Wesley James Young and Dave Imbriaco: Points on Healthcare
What is Seen and Not Seen,
Wesley James Young:
The most important point about health care is whether or not the sick are being healed. The current debates over insurance schemes are disingenuous to this self-evident truth. Insurance does not guarantee treatment[1], as you may know from the many complains about long waits in European countries for treatment. Insurance is supposed to guarantee that people will be paid for their labor, but that is not necessarily the case[2][3]. The doctor is less wealthy when confined to the artifice of a state run system. There are those who would point out that we could correct the problem doctors fleeing from the state and turning away Medicare and uninsured patients by forcing all doctors to work for the state, but that opens a new set of problems. What happens to insurance companies and the people they employ? How will the state allocate resources without creating shortages? If the last question perplexes you, consider the tendency for Canadians to cross the border to get operations they cannot afford to wait for. Insurance does not lower costs, it merely hides them.
People demand three things in their health care: the latest treatment, with unlimited access, immediately. Unlimited access requires someone to pay. One might think that the state can raise taxes to pay for these costs, but it does not work like that. The prices rise and the state can no longer afford to pay for them. The ignobly quixotic movie Sicko had many sad stories about people being denied treatment by insurance companies. Unfortunately someone else, the state, has to deny treatment across the pond[4]. Lower wait times requires more hospitals and more doctors, an expense that makes things worse for state run systems. Some people are against insurance companies screening for pre-existing conditions and charging higher premiums. If everyone has to pay the same rate and sicker people cost more, then what happens to insurance rates? The rates can rise or they might stay the same and the coverage will decrease.
There is more that can be said about the problems of health care, but three paragraphs is hardly enough. Some changes that may improve the current set of arrangements are: Allowing more flexibility in insurance premiums, changing the way Medicare pays doctors so they are less incentivized to give more treatments regardless of cost, making medical malpractice suits more costly to the plaintiff, removing the various laws regulating what an insurance company has to provide in a plan. Some of these points may not directly connect with earlier statements but the space allotted does not allow for a complete coverage of every point to be made. Hopefully you will give them their due consideration.
A Timid Observer,
Dave Imbriaco:
First and foremost, the American healthcare system is broken beyond repair. The United States spends more than any other developed nation on healthcare and gets worse results. France and Canada, who have universal coverage, pay $2,931 and $2,736 per individual annually on healthcare while the United States pays $5,267 per person per year.[5] The fact that we spend nearly double what our northern neighbors do on healthcare and have horrific results is pathetic. Furthermore, if nothing is done to fix our healthcare system, by 2016 we will be spending $4 TRILLION, yes, trillion, on healthcare alone (20% of our GDP).[6] Last year, we spent $2.4 trillion on healthcare nationally[7] (given these numbers, a $1 trillion (the plan is now speculated to cost a little more than half that original amount) reform package sounds a lot more appealing now, doesn’t it?). Lastly, only in American can you legally be kicked off of your healthcare plan even if you’ve paid all your bills and premiums as soon as you get sick. Don’t believe me? Three different insurance executives told Congress themselves that they would.[8] We’re America for Christ’s sake, we can do better than this.
Healthcare reform is also not real without the creation of a strong government-sponsored program. Such a program can be funded by increasing taxes on people making more than $250,000 a year (about 2% of Americans, I’m utterly sick of all these “tea parties”). We simply cannot trust the private insurance companies to reform and police themselves in lieu of real reforms. My conservative opponents will argue here that this will jeopardize the entire healthcare industry and potentially put private insurers out of business. So what? It’s the private insurers that deny people coverage for “pre-existing conditions”, arbitrarily raise premiums on a whim and look for any way possible to get out of paying up when you do in fact get sick. Unless they make drastic changes to how they do business, if private insurance companies are put out of business by cheaper, better government healthcare, good riddance. The free market is the wrong tool to guide health insurance – profit should not be an incentive in healthcare: care should be the incentive.
Conservatives love to look for Canadians or Europeans who are dissatisfied with their healthcare systems to argue that public healthcare is a bad idea. Yes, public systems have problems but the benefits of public healthcare far outweigh the costs of it. Public health care isn’t some draconian system that “puts a government bureaucrat in between you and your doctor” – the biggest lie currently being spread about government plans by the American Right – a public healthcare system that is accountable to all taxpayers and not a small group of shareholders and executives will keep Americans healthier. The for-profit healthcare system that we have in America is really what is making us sick as a nation. As mentioned previously, if nothing is done, healthcare spending is going to essentially bankrupt the federal government faster than the Republican Party.
[1] http://www.guardian.co.uk/uk/2007/jun/07/politics.health
[2] http://www.spiegel.de/international/0,1518,399537,00.html
[3] http://www.nytimes.com/1992/04/12/us/physicians-refuse-medicare-patients.html
[4] http://online.wsj.com/article/SB124692973435303415.html
[5]http://www.outsidethebeltway.com/archives/health_care_spending_international_comparisons/
[6] http://www.nchc.org/facts/cost.shtml
[7] http://www.nchc.org/facts/cost.shtml
[8] http://www.latimes.com/business/la-fi-rescind17-2009jun17,0,3508020,full.story
Hi Guys,
Both here in my “Fatherly Governance” column and on FaceBook, http://www.facebook.com/home.php?ref=home#/topic.php?uid=73970050251&topic=10203, I advocate replacing health insurance with Municipal Medical Departments (MMDs).
My father pointed out to me, some forty odd years ago when medical insurance started, their fundamental economic truth: health prices reach equilibrium at out-of-pocket cost to the “consumer” or, more concretely, a 20% co-pay resulted in a fivefold increase of doctor and hospital fees. That is what has been driving the astronomical growth of health prices.
By removing this distortion to the market for medical services and rolling many of the expenses into state medical educational systems, MMDs will easily roll back total medical expenses to their 1950’s , pre-medical-insurance levels.
“The ignobly quixotic movie Sicko had many sad stories about people being denied treatment by insurance companies. Unfortunately someone else, the state, has to deny treatment across the pond.”
Yeah, but they’re being “denied” (in reality, they’re just waiting, sometimes for rather long times, yes) OPTIONAL surgeries and treatments. If what they needed was life-threatening, they would be seen right away. Sadly, this is not the case in America as Sicko pointed out.
“Lower wait times requires more hospitals and more doctors, an expense that makes things worse for state run systems.”
Why does a government program get worse only because it gets bigger? Why didn’t we apply the same logic to companies like AIG over the past 8 years? Not to mention there are programs that encourage people to become doctors in fields with high demand. I don’t remember the name of the specific program, but there’s one that essentially pays for one’s Medical Schooling in full if they go into a medical field that needs more doctors.
In answer to your first point: That would depend on the immenance of death. A man having a stroke is hardly the same thing as a man dying of cancer.
In answer to you second point I provide the following exemplar: due to the high intial cost and low marginal gains, it is cheaper for one hospital in a given area to have a MRI machine than for evry hospial to have one. But going for the cheaper option will lead to a longer wait time for an MRI scan.
If every hospital purchases an MRI machine, then the resulting customer base that will use these machines will be diluted between each hospital. Faced with low demand for the MRI machine, the hospital will increase the price to cover its costs. This will effectively prevent many people from ever affording an MRI let alone just having to wait for one. I believe that given the choice between no health care and waiting for health care, most people would choose waiting for health care over and over again. And for all the comments about problems with European health care, I have never met a single European who would trade their system of health care for ours. Further, the number of Canadians who travel to the United States is tiny compared to the number of Americans who travel abroad for medical procedures. Costa Rica is beginning to develop a “medi-tourism” industry. My parents went there for a trip (for eco-tourism purposes) and met an American who was there for back surgery. He injured his back working (in construction or carpentry I believe) and his insurance would not cover the procedure in the United States. He traveled to Costa Rica and obtained the procedure at a fraction of the cost (my memory recalls that it was between 1/5 and 1/4 of the price in the States), and received the same level of care he would have had in America.
“I believe that given the choice between no health care and waiting for health care, most people would choose waiting for health care over and over again.”
My experience leads me to agree.
Perhaps this may helpful for those of you who have not experienced socialized medicine firsthand and instead rely on what is told to them secondhand. I read this debate and could not help but mention that I was just treated for a very minor medical problem in a country with socialized medicine (Greece). Even though my problem was extremely minor and did not need to be addressed that day (or even that week, for that matter), I was in and out of the hospital in about an hour and a half at the most. While I waited, people with serious medical problems jumped the line and were admitted immediately. Moreover, this occurred on a Monday, a day in which more government operated buildings are closed than not in Greece for cultural reasons. As someone who has private medical insurance back in America, this system does not seem in the least bit ineffective to me; I did not wait for an absurd amount of time and my ailment was addressed.
In response to Alex: My attempts to locate sources to help me accertain why the price differental exists in Costa Rica have been fuitless but I am not certain one can make an apples to apples comparison of our country and their. The price differental may have a lot more to do with Costa Rica being a less wealth country. the buying power of $3,000 in the south may be similar to the buying power of $14,000 here. Of course this is simply speculation and I would need more data before I could argue this as fact.
I would also be cautious of holding a contry with at least 12% inflation and no millitary to spend money on as firm basis of comparison. One is an argument for the insustainability of such a plan on these shores and the other is an argument for the possible insustainability of such a plan on their shores.
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