Cod oil vs ritalin. Ritalin. Ritalin debate. Expired ritalin….

The day the members of Congress and the President reduce their salaries & compensation to that of a postal worker is the day they can expect health care providers to do the same.

Let’s be honest: they’re receiving those subsidies now, through the least efficient system possible – the billion-dollar shell game of cost shifting, where hospitals and clinics charge inflated prices to insurance companies and people who pay their medical bills, in order to cover the costs of writing off indigent care.

I had to be hospitalized a few years ago. It was a basic semi-private room, expensive antibiotics, and all the daily lab tests.

The bill for six days was $36,000. Insurance paid $12,000. I paid $660. The bill was considered settled.

The people who get socked are those without insurance. Insurance companies pay something resembling the real cost (which I’m guessing at about $9000 — $1,500 a day, including the expensive antibiotics).

I am currently pregnant with my second child. Before my husband and I started trying, we shopped around for health insurance coverage and seriously considered just going without it and saving the money up front to cover the costs of the birth and such. What pushed us into buying insurance was that we really have no idea what anything actually costs.

I have no history of complication in child birth, but that in itself can be a crap shoot. We knew to prepare for approximately a certain amount if I had no complications, but what if I did? What if there was something wrong with the baby and he/she needed extra care? What about the cost of a c-section? And so on.

There was just no practical way to prepare and save up enough for the birth because we have no clue what the bill for a worst case scenario would look like.

I also think more people would opt for true emergency only coverage (like a high deductible plan w/no copay) if they could see what routine checkups and preventative care actually cost. Taking my toddler to his well-child checkups and paying for the whole visit out of pocket is substantially less expensive than what we pay per month to insure him. If people could see that and began taking care of routine visits on their own instead of it being filtered through the insurance provider’s maze, costs might come down.

That being said, we should not oversell preventative care as a cost-saving device. In the longer-term, people saved by preventative care inevitably die of something else, and frequently, treating that “something else” ends up being more expensive on balance.

I don’t say that to sound like Scrooge. To the contrary, I say it to point out that the logic of gov’t-controlled healthcare inevitable slouches toward cutting off expensive “end of life” care. Seniors and soon-retiring Boomers ought to be made acutely aware of where the path leads.

Karl on June 9, 2009 at 1:54 PM

If we don’t kill medical research and development by nationalizing it and screwing up the profit incentives, it seems to me that early detection and prevention will become an increasingly important part of everyone’s medical experience. Early screening and wellness benefits aren’t a magic bullet, as you pointed out, but there are already a number of potentially serious illnesses that can be easily controlled if detected early. Besides cancer screening, another example would be hypertension – it’s fairly easy to control with relatively inexpensive medicine if caught early, but left alone, it becomes the “silent killer.”

How many low-income and immigrant patients are walking around with serious blood pressure issues that could be easily treated, if only they were given better access to diagnostic and preventive care? The current system of treating them as charity cases in hospital emergency rooms is as ridiculous as expecting them to show up at grocery stores when they’ve almost starved to death, to receive charity food.

davidcaskey on June 9, 2009 at 1:53 PM

Thanks for those excellent points! I didn’t address malpractice insurance in my original post… it seems worthy of a whole discussion on its own. Since you brought it up, one aspect of Obamacare that’s been nagging at me is the reality of the malpractice industry. Trial lawyers make a huge amount of money from it – consider the example of John Edwards and his millions. Trial lawyers are also major power players in the Democrat Party. Are we supposed to believe they’re all going to go away when the super-state controls health care? Or is it more likely that any sort of nationalized health system will have even more opportunities for trial lawyer profits built in?

Of course there is not now, nor has there ever been, any state or township in America that was unwilling or unable to provide necessary medical care to every citizen. It’s always going to be there, the only option is whether or not there is any rational reason for healthcare to be CENTRALLY CONTROLLED by the federal government. And the answer to that is always a gigantic “no.”

logis on June 9, 2009 at 1:47 PM

I think an important step in reforming our health care system is to be upfront about the various costs doctors and hospitals incur, including uncollectable charity work. Cost shifting is a huge factor in certain parts of the country, particularly border states, where the pressure of providing care for illegals has caused hospitals and emergency rooms to shut down. As you pointed out, the maze of claims and subsidies built into Medicare and Medicaid make things even more confusing.

People sometimes feel squeamish about introducing icy business concerns into a noble endeavor like medicine, but proper business practices will increase the quality and availability of medicine, which is good for everyone. I would daresay few business managers would be comfortable with an enterprise whose true costs and income stream were hopelessly confused, and in some cases deliberately hidden. When a patient receives treatment – anything from diagnostics to critical care – a great deal of his bill has nothing to do with the services he received. It’s no wonder people find health care such an alarming topic of discussion.

My wife works in administration (strategic planning and business development) for a local health system. Your point has been echoed by her for many moons. Well said!

Let me first of all say, I’m not against healthcare reform at all. I just happen to believe it should be done sensibly.  Why people aren’t discussing the following is a mystery to me…

We have some of the highest prescription drug co…

That being said, we should not oversell preventative care as a cost-saving device. In the longer-term, people saved by preventative care inevitably die of something else, and frequently, treating that “something else” ends up being more expensive on balance.

I don’t say that to sound like Scrooge. To the contrary, I say it to point out that the logic of gov’t-controlled healthcare inevitable slouches toward cutting off expensive “end of life” care. Seniors and soon-retiring Boomers ought to be made acutely aware of where the path leads.

1. First and foremost, eliminate the DEA and every other control over the free flow of all drugs. Arrage to have pharmacies cover the mundane things people come in with and that they can purchase pills to take care of themselves. Other countries already do this, that makes us less free not to have the right to pills that would cure pneumonia or take care of the worst of back spasms.

2. Stop drug commercials and those ads that encourage the use of a doctor.

3. People should be instructed to care for themselves.

If we did the above, even accounting for those that would miss use the system, we would reduce doctor visits by 30 to 50%.

4. Reform malpractice. I testify for attorneys on both sides and can tell you there are some very bad doctors out there but they are not the ones being sued.

5. Eliminate forign doctors, even those already in the US. They are here only for money and do not have your interest at heart.

6. Have the government pay their share. That is why medicine is high, the fact that your insurance premium is really a hidden tax.

7. Eliminate the thought that 90 year olds need the same level of care as 40 year olds.

8. Regulate the insurance companies such that they take pre-existing cases, have reasonable premiums and actually pay the bills without distortions in normal English. Currently they are not regulated.

Let’s be honest: they’re receiving those subsidies now, through the least efficient system possible – the billion-dollar shell game of cost shifting, where hospitals and clinics charge inflated prices to insurance companies and people who pay their medical bills, in order to cover the costs of writing off indigent care.

That’s not true. Most hospitals have always been charitable institutions since a very long time before prices skyrocketed.

What caused the drastic health treatment of recent years is Medicaid and Medicare. They base their payments on “average” amounts for similar ailments and treatments, and then they pay a drastically discounted amount for that – about a third or less.

So, the Captain Obvious solution that all hospitals went with was to drastically increase their “average” prices and then work out incredibly complicated kickback and fee reduction programs with insurance companies. It’s been a giant merry-go-round ever since then.

As always, the big losers were the taxpayers and any consumers caught in the middle — people who had some money they could spend for improved service, but not the top of the line insurance needed for the gold plated version.

Of course there is not now, nor has there ever been, any state or township in America that was unwilling or unable to provide necessary medical care to every citizen. It’s always going to be there, the only option is whether or not there is any rational reason for healthcare to be CENTRALLY CONTROLLED by the federal government. And the answer to that is always a gigantic “no.”

It would be a shame to stifle them because politicians fool the public into believing that mediocre health care, spread thin by a clumsy and corrupt state, is somehow “free.”

Socialized medicine, with its rationing, institutional aversion to experimentation, and emphasis on hiding costs – while it convinces patients to be satisfied with less – is the opposite of health.

Not sure which is the better point. I signed on for a low cost HMO instead of a PPO to save money once. Once!

there is no market for health care insurance in the US.

” There’s a market for auto insurance, as anyone can tell who’s seen a Geico, Progressive, AAA, State Farm, Allstate, etc… commercial. There’s a market for a lot of things (flat panel tv’s, cars, computers, etc…) but not healthcare insurance. Let the carriers cross state lines and offer insurance nationally and let the employees choose their own plan. Now, if you’re unhappy with your insurance plan your employer will likely say “I’m sorry but it seems to work for the rest of our workforce and this is the best plan we can afford.” Let market forces work. No need for healthcare to be a “crisis” in the first place.

the breast cancer issue is a hot one. and those women will march on bambi, their congressional offices & burn up Congress’ phone lines. that is where we should target our anti-socialized medicine thrust.

kelley in virginia on June 9, 2009 at 10:50 AM

That’s a good point. I used colorectal cancer as an example because it responds so well to treatment when detected early. I had my own colorectal scare a couple of years ago (turned out to be nothing, thank God) so I have some personal experience with the importance of early screening.

A greater emphasis on regular checkups, prevention, and improved diet and exercise would take a lot of the strain of the medical system, to say nothing of improving the lives of patients.

the breast cancer issue is a hot one. and those women will march on bambi, their congressional offices & burn up Congress’ phone lines. that is where we should target our anti-socialized medicine thrust.