugs at your heart to look at these children, some living in squalor and apparently suffering from some disease in addition to partial starvation. Who wouldn’t want to reach out and lend them a helping hand?
In Congress today our Representatives and Senators are about to vote on legislation that is intended to take that right away or at least generalize it so that we as individuals will no longer have the right (option) to make the decision to reach in our pocket and share some of our savings with those that are in need. When this legislation is in place, the Federal Government will decide when, where and how much of our personal earnings are to be spent for the wellbeing of our fellow human beings who are perceived by a government bureaucracy to be in need of medical care. Perhaps it will raise the level of medical services available to the 40 million or so men, women and children who are not able to afford it, have been turned down for it, or who just don’t want to purchase health insurance today. But will this perceived approach generate a continued high quality of medical services or will it merely make a lesser but general volume of lower quality care available to everyone?
In thinking about this, it occurred to me that healthcare is one of, if not the only, service that can not be allocated by market forces without having disproportionate results relative to treatment or services made available to all individuals. I can’t think of any other want or perceived need that has this or a similar kind of clearing process. When we get a disease, we don’t ask the price for a procedure to cure it. We expect to have every available medicine or treatment used to make us well again. If we need to have treatments that could cost hundreds or thousand of dollars to provide, so be it! We need it and we should receive it. We have solved this dilemma by forming organizations that allow us to transfer some of the expense risks to others in the same group. We call that an insurance company. This system has worked reasonably well as long as the cost of providing those medical services is low relative to the number of medical incidents and the financial ability of the participants in the organization as a whole to fund or pay for the aggregate cost thereof. With the creation of these third parties to the transactions between individual patients and their healthcare provider, the individual or health beneficiary is disconnected from making a valuation of service versus price. This is the same process as if a dozen people go to dinner and decide to split the bill equally among them. One individual may not feel too hungry and want just a salad or so while another with a greater appetite feels like ordering lobster tail and a bottle of wine. As you can figure out, the individual with light appetite isn’t going to want to pay his share for such excess by one of the group so he will order the Lobster also just so he doesn’t experience a disproportionate cost for his salad as he subsidizes his friend’s desire to order the most expensive item on the menu. Because everyone thinks the same way, the bill for the group therefore increases to the highest aggregate amount.
This is what is wrong with the insurance based healthcare system today. Everyone wants “Lobster tail” health care to be available even during times when their appetite is modest or they may not even be hungry at all. Every individual needs to be a party to the pricing structure for healthcare services they believe they need. They should have options available that relate to their ability to pay or their perception of the benefits to be realized from one type of care versus another more or less elaborate type of care. But they should have a responsibility to pay some relative part of the cost of the services they select. This should not be a fixed percentage but an incremental portion of the cost. The medical services profession would become more competitive and work toward improving the price/effectiveness relationship rather than just work on developing effectiveness as they are motivated to do today. They should be challanged to deliver the highest form of care for the patient’s ability or willingness to pay.
The Democrat’s healthcare legislation is geared to trying to mandate that doctors provide appropriate medical services based on standards set by a government bureaucracy, shift the costs of general services for all user patients, regardless of their financial resources, to those taxpayers earning higher incomes, and charge employers a minimum of 8% of payroll to help pay for the government run plan. There will be no constraint upon, nor competitive price/effectiveness relationships for medical equipment, medical services or hospitalization. Suppliers of these services or products will only have to demonstrate effectiveness to be included in standards of performance required to earn compensation.
While the legislation is still pending, the opponents to this government controlled insurance-healthcare service program will need to make their voices known for any hope to prevent this major shift in responsibility for, the future availability, and quality of our nation’s healthcare services. We need to step back and redefine the issues and the potential solutions for this nation’s healthcare delivery system.
On Man’s Opinion –Bud Brewer
Obama and the other fools in Congress will probably be able to pass a hybrid health care plan without a public option which will motivate them to celebrate a victory. But there’s so many hidden components of this bill that will make it impossible to avoid the public option eventually. The fines for individuals/families that do not acquire health insurance could be as high as $250k per family and considered a felony! Worse than income tax evasion. I agree with you that with this system, there’s no way that quality or equality of health care as we know it will be able to survive.