Who Will Pay for Healthcare?
June 5, 2009 by Will Marre
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As the debate on health care rages on in Congress it is sobering to watch the gears of politics grind slowly through the constant dump trucks of sand delivered by the powerful economic interests of the health industry. The incentives of the industry are often contrary to health. Insurance companies make money by charging small companies and individuals who have no bargaining power exorbitantly higher rates than employees of the government or large companies who do. Insurers make more by denying claims of the seriously ill and excluding people who are afflicted with a pre-existing condition. In short, they prosper and please their Wall Street analysts by limiting benefits, which is a cruel way of rationing health care. That’s the very term the far right uses who oppose universal health care.
The economics of drugs is also a labyrinth of questionable practices. Many drugs come as the result of taxpayer-supported research at the National Institutes of Health. Drugs’ retail cost varies greatly based on what country you live in or health plan you have. Again those who have no bargaining leverage pay the most. And most strangely the drug companies spend much more on consumer advertising than on research.
On the cause of the illness side of things, we have cigarette makers who don’t want to be regulated by the FDA even though their product kills 400,000 Americans a year and will kill over a billion people worldwide in this century. That’s 15% of the entire world population currently living. And the fake food industry continues to design, package and sell high calorie low value foods to people most unable to find affordable fresh food. Of course these industries massage their collective consciousnesses by telling themselves we only make what people want. If that logic absolves them from the death and suffering caused by the common use of their products then I guess it’s hard to blame cocaine and meth. dealers who are only meeting the demands of the market. It all carries an economic logic that relieves everyone of his or her social responsibility until your mother or sister starts suffering from diabetes or your father dies of lung cancer.
So we have Congress and their mighty lobbyists trying to sort out an affordable health care plan. I am pessimistic because today we need leadership not compromise. Compromise which ends up with a little of this or a little of that produces a lot of nothing for consumers and new revenue streams for those who see this as an economic exercise.
There are many brilliant solutions to our many health care challenges. And yes, they would overall cost all of us less money, but we have no voice in this debate because there is nothing to be economically gained. So the gears grind on. Who will pay? We will. What are your ideas/solutions?
For more on my views of health care, read the 4th American Revolution.
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I’m also fairly pessimistic about health care in this country. Too much money and political power in the existing system. There is no incentive to change until they suck the whole economy down with it. They won’t change until we the people take the money away from them. Not likely to happen anytime soon.
I’m very optimistic about the future of healthcare in this country and around the world. People are beginning to realize that the government and the large pharma companies, insurance companies and huge institutionalized health conglomerates can not help them as much as they can help themselves.
And as the big companies and governments crumble under their own weight, the individual becomes empowered.
Can healthcare reform be accomplished in our lifetime? It all depends on the context and definition in which we place reform. We shall see some form of action during the current administration’s term-whom will it be beneficial to? The populous? The government? The investors?
I seriously doubt the nod will go to the people who need it most. The goods and services that are provided in the states, not to mention the research, are superior and vastly more expensive than in any other part of the world.
This cleaves the classes into two succinct parts: the haves and the have nots. If one becomes seriously ill, it is difficult to imagine that the state will pick up the tab or subsidize it enough to where it becomes affordable. Whereas those who have money need not worry about such a partnership.
One need only merely look at the dental profession and their model for wellness. Without HMO participation, wellness and prevention costs are relatively low and major surgery is usually not stratospheric.
A study of industrialized nations with universal healthcare is warranted. I am quite familiar with a few European models, where the income tax rates are higher (with the exception of England who employs a sliding tax scale and still manages to offer universal healthcare) but service suffers a bit while covering all for their basic needs.
Much of America’s health issues are germane to eating/exercise habits. The FDA isn’t very helpful either because they are tied into NAFTA treaties and imposing their will on much of Europe. If we can educate ourselves about who the FDA really is and how they operate than wellness can begin. Perhaps then we can begin to shy away from all of the “illnesses” or diagnosis therein, where we continue to keep drug companies and ancillary corporations in business. Then we can begin to see the savings and benefits of a true universal health care system.
Sometimes to see the illumination of day we must shake hands with the dark of night.
Thank you Bill, for another eloquently put, and important message.
Over and over the media pushes the messages of the PR firms (public relations firms) that are hired by the big guns in the current system of medicine. Don’t call it “health care,” because it is not. It is merely disease management. Yet the insurance and pharmaceutical lobbyists, along with hospital associations lobbyists want everybody to be part of their system. They would love for it to be mandated that every person is required to take part in their broken system. Well, I don’t want that!
It sickens me when over and over, people tell me that their visits to the doctor are covered so they don’t cost anything. They really think they are getting their disease management for free. What a joke! What about that insurance premium you just paid, and paid last month, and paid every month since you’ve had your insurance plan? Oh, you don’t pay a premium? Then your boss is paying it. It’s not free. And if it comes out of your paycheck on payday, it is still not free.
Then there’s the false belief that you are really saving money by only going to the “providers” on your plan. This limits you in your choices for your own health. Imagine, you just met a different type of licensed doctor who knows he can help you without pharmaceuticals, yet since this other type of licensed doctor is not on your stingy plan, you think it costs more to go to him, and you don’t.
So you keep going through the whole route of “this medication,” “that medication,” “this doctor on your plan,” “that doctor on your plan,” and after more than 3 months your condition is now chronic. How much did you really pay for that “free” medical management? Count up the number of months you were on the plan, and multiply by the premium you (or your boss) pay. Would you have ever spent nearly as much for something that doesn’t work after 3 months if it were being paid directly to the doctor? No way!
So you go to this doctor who is not on your plan, and find out it will take a month to see substantial improvement, but you think it is just way too expensive because you have to pay the doctor directly (even though his fees will be less than the amount of your monthly insurance premiums). So you keep going back to the same old disease management that you have been using because you think it is “free.”
Well, this is the broken system that the big money in medicine want everyone to have. They keep saying, through their public relations firms - disguised as news - that if everyone would just play their game and be on their plans, your premiums would go down. Now, if you are a thinking person, you can’t possibly believe that line of reasoning! When a business controls all of the market share, does it mean they just lower their prices, just to be fair? No way.
We should never be forced to participate in the broken, disease management plans of today, just because some selfish people think they will reduce their premiums or believe they will get something for free.
Solutions:
1. Self care. Most people buy insurance, or want insurance because they think they will get some kind of chronic disease. Chronic disease is most often related to lifestyle choices. Wake up! You can’t eat junk food everyday and think that you will be able to maintain your health!
2. Healthy care. Imagine going to a new kind of doctor who is not searching for disease in your body, but instead is looking for signs of outstanding health. You go to this new kind of doctor and you discus diet, supplementation, sleeping habits, and other lifestyle choices that will lead you on a path of health, not chronic disease.
3. Crisis care. This is exactly the system we have today, and it is necessary in a very limited role. It is the other main reason why people want insurance plans. Let’s get chronic disease management out of crisis care. Chronic disease (more than three months duration) is largely preventable by proper self care and healthy care. Insurance plans that cover crisis care alone, without all the bells and whistles, would have to be priced differently than the current types of bloated plans of today. That is, of course, unless people continue to believe that when insurance company profits go down, that premiums must go up.
See another article I wrote related to this topic at:
<a href=”Original_Articles_by_Dr._Lieberman_5.html” title=”managed care and insurance company lists”
Interesting topic Will.
I remember having discussions with friends during the elections and debates over healthcare and I came up with an idea I like to call “dying to see the doctor”.
I wondered what would happen if every American had a 50k life insurance policy. In my figures I made the govenrment the insurance company that sells a policy for $60 per year to every man, woman and child in America.
The idea would generate $87.3 billion in net revenues for a healthcare plan (based on current death rates). According to the Obama/Biden plan - more than enough to cover all the uninsured in America.
For a family of 4 the plan would cost .65 cents a day. If they paid premiums for a lifetime they would total $18,840 and return $200,000 to their family in death benefits.
I am sure there are a thousand reasons not to do something like this, but it is fun to think about…
Stan
Personally, I am sick and tired of governments, ANYWHERE. Since everyone’s 40% that goes to the FEDS goes towards absolutely nothing but paying off the debt to international bankers, how about we stop paying them. Our government doesn’t work for you or me anymore, and that is a fact. Name me one thing that has worked ? Really worked. All of these people aren’t PUBLIC SERVANTS anymore, they are CAREER politicians, exactly the opposite of what the founding fathers had in mind for this country. They’re not just serving the country for 4 to 8 years, they’re now worried about their paycheck and retirement just like anyone else is. The level of conflict of interest on Capital Hill is the highest anywhere in the world.
The only way we find ourselves in a better situation is one thing- DOWNSIZING the government. People might not want to admit to it, they might be too scared, or too busy with their own lives, but we are in a state of tyranny. We truly are. We have been taken over by bankers. They are centralizing power. Massive consolidation.
Universal healthcare happens when we stop paying the 40% to the FEDS, and KEEPING IT. We take care of ourselves !! Let the states handle everything else. The FEDS DO NOT have your best interest, trust me. I feel like I’m in a Twilight Zone episode, with experiencing a new war every 8 years to make sure the Military Industrial Complex is satasfied and cashing checks still. Then big pharmaceutical comes out with a new drug to make sure a 5 year old has a longer attention span. The state of this country is ridiculous, and sadly, will continue to be. ALL BY DESIGN.
Godspeed.
By the way, I totallty forgot to add. This country will never be about CURING people. This country will always be about MAINTAINING people. Big pharmaceutical doesn’t want to CURE you, they want to MAINTAIN you. Why ? Very simple, MORE MONNNEEEYYYY. They want you to keep popping pills to maintain yourself. There is NO MONEY in curing people !! Just for me personally, I found that the farther away I take myself from the whole “American” lifestyle and mentality, the healthier I get. No pill popping. No junk food. Nothing processed. No GMO’s. I keep it all completely natural and organic. And hope for the best.
Godspeed.
Universal health insurance is a must! We already are paying for the uninsured through higher costs for insurance and every other aspect of health care. Many people who can afford health insurance simply don’t get it then declare bankruptcy if they have a health crisis (I’ve had many people tell me that this is their plan). This just dumps the costs on those who do pay. Some people can’t afford health insurance or can’t get insurance. Are we really willing to let these people suffer (many through no fault of their own)?
Some of our current health care cost is due to people not getting the preventive services they need due to cost. So they delay and their care ends up costing many times more.
I do think that personal responsibility should be considered. Incentives (such as care beyond the basics) should be given to people who live preventive lifestyles. You smoke, you lose (or do not gain) some coverage. Etc.
However, in the process of covering everyone we must get the cost down. That means shedding the litigation costs that add to every aspect of health care: malpractice, equipment, drugs, etc. Mediation is a good alternative.
We need to get the pharmaceutical companies to change the way they do business while protecting people against the selling drugs with known harmful side effects. Expedite the drug testing process.
We need to expedite the entire system, decrease the paperwork/red tape, centralize services, go back to nonprofit hospitals, control CEO pay, etc.
For the amount that I pay out-of-pocket for insurance, I could easily pay more taxes. If the system was centralized, it would be easier to control costs including the pharmaceutical companies. As a civilized country, I do not understand how we can continue to let people suffer, worrying about getting the care they need. Those people who do not support universal coverage may not know someone who has used up all their benefits due to some catastrophic health incident (an accident, etc). It could easily happen to you or someone you love.
[...] be. So let’s hear your ideas. You can also read some of your ideas/comments on my post, “Who Will Pay for Healthcare.” Thank you for your insightful [...]