Defining Terms & Addressing Actual Problems   6 comments

According to the media and the CBO, about 20 million (could be 24 million) Americans will lose their “health care” under the GOP plan to replace (uh, tweak) Obamacare.

Image result for image of a doctor's scaleI’d be horrified if I knew what that meant. How exactly could I, an active, healthy, middle-aged person who eats (relatively) healthily and enjoys the outdoors (in some months) “lose” my health care? It’s not a cell phone or sweater that can be stolen or left on a park bench. Health care is what I do to keep myself health – diet, exercise, avoiding risky behaviors (uh, except for going into the Alaska wilderness well-armed) and not abusing drugs, including alcohol. I did that before Obamacare was enacted and I will continue doing it after that mistake is reformed or collapses of its own bureaucratic inefficiencies. It really can’t be taken from me because it doesn’t rely on anyone else but me.

You see, health care is not medical care. The terms “healthcare”, “medical care” and “medical insurance” are often used synonymously, but they really have radically different meanings. No, we’re not talking semantics here. There are serious policy implications of using the wrong words. This sort of lazy use of language by the media and politicians leads to an entitled attitude among the people.

 

Medical care or treatment is what you seek from medical professionals when you have a medical problem and aren’t in good health. See the difference? When I become unhealthy, I seek medical care because my health care has proven inadequate.

Medical insurance is what you obtain to protect yourself financially from a catastrophic illness or injury requiring expensive medical treatment.

Back before Obamacare, you could save a lot of money by taking care of your health (health care). Brad and I only ever satisfied our deductibles when we had babies or when our daughter needed braces. That’s because we work hard on our health care. Not everyone does, however.

The total cost of medical care in the US would be significantly reduced if Americans simply took care of their health. Examples?

  • Overeating is estimated to cost the nation $200 billion for the treatment of diabetes and heart disease alone, not including joint problems caused by being overweight.
  • Smoking-related medical problems are estimated to cost the nation $133 billion.
  • Alcohol and drug abuse add another $350 billion.
  • Sexually-transmitted diseases add $16 billion.
  • Reckless driving and other reckless behavior add untold billions more.

And none of these figures include the cost of Social Security Disability payments or other income support for those incapable of working due to medical problems stemming from overeating, smoking, drug addiction, sexually-transmitted diseases or reckless behavior.

Using these figures, the total cost of preventable illnesses and injuries is $699 billion at the minimum. We could round it to a nice neat $1 trillion when all the other costs are included. That’s $2,184 to $3,125 per citizen. In other words, the 30% of the population that foregoes health care (by not taking care of their health) are inflicting these medical care costs on everyone else.

There are those who will insist that society has a moral responsibility to provide medical care to those who can’t afford it, but virtually nothing is mentioned about the moral responsibility of individuals to not inflict costs on the rest of society because they lack self-control and self-respect.

So why doesn’t the media cover that? Take a really good look at the advertising on media and you’ll see the reason. Notice all the commercials for drugs and snake oils to address the infirmities and conditions stemming from a lack of personal health care. They would lose advertising dollars if they addressed the real issues of health care rather than demanding that we all pay for the medical care of everyone else.

When Obamacare first came under consideration, it was designed to address the approximately 6% of the country that lacked health insurance. Many of these people were healthy and health-caring individuals who didn’t want to pay for health insurancebut we were told we had a moral obligation to force them to submit and spend money on something they didn’t feel the need to buy. It’s a lot easier to put pressure on 6% of the country than on 30% of the country. So, no politician in his right mind would dare bring up the issue of health care when he could focus on the feel-good topic of medical care.

Let’s be honest about this. Very few people need anything more than a high-deductible medical insurance policy with a health savings account. The 70% of us who take care of our health generally don’t consume a lot of medical care. Common sense dictates that you have a low-premium, high deductible policy so that you can pool risk of a catastrophic illness with others, but it’s really pretty silly that we think we can’t afford over-the-counter medications and contraception. The vast majority of us could if we spent our money wisely. Yet, here in the United States medical care/insurance ranks 5th behind housing, food, cars, and entertainment. In other words, we subsidize medical care/insurance so that the masses can buy “stuff” rather than save money toward their old age and so that old people don’t have to move in with their kids when they stop making an income.

The cowardly framers of public opinion say that medical care/insurance must be socialized (provided by the government) because it’s a fundamental necessity. Oddly, they don’t advocate the same for food, shelter, clothing and transportation. Well, there were a few Obama czars who were hardcore Marxists who might have liked to see these industries socialized for the “good of the poor”, but they knew Americans would object to being forced en mass to buy their food in government markets, live in public housing, wear a standard uniform of clothing, and ride the same model of bicycles to work. Even the Chinese have finally rejected that way of life. Still, the American poor are kept dependent upon targeted social-welfare programs, such as food stamps, housing vouchers, and free-ish medical care through Medicaid.

Of course, if you debate these folks, they will insist that medical care/insurance is different. It doesn’t have the immediacy of food, shelter, clothing, and transportation. Because it’s not something people need every day, it requires people to plan ahead, defer gratification, make trade-offs, and save for medical emergencies. Valid point. The 30% of the population that doesn’t take care of its health probably has difficulties in these areas as well.

May I submit that there are ways of addressing this sad side of human nature other than socializing the entire medical industry, engaging in massive income transfers, or hatching unwieldy centralized plans in Congress that will only serve to raise costs and make people even less willing to take care of their health. Rick and I have been hinting at this through this series, but you can also find these ideas in many other sources including medical journals.

Simply put, you don’t put the problems of the 30% of the population who are poor decision-makers on the backs of the 70% who are able to think ahead. Instead, you find a way to address just the 30% and let the 70% go on making good decisions for themselves.

Although Rick and I were skeptical of Rand Paul’s plan before the text was available and still believe it needs to go further, it is certainly better than what the House GOP is offering with the American Health Care Act. It’s filled with details that put good decision-makers back in control of their own health care, which includes medical insurance in case they need medical treatment.  Check it out. https://www.paul.senate.gov/imo/media/doc/ObamacareReplacementActSections.pdf

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6 responses to “Defining Terms & Addressing Actual Problems

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  1. Why are people on disability benefits for sexually transmitted diseases?

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    • Good question!

      Some sexually transmitted diseases have long-term health consequences. AIDS and Hep C are two that will disable a person without appropriate medical treatment. HIV drugs are not affordable under a working-class incomes (even with insurance, they’re pricey), so the “solution” here in the States is to stop working, go on benefits, and have Medicaid pay for the drug regimen. Hep-C has a similar expectation.

      I absolutely think it’s stupid, but it’s actually fairly easy to get on benefits here in the States. Claim “chronic fatigue” or “fibermyalgia” or “generalized anxiety” (all diagnoses that have subject criteria) and you can stay home and sit on your butt for the rest of your life with your housing, medical, and food paid for and usually your utilities subsidized by the government.

      For 15 years, I worked for a non-profit social services agency, so I have direct knowledge of this.

      Because the Social Security Administration knows these diagnoses have subject criteria, it’s easier to qualify if you have some sort of underlying condition that would explain your “primary” condition. “Generalized anxiety related to chronic Herpes 2” was a common diagnosis, but I’ve also seen the diagnosis without support. The underlying conditions just makes the qualification process faster. I left there in 2012 when Medicaid expansion was just getting underway. My former coworkers say it’s just gotten easier under the Obama administration.

      About half of our clientel were actually sick (schizophrenia and bipolar with psychotic features being the big ones), but the other half were people gaming the system and sucking up the resources the other half needed.

      Once you open the door to the welfare state, it’s nearly impossible to prevent such fraud. Someone will always be able to find a doctor who will believe their sob story and fill out the paperwork for disability support. We had one on staff who believed every sob story she ever heard.

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      • Are you serious – generalised anxiety R/T HSV2? Aust has just released immuno suppressant tx for HepC, subsidised, high success rate which eradicates HepC completely, in order to cut nat health costs. It will soon be rolled out in jails & within homeless. At the mo, it’s the middle class / affluent getting t’ment. It is stricter criteria here to get on DSP, not impossible but it depends what the pt will try & claim. Sure, I know pt’s on DSP with HIV, but to be fair, I’d be suicidal & depressed if I had HIV, too.

        Liked by 1 person

      • But therein lies the problem, Daria. By subsidizing their meds, at least here in the US, we see strong evidence that we are tacitly encouraging the very behaviors that caused them to need the meds in the first place.

        This is the vicious cycle that we have created. These people don’t take care of themselves (health care), so then we decide that we must pay for their medical care (or medical insurance) to overcome their lack of health care. Moreover, we reward them for now being in ill health by giving them other benefits. That sends a strong message to the next generation that they don’t have to take care of themselves either and that it’s really kind of good not to, since you’ll be rewarded for destroying your health, but you have to work and do things for yourself if you take care of yourself.

        Rick has seen it as a doctor in Missouri and in Britain. I’ve seen it on my tribe’s reservation and in Alaskan villages. The more the government incentivizes unhealthy behavior by paying for the consequences, the more unhealthy behavior we see.

        It’s ironic (but not funny) that six years after the passage of Obamcare, our mortality rate is lower than it was in the 10 years before its passage.

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