Archive for the ‘#medicalcare’ Tag
There’s a common misconception that if you’re opposed to government services, programs and/or departments, then you’re opposed to building roads, education, people getting affordable health care and even people taking care of the sick and elderly. These misconceptions are becoming more apparent as the free market offers solutions and options using innovation and technology, as the government continues to fall in on itself.
Six months into the pregnancy, we received a letter explaining that due to the changes in the law, our policy would no longer cover maternity services.
I continue to be amazed at the ingenuity of people and individuals working toward solutions in the marketplace, in spite of government. Over time government has assumed more and more control over medical decisions that individuals make everyday.
My Own Experience
I have paid my dentist out of pocket for many years and had private insurance for major medical only. In 2011, my wife and I were expecting our first child and had private health insurance which was slowly being limited more and more by regulations from the Affordable Care Act and Patient Protection Act. It was dreadful!
Six months into the pregnancy, we received a letter explaining that due to the changes in the law, our policy would no longer cover maternity or OB-GYN services. This meant that our insurance would no longer pay for anything related to the birth of our daughter. We searched and shopped for insurance that would help cover the cost of the hospital and birth, but the more government regulations and controls were placed on the market, the more difficult it became to actually get affordable medical insurance and health care.
We spoke with our doctor about it and found that by avoiding insurance altogether and paying the doctor directly, it reduced all costs associated with pregnancy by 60%. We avoided the government-burdened insurance market and paid the doctor directly.
This model of doctors and patients actually working out agreements and paying a flat fee in exchange for medical services is actually very effective. If we could only bypass the government regulations and laws on health care, more people would get better service at a more affordable rate.
One awesome example of markets finding ways around the government’s stronghold on medical services is the Surgery Center of Oklahoma. In order to run their own practice with the least amount of government interference as possible, two doctors formed this practice 15 years ago. The goal was to eliminate the inefficiencies that accompany hospital networks and Medicare/Medicaid networks in order to run their own practice. The practice has done so well, that it has grown to over 40 doctors now.
According to them:
It is no secret to anyone that the pricing of surgical services is at the top of the list of problems in our dysfunctional healthcare system. Bureaucracy at the insurance and hospital levels, cost shifting and the absence of free market principles are among the culprits for what has caused surgical care in the United States to be cost prohibitive. As more and more patients find themselves paying more and more out of pocket, it is clear that something must change. We believe that a very different approach is necessary, one involving transparent and direct pricing.”
This has allowed them the ability to perform the best quality surgeries at the lowest and most transparent cost. All of their procedures and costs appear on their website. By bringing this level of transparency to the public, it has forced a price war for surrounding hospitals to post prices for procedures, something that is often hidden. This has brought costs down in surrounding areas.
Exiting the rat race of hospital networks and eliminating acceptance of government payments has allowed them to cut the cost and provide a better service.
In spite of what government does, people around the country are finding ways to lower costs and raise quality in the most competitive and realistic manners.
Flat Fee Memberships
The difficulties with getting health care at affordable rates come not from marketplace inadequacies, but from government regulations.
Another great example, are physician’s offices like Irmo Primary Care, Gold Standard Pediatrics and many others that are starting flat fee pricing for memberships and monthly medical services called Direct Primary Care. These practices are helping to once again bring patients and doctors together without interference from government and bureaucratic middlemen. I love streamlining services!
Dr. Bryan Hill, a South Carolina pediatrician, opened his direct primary care practice in September. “Instead of accepting insurance for routine visits and drugs, these practices charge a monthly membership fee that covers most of what the average patient needs, including visits and drugs at much lower prices.”
It’s sad that most of the difficulties with getting good health care at affordable rates come not from inadequacies in the marketplace, but from the many regulations by central planners in government.
History has shown us that free-market forces have the ability to lower costs and increase quality while fostering new growth and innovation. It puts the power in the hands of consumers, where it should be. If government would just get out of the way, then the free-market can fix the problems with healthcare.
Real skills for professional success from successful entrepreneurs. Learn more at FEEcon.org
Source: How the Market Is Already Repealing Obamacare | Stewart Jones
American citizens have several cultural attitudes toward health care and savings that has resulted in an economy that spends one-sixth of the GDP on medical care. Other countries don’t pay so much and many of them have universal medical coverage.
So what’s our problem?
A major issue is that Americans have stopped saving anything. Many of us have retirement accounts, which work because it’s not easy to tap into them, but most of us do not have savings accounts. I recently read an article by a financial guru who spent most of the article ripping into Dave Ramsey for suggesting that paying off debt and having 3-6 months of living expenses in savings made no sense to her. You should be investing those funds, not leaving them in the bank account.
So, naturally, since, they don’t believe in savings, the American middle class does not believe in saving up for medical care expenses. The idea that you should have $10,000 to 15,000 in savings for a potential acute medical episode is ridiculous in most people’s minds. This isn’t pre-World War 2 America, nor are we a 3rd world country. That’s “wasted money” just sitting in a bank.
We object to paying one-sixth of our personal income directly on health-and-medical expenses, but we also resent paying one-sixth of the government’s treasury on health-and-medical expenses. We are less willing to spend public funds to pay for health maintenance than we are to pay for medical services, even though study after study shows that we get better results from getting people to change unhealthy lifestyles than from treating the consequences of those lifestyles. You can’t really blame the American middle class from objecting to paying taxes in order to support people who are very poor or very sick when they themselves work hard to have an income and to take care of their health. Americans are not Scandinavians. We believe in personal responsibility, if only for other people.
Americans, especially medical care providers, do not want to think of medical care as a commodity that is bought and sold in an open market subject to supply and demand rules. Providers want to be paid (and paid well), but they don’t want to think of themselves as capitalists selling their services, so they prefer payment that comes from third parties where the price is hidden from consumers.
Americans are individualists at heart and object to telling other people how to live their lives or being told by others how to live theirs. This means that the right to live an unhealthy lifestyle is considered sacrosanct in the United States. Under the ACA or universal coverage, that means that healthier individuals pay for the poor choices of less healthy individuals.
Americans also tend to live in a state of denial about some health choices, so that about one-quarter of our population engages in unhealthy lifestyles that have long-term medical care expense consequences, the cost of which are born by people who take care of themselves rather than the poor decision makers who require the expensive long-term care.
Americans enjoy being “early adopters” of new treatments, which are often much more expensive in their early, experimental stages than when they have been available for many years. Forty years ago, when medical care was a smaller share of the economy, we could afford that attitude, but new treatment options now require expensive equipment and highly-trained specialists. Although these treatments promise incredible results, they are expensive to the individuals receiving the treatments … or the group that’s paying the bills.
All of these attitudes conspire to make the “Affordable” Care Act, or any replacement other than the free market, incredibly and increasingly expensive for all of us. Universal coverage will only exacerbate the problems that these cultural attitudes engender, leading inevitably in medical care rationing and resultant lack of availability of care, with the end results being similar to England’s 45% higher mortality rate.
Yes, we could choose universal coverage and then attempt to outlaw everything that makes people unhealthy. Good luck with that! It hasn’t worked in France and England, which is one reason England has a 45% higher mortality rate than the US.
Alternatively, we could work with human nature and return our medical care system to the free market it began in. Lift the government-created restrictions against individuals forming groups to drive down medical insurance costs. Lift the government-created restrictions that prevent us from buying insurance across state lines. Life the government-created monopoly against increasing medical schools and opening clinics. Yes, that would mean that some people wouldn’t make good health choices and wouldn’t have medical care coverage when those choices require them to seek medical care. That would be the consequence of being a poor-decision maker and it might drive some of this group to make better choices. Additionally, medical care would become less expensive because government-created barriers to care and affordable insurance would no longer be a factor in price.
We have a choice to make in this country. Do we want reduced access to expensive care, but everybody having insurance or do we want improved access to affordable care with some people choosing (for themselves) not to have insurance?
I know which one I prefer and which one I believe would result in improved health results.
I believe sincerely that everyone should have the right to do whatever he wants, provided it doesn’t harm other people or their property. I’m not saying I like it or think it is good for you, but I stand by your right to smoke like a chimney (so long as you don’t do it in my airspace), drink like a fish (but not if I share a household with you), or eat like a hippo (so long as I don’t pay your grocery bill).
Sadly, your lifestyle choices became my problem when the Affordable Care Act was passed. Your poor decisions now cost me money, which is a form of property. Hey, you, with the 50-inch waistline … that’s my kid’s college education in medical expenses that you expect me to pay, so yeah, I have a problem with the Affordable Care Act.
Back in 2009 when the Democratic-dominated government started touting the Affordable Care Act, they assured that the expansion of medical insurance coverage to all Americans would come at no cost to any citizen. A lot of us (about 60% of the electorate) were skeptical and that time and anyone paying even cursory attention to their medical insurance premiums since the go-live date for Obamacare knows our skepticism was well-founded. Medical insurance premiums have dramatically increased for most Americans not in the subsidized classes.
It might have seemed like a noble idea – that everyone should be required to have medical insurance just in case, but the Affordable Care Act also required medical insurance providers to cover pre-existing medical conditions.
That means that health-conscious people like me must subsidize medical care costs for people who make poor health choices. These poor health choices lead to diabetes, coronary artery disease, cancer, obesity, COPD, etc., all long-term chronic diseases that require expensive treatment. Coverage of pre-existing medical conditions greatly increased the cost that medical insurance providers were forced to pay out for treatment. This was supposed to be offset by young, healthy adults joining the health insurance pool, but younger, healthier people take one look at the expensive premiums and choose to pay the mandatory fine, because it is less than the premiums. This increases medical insurance premiums even more.
As Rick tried to highlight, individuals are less likely to make wise health choices if it is perceived that they will not have to bear the financial consequences of those choices because insurance paid by others covers the majority of the costs. Medical insurance holders are able to seek out healthcare services without the cost of those services being a major deterrent, which encourages people to go to the hospital and doctor for very minor ailments. After all, you want to get value for what you are paying for. Then doctors are motivated to extract the maximum amount of payment … prescribing expensive and sometimes unnecessary treatments and medications because insurance is covering the cost.
Rick points out that doctors and hospitals are often at the mercy of insurance companies and what gets approved for coverage, so they use a scatter-gun approach toward billing. Patients often demand more expensive treatment because of an impression that it’s better and because cost isn’t an obstacle. This completely undermines doctor-patient relationships where the goal is to choose the best and most sensible treatment options based on a cost-benefit analysis.
All of this has increased the cost of medical insurance. While providing medical coverage to everyone seems very humanitarian, it forces health-conscious people to subsidize the medical care costs of people who make poor choices and is causing employers to drop insurance coverage as it becomes unaffordable. If current trends hold, and there’s no reason to believe they won’t, the Affordable Care Act is going to bankrupt the middle class.
We’re not joking when we call it the UN-Affordable Care Act.
In a perfect world where liberty was still an ideal we upheld, everyone would be able to live their life however they want and be accountable for the personal and financial impact of their choices. The fact that I love bacon even though my family has a history of stomach and bowel cancer would not matter in the least to you because it wouldn’t affect you. Unfortunately, with the ACA, we’re all in this mess together, which means we all affect each other. It becomes absolutely imperative that we all strive to be the healthiest people we can be so as to reduce the economic burden on our neighbors.
Please don’t think I’m down on obese people to the exclusion of smokers or alcoholics or whatever. I’m using obesity as my demonstration condition because of the costs associated with it and it’s lack of social stigmaticism. My Baptist friends who don’t drink or smoke will smugly sit on their ample rears complaining that I’m wrong. “Being overweight is not unhealthy and has no impact on the cost of healthcare,” they will say.
Sorry, folks. You’re wrong. Research demonstrates that obesity and even being moderately overweight are the second leading causes of preventable death, right behind tobacco usage.
Here are some alarming economic implications for obesity:
- Obese adults spend 42% more on direct medical care costs than adults who are a healthy weight.
- Per capita medical care costs for severely or morbidly obese adults (BMI >40) are 81% higher than for healthy weight adults. In 2000, around $11 billion was spent on medical expenditures for morbidly obese U.S. adults.
- Moderately obese (BMI between 30 and 35) individuals are more than twice as likely as healthy weight individuals to be prescribed prescription pharmaceuticals to manage medical conditions.
Did you know that 68.8% of the US citizens are considered overweight and obese? That represents a dramatic impact of overweight and obese individuals upon our medical care system.
Obesity is just one of many other preventable medical conditions that contribute to the cost of medical insurance, but obesity and being overweight are the most widespread.
We would all be personally well-serviced by quitting smoking, drinking less alcohol, exercising more, making better food choices, taking supplements wisely, and getting adequate sleep. There’s the direct positive impact on yourself, but better health habits would have a direct positive impact on the economy, and especially those of us who are forced to bear the cost of our nation’s medical care costs.
Unfortunately, you won’t see a financial benefit to making these changes. Unlike car insurance, where you receive lower premiums if you are a good driver who doesn’t have a lot of accidents, getting healthy doesn’t work the same way. Unlike life insurance, where you receive lower premiums if you’re a healthy individual, the ACA assures you will be paying for others who don’t make the same wise choices.
A less health population, which is indicated by slipping mortality rates. Although it sounds like such a great idea to provide medical insurance to everyone so they will be “healthier”, the reality is that the United States population has become less healthy as more of us have become covered by medical insurance.
There’s a lot of misinformation floated about Obamacare repeal. For example, the hysteria over how “20 Million people will lose coverage” – absolutely not true.
These figures are from Forbes and the Heritage Foundation, taken from actual government statistics.
The United States medical care crisis has been a long time coming.
In 1910, the physician oligopoly was started during the Republican administration of William Taft. The American Medical Association lobbied the states to strengthen the regulation of medical licensure and allow their state AMA offices to oversee the closure or merger of nearly half of medical schools and also the reduction of class sizes. Those restrictions remain in place today, severely curtailing the number of doctors who can enter the market because the bar is very high to get into medical school.
In 1925, prescription drug monopolies begun after the federal government (under Republican President Calvin Coolidge) started allowing the patenting of drugs, essentially creating monopolies.
In 1945, buyer monopolization begun after the McCarran-Ferguson Act led by the Roosevelt Administration exempted the business of medical insurance from most federal regulation, including antitrust laws. (States have also more recently contributed to the monopolization by requiring health care plans to meet standards for coverage.)
In 1946, institutional provider monopolization begun after favored hospitals received federal subsidies in the form of matching grants and loans provided under the Hospital Survey and Construction Act, passed during the Truman Administration.
In 1951, employers started to become the dominant third-party insurance buyer during the Truman Administration after the Internal Revenue Service declared group premiums tax-deductible.
In 1965, nationalization was started with a government buyer monopoly after the Johnson Administration-led passage of Medicare and Medicaid which provided government-provided health insurance for the elderly and poor, respectively.
In 1972, institutional provider monopolization was strengthened after the Nixon Administration restricted the supply of hospitals by requiring federal certificates-of-need for the construction of medical facilities.
In 1974, buyer monopolization was strengthened during the Nixon Administration after the Employee Retirement Income Security Act exempted employee health benefit plans offered by large employers (e.g., HMOs) from state regulations and lawsuits (e.g., brought by people denied coverage).
In 1984, prescription drug monopolies were strengthened during the Reagan Administration after the Drug Price Competition and Patent Term Restoration Act permitted the extension of patents beyond 20 years. The government has also allowed pharmaceuticals companies to bribe physicians to prescribe more expensive drugs.
In 2003, prescription drug monopolies were strengthened during the Bush Administration after the Medicare Prescription Drug, Improvement, and Modernization Act provided subsidies to the elderly for drugs.
In 2014, nationalization was further strengthened after the Patient Protection and Affordable Care Act of 2010 (“Obamacare”) provided mandates, subsidies and insurance exchanges, and the expansion of Medicaid.
With each new law or set of new regulations, restrictions on the medical care market went further, until, at some point in the 1980s, people began to notice the cost of medical care had skyrocketed … soon to be followed by the cost of medical insurance.
As regulators allowed special interests to help design policy, everything from medical education to drugs became dominated by virtual monopolies that wouldn’t have existed if not for government’s notion that intervening in people’s lives is part of their job.
We started meddling in 1910, but costs didn’t go up immediately and that causes a lot of short-sighted people to think the regulation is not related to the increased costs. They’re wrong, but some regulation was more harmful than other regulation.
In 1972 President Nixon restricted the supply of hospitals and clinics by requiring institutions to provide a certificate-of-need, then in 1974, the president strengthened unions for hospital workers by boosting pension protections, which increased the cost for hospitals. This move began to force doctors who once owned and ran their own hospitals to merge into provider monopolies. These, in turn, are often only able to keep their doors open with the help of government subsidies, so increasing costs to taxpayers..
As the number of hospitals and clinics became further restricted and the medical care industry became obsessed with simple compliance, patients were the first to feel abandoned. According to Business Insider, the average doctor has thousands of patients, and each visit lasts less than 30 minutes. As many in my parents’ generation can attest, doctors listened to their patients prior to the government’s slow but absolute control of medical care, doctors listened to the patients and medical care was easily affordable. Now, doctors can hardly recall the conversations they have with the people they are supposed to be looking after.
Insurance is not the same thing as medical care, but President Barack Obama pushed further restrictions on the insurance industry by touting the Affordable Care Act as a piece of legislation that would make insurance more affordable. That didn’t work out. Insurance had already been increasingly slowly over the years, but since the passage of the ACA, there’s been an average increase of 153% in premiums. And as a result, a new group of independent medical care professionals ignited one of the most liberating revolutions in recent U.S. history. As ACA became increasingly suffocating to patients and providers, many doctors ditched the system altogether while others went into the primary care business.
On average, members of these direct primary care clinics pay as little as $60 per month, with couples paying about $150, which is a lot less than the cost of full medical insurance. Without having to handle heavily regulated middlemen, patients have a clearer picture of how much they spend on their health by being members of such practices. They also enjoy the peace of mind of knowing their doctor.
Studies have already demonstrated that when there is good communication between doctors and patients, treatments are more efficient. This is not simply because doctors are giving patients attention, but also because they are able to tailor a certain treatment to that patient’s lifestyle, health, and activities.
What many people don’t understand about government-run medical care is that government bureaucrats apply a one-size-fits-all mentality to everything, but what bureaucrats fail to understand is that they do not possess all the answers. Only a doctor who is paying attention will be better able to help the individual patient. Those needs cannot be addressed by a few thousand new regulations under either the ACA or the AHCA.
What this growing movement seems to suggest is that, even if doctors and patients are unaware of the interventionist forces driving the cost of doing business and receiving medical attention, they’re still driven into the open arms of the free market at some point or another.
I believe that we all have a right to medical care, but not in the way the progressives want us to believe. My belief is similar to the belief I have in the right of free speech and the press. You have a right to write and publish and to gain access to the tools to do so, but you don’t have a right to compel others do do it for you. So, if the local newspaper doesn’t want to run your article, it doesn’t have to, but if you pay for a blog or your own printing press, nobody has a right to stop you from publishing.
I have the same belief in the right to medical care. You have a right to access care that you pay for, but you don’t have a right to compel others to provide it for you.
Sadly, the United States government at both the state and federal level have erected barriers that limit your access to medical care. The steepest of those barriers are the licensing laws. Removing those barriers should lower costs while improving quality.
Both of my children and two of Rick’s grandchildren were delivered by direct-entry midwives, but barriers against such practitioners in many states limit access, driving up prices and, if you compare US outcomes to European outcomes, endangering the lives of mothers and their children.
Regarding the different classifications of midwives, the regulations vary from state to state. Nurse-Midwives are legal nationwide but different states have different regulations that cover what they may do, if they can work independently of a doctor, or if they must be supervised by one.
Certified Professional Midwives (CPMs) have been to a school for training but are not nurses. Twenty-six states allow CPMs to practice with some variations in what they legally can do.
Direct entry midwives typically study as an apprentice under someone else before beginning their individual practice, and their practice varies from state to state. Their legal standing is not clear in some states.
Since Medicaid pays for almost 50% of all births, midwives offer the nation an opportunity to save tax dollars while providing mothers with another choice. Europe uses direct entry midwives for 80% of their deliveries, nurse-midwives for most all of the others and their mortality rate for mother and child are much much lower.
It isn’t just the barriers to midwives that have created problems for patients. Other workers have seen their professions restricted as well, and with that comes physical and financial harm to patients. Nurse practitioners should be at the top of any list of professionals allowed to work without restrictions nationwide.
Nurse practitioners are an often overlooked source of health care and, according to Kaiser Family Foundation, can “manage 80-90% of care provided by primary care physicians.” Research shows that patients are just as satisfied with the quality of care provided by nurse practitioners as by primary care physicians.
An Institute of Medicine Report, from 2011, The Future of Nursing: Leading Change, Advancing Health, states that “what nurse practitioners can do once they graduate varies widely for reasons that are related not to their ability, education or training, or safety concerns, but to the political decisions of the state in which they work.”
Twenty states allow nurse practitioners to work independently of physicians to diagnose and treat patients. Twelve states require physicians to supervise nurse practitioners. Nineteen states allow them to practice as long as they have an agreement to work in collaboration with a physician. Other laws limit their scope of practice by not allowing practitioners to prescribe drugs.
With the aging of society, we will see an increase in the need for medical care, but layer upon layer of regulations makes it hard for practitioners to enter the field and thereby makes care expensive, complex and frequently unavailable.
Removing these barriers is key to improving access to medical care and lowering costs. Obamacare made those barriers even higher, but now we have an opportunity to remove the barriers entirely and allow the open market to work as it should. Let’s lead the way!
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.
I’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 insurance, but 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