Monday, January 7, 2008

Finding Money to Feed the Monster

I watched my first political debates Saturday. There are several reasons these were the first. To begin with, I don't believe there should be any debates in an election year before the actual election year. Secondly, it was on a Saturday night, instead of Sunday, when people should have other, more restful things to do. Thirdly, it was moderated by Charlie Gibson, who, if he were running, would be my candidate of choice, regardless of his party. He looked better than anyone behind the desks.

While much of the debate was mildly entertaining, not really much was accomplished. Sure, they say that Romney and Clinton took a beating, but after all, this is New Hampshire, and by Super Tuesday, these delegates won't even matter. It was the same with Iowa. The Caucus meant even less. The dirty secret seems to be that, even though she finished third, Hilary actually garnered the most delegates. I must admit that, first, I wouldn't know why, and second, I don't even know if that's true. One reason to doubt it is because Obama hasn't thrown a fit about it.

So what did I learn from the debates? That no one has a real health care plan. Don't get me wrong. I think everyone talked about health care, though I can't remember what Richardson said. But, for all the differences that the Democrats and Republicans have, they have one thing in common. When they hear "health care," the only thing they see is insurance. If I heard right, Romney, McCain, Huckabee, Giuliani, et. al. want to make sure that the government makes health insurance available to everyone. They have different methods, but really, they all end up in the same dark alley, which will be familiar to the American taxpayer, as he has been mugged there before. The Democrats, on the other hand, don't want to facilitate health care; they want to be health care. Whereas the Republicans just want to roll you and leave you face down without your wallet, the Democrats want to make sure you never get up. Lest that be considered favoritism of one party's plan over another, let me quickly say that both plans will kill what little health care that is currently available to self-sufficient American citizens.

The problem is that they are going to insurance first. That was never intended. If you are under 40 and reading this article, it may come as a surprise to you that there was a time it did not take a day's wages to visit your doctor at the local clinic. Amazingly, for that low price, he could get everything done in one visit, and many times, he didn't even have to write a prescription because he had fixed everything in his office.

I blame insurance for the current medical crisis in our country, but not for the same reasons as the candidates did Saturday night. To them, it is the big, ugly insurance conglomerate that is taking our money and then refusing to pay our medical bills. While I acknowledge that there is much that needs to be changed in the insurance industry, let's see how they got there.

For that, I would like to take you to an emergency room visit two years ago with one of my own children. We thought he had fractured a femur; thankfully, he had only bruised it, and we received quality medical care. The sign at the emergency room told us that the fee was 200 dollars. I didn't worry too much, because my policy at the time paid up to 200 dollars for an ER visit. However, I got a bill for 250 dollars. Does that mean they added fifty dollars to my bill? Of course not! That would be unethical! They actually added 250 dollars to my bill. You see, that sign was for the uninsured. When you have insurance, your company is billed 450 dollars. After my company paid the bill, I had to pay the difference. If I had just not told them I had insurance (at a cost of 550 a month at the time), I could have gotten off for fifty dollars less. I have a new company now, and we have an agreement. The ER never sees my insurance card. They just send me a bill, which I pay and then send to my insurance company, who reimburses me.

My doctor's office wanted to see my card on the last visit. I said I didn't have one. "Oh," she said, "Surely you have insurance." I explained that I had only hospitalization, that I had no copay or other help. She still wanted to see the card because, in her words, "We often can still get something from them." I refused, and she shrugged and hit the "print" key. I had already written the 75 dollar check, and saw the bill for 60 dollars. I quietly flipped past that check and wrote one for fifteen dollars less than the little blue sign over the cash register said. Why? Because it's cheaper when you don't have insurance.

I want to tell everyone the truth, a truth so clear that I don't understand why no one in Washington sees it: our number one culprit of higher medical costs is the abundant availability of insurance plans, and the medical community's abuse of it. Have you ever been billed by a hospital after your insurance had already paid them? I have, and I'll bet you your next month's premium you have, too. Those of you in big company group insurance plans don't count. In those, the hospital just double-bills the insurance company, and usually gets it.

If we try to solve the medical care crisis by increasing insurance coverage and funding it with phantom government dollars, Huckabee's statement will soon be truth instead of hyperbole: a kleenex will be a thousand dollars. In the 1970's it was 15000 dollars for an allen wrench in a military contract, or 800 dollars for a hammer or commode seat. We've seen how providers work when they have government deep pockets to pick.

I would like to see one person attack the real problem: actual medical costs. It has been too easy for 40 years: if insurance is paying it, we don't worry about the cost. I know a man who is in great shape for his 80 years, who was confronted by his doctor who wanted to run an unnecessary test. After being told that, one, he didn't need it, and two, it was expensive, the doctor responded, "Why worry? Your medicare will pay for it!"

I have a solution to the health care crisis, but I know it's unworkable. If tomorrow morning, every American canceled his or her insurance coverage, opted out of medicare and medicaid, it would be a rough six months, after which, the prices for medical care would start to plummet toward reasonable rates.

Major insurance companies and medicare are, at this moment, food for a ravenous beast, a growing medical culture that demands ever-higher prices. Local hospitals and clinics are closing, and family doctors are moving from the small cities. Medical treatments take more than one visit now, and doctors are specialized and require that we be bounced from clinic to clinic. True specialists won't see us until we pay another doctor a hundred dollars to recommend us to him.

And we do it because "insurance will pay for it." The big monster is fed, and he grows bigger, needing ever more food. Now, our top ten candidates (with the possible exception of Ron Paul) think the answer to the health care crisis is to put more money into it, feed it, and make it bigger.

John Edwards wants to require us to have two government-paid physicals every year. That's just what we need: make everyone go two more times a year to the already overcrowded clinics and wait an hour and a half beyond our scheduled appointment. I seriously doubt that Edwards has been in a public clinic -- at least without a legal deposition in his hand -- in thirty years.

One more thing. One candidate, maybe Edwards, but it could have been Obama, said that his recommendation was that all Americans get the excellent coverage that he and his fellow lawmakers get. I have a better idea: that he and his fellow lawmakers get the substandard coverage that we do. If Hilary had to go to the same clinics we do, with the same insurance we have, she would not be touting universal health care; she would be demanding what I'm talking about: affordable health care.

There was a time when routine medical care could be covered out of pocket. A night in a hospital room was much cheaper than a night on a luxury liner. That's no longer true because we continue to feed the monster, and I'm afraid that in November, Americans will elect a president and congress that want to solve the problem by giving it more food.

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