My last column on my experience with the health care system in our valley garnered more than the normal number of responses, and a couple of them caught my attention. They also show the disparate ways people want the issue addressed. For this column, I’ll offer a general replay to the first. And if Congress hasn’t screwed up our health insurance system before the next paper, we’ll have some fun with the second in that edition.
The first response came from a local insurance person I know and respect. His initial comment caught me off guard, but I understood why it was said. That’s because I didn’t fully ferret out my thoughts and point in my previous column, particularly in my closing comments related to single-payer health care and how it would destroy our current level of care.
So, to expand a little on what I wanted the gist of my previous column to be about was the quality of the people and facilities providing health care in our valley. I’ve had great experiences at St. Mary’s Hospital, Community Hospital and Colorado Canyons Hospital — all in the past year. The people who work there are wonderful, the facilities top-notch and services and care they provide excellent.
I tried to piggy back that onto what I feel is the greatest threat to that kind of service, which is single-payer, line-item budgeted, government-run health care in which bureaucrats would decide who gets what care and when, what facilities or doctors can perform the services and how much those facilities will be paid. I fear this greatly because that’s the only way government can run a self-insured, budgeted program. Which brings me to the point my reader made.
The reader correctly pointed out that the care my parents have received was indeed through my much-feared, single-payer, government-based system called Medicare. But only in this sense: My parents had no choice. There’s simply no opt-out of Medicare on one’s paycheck. There are no options in one’s payroll deductions to set up an account using the “Medi” taxes to fund health insurance for later years in life.
Secondarily, Medicare is supposedly a self-funded insurance program. Therefore, the health care those insured should have access to should not differ from anyone else’s private insurance-based care. But that’s not how it works, and there are myriad reasons. It mostly comes down the simple fact Medicare reimburses based on dollars budgeted, and those dollars are necessarily rationed because there’s only so much money each year allotted for services. There’re only two ways to meet that shortfall, both of which create some form of crises: Rationing the amount of care patients have access to in terms of services or reimbursing at a consistently lower rate. We tend to use more of the latter than the former. But in the end, the latter will always lead to the former. Don’t think so? Ask yourself why more and more doctors refuse Medicaid patients.
So, there’s my better explanation of why I oppose single-payer, line-item budgeted, government-run health care. I also hope you’ll start referring to it in that manner because it could get the message across to those who blindly support it. Let me put it this way, if your government-based policy is budgeted to provide 20,000 bypass surgeries for a given fiscal year, you better hope you aren’t bypass number 23,250 eight months into that year. Get the picture? And to take it to the extreme, I envision the first question asked when someone goes to the doctor would be something similar to, “Who’d you vote for this last election?” Or, to make it more sinister, “Your voting papers, please.”
But let’s escape my personal paranoia for the remainder of the column and allow me to tell you where the e-mail proceeded in content.
My reader’s next comment hit pretty hard as well. “The real problem with health care is that ALL (emphasis mine) get served, and the myriad methods of payment — VA, Medicare, Medicaid, private insurance, charity and private party — all mask the cost of care to the consumer.” The reader could not be more correct. To most folks, because of the government intrusions that have led people to demand that employers (and now taxpayers) provide their “health care,” people literally have no idea how much these policies cost. Most people think health care policies only cost what’s deducted from their paychecks. This doesn’t cover squat, nor does your deductible, hence the term deductible.
In what became a pleasant, intuitive, e-mail exchange, the other number that stood out was $3.2 TRILLION. That’s what this country spends each year on “health care.” It’s the single largest component of our GDP. It’s that big for the simplest of reasons: that’s how much it costs to provide health care to all who seek it. But it gets covered in good and bad ways. Some by the “Medis” paying too little, some by insurers of the insured paying too much and a whole lot by people paying nothing at all.
I’m willing to work toward an overall, government/private solution, because that’s where it has to come from. Where it will not come from is another politically based, government-mandated, controlling of the system.