Americans are clamoring for health care reform. Driving the demand for reform is the belief that health care is too expensive and is costing the taxpayer too much money. The cost to the taxpayer is attributed to the estimated 40 million uninsured people in the country. Economical issues, as opposed to ethical and moral issues, fuel the debate between liberals and conservatives on the issue.
Progressives in particular, are pushing hard and heavy for a “single payer option” which would essentially make private insurance companies redundant in the relative near future. They argue that private insurance companies are making too much money and not living up to their duties to provide coverage for their customers. In making the arguments, they trot out what they consider to be egregious examples of abuse of insured people. People being denied treatments recommended by their physicians.
Conservatives argue against the single payer system under the belief that the government is incapable of effectively and efficiently providing responsible medical care to the public. They also object to the fact that the middle class and above will end up footing the majority of the health care reform bills. To that argument, the Progressives argue that the savings will more than off set the costs. Both side use comprehensive confusing statistics and figures to attempt to make their points.
Missing from the arguments is one important thing: A definition of what constitutes health care. In short, everyone is discussing health care and there is not a clearly defined and accepted definition of what constitutes “health care” anyplace on the table.
The Merriam-Webster Medical Dictionary defines health care as:
the maintaining and restoration of health by the treatment and prevention of disease especially by trained and licensed professionals (as in medicine, dentistry, clinical psychology, and public health)
Equally as ambiguous, the Medical Dictionary of the Free Dictionary defines health care as:
The prevention, treatment, and management of illness and the preservation of mental and physical well-being through the services offered by the medical and allied health professions.
Interpreting these two definitions would largely depend on how certain words in the definition could be interpreted. For example, “restoration of health” could be interpreted to mean that if health could not be restored, then treatments should cease. The term “management of illness” could also be interpreted to have a similar meaning.
It is doubtful that Americans are prepared to accept either interpretation. Americans have developed a fear of death over the last 4 decades or so. In the 50′s and 60′s for example, when a person died from any cause what-so-ever, the prevailing view was that ‘God had called the person home to heaven as that person had fulfilled His mission on earth.’ In the 70′s, the consensus changed when lawyers introduced the concept of “wrongful death” in civil suits seeking millions of dollars for the survivors of the deceased.
Conservatives created an outcry in the debate when they claimed that a government run health care program would establish “death panels” with strangers deciding when grandma would die. Of course, the conservatives have long believed that only God should decide when someone dies, except in the case of servicemen fighting for their country implementation of the death penalty. Interestingly enough, the liberals denied that death panels would result, and implied that everyone would be afforded every opportunity to extend their life as long as is medically or humanly possible.
This claim by the liberals however is not entirely consistent with their support for letting Terry Schiavo die. Schiavo was in a persistent vegetative state, something which the conservatives denied, largely in the absence of any credible medical evidence. Liberals supported removing her feeding tube. It also should be noted, at least in passing, that many of the cases that have been trotted out by the liberals as examples of people who have been wrongly denied insurance coverage for treatments were in fact people who had terminal diseases for which no cure existed or exists.
Defining Health Care
No doubt, an essential element of health care is preventative medicine. Whether preventative medicine works or not is open to debate. It is estimated that 70 to 80% of the American public has some form of health insurance today. That means that they do have access to primary care physicians who presumably are pushing the concept of preventative medicine. Despite this, Americans are known world wide for being the most obese people in the developed world. Americans are also the world’s largest consumers of illegal drugs. They are also the world’s largest consumers of prescription drugs. Because of the life style – a voluntary life style which Americans maintain, they also have the largest incidence of heart and kidney diseases in the world. These factors can go a long way toward explaining why the American health care system receives such low global grades: Americans really do not care about preserving their health. All they want are treatments that will enable them to continue their decadent and harmful life styles. Hence, the arguments surrounding “preventative health care” as being a benefit of a national health care program can largely be ignored.
End of life care is something that needs to be discussed and incorporated into any health care legislation. Once this issue is clearly defined, then, and only then, can prognostications about the final costs of health care begin to be determined.
Option One: Health care shall include all treatments designed to prolong a person’s life as long as is humanly possible and without regard for the effectiveness, cost or potential success or lack of success for any treatment.
Option Two: Health care shall include such treatments that are necessary to attempt to cure a disease, but if it is determined that the disease is no longer treatable and the chances for recovery are non-existent, then the only health care that shall be provided shall be that which is necessary to allow the patient to continue their life with as much dignity as possible, with appropriate steps taken for the management of pain.
“Option One” of course carries with it the highest expenses, costs and utilization of health care resources. This option of course removes from the equation the possibility of the so called “death panels.”
“Option Two” of course requires lower expenses and costs. It also can open the door to the prospect of “physician assisted suicide” which some would claim would be a true sign of a progressive health care system.
(Other options would also have to be included to cover all possibilities for such treatments or procedures which would take into consideration a person’s age, mental condition and physical abilities. Those treatments of procedures would cover things like joint replacements, heart procedures, etc.)
The primary question is: Are Americans willing to let “nature take its natural course” or do they demand that the health care system be used to wring the maximum amount of life out of an individual without regard to the cost, or perhaps even the lifestyle that the person willingly engaged in or is capable of today.
Again, we return to the concept of “preventative medicine.” Fat people know that they should lose weight without having to visit a doctor. Liberals in particular are quite willing to make excuses for fat people, usually quoting sociological and socioeconomic reasons for obesity. What must be brought into the entire “economics of health care” issue at this point is the fact that the second largest expenditure of tax dollars today is for “income redistribution programs” (welfare programs operated by a variety of federal and state agencies) designed to assist poor citizens. The conservatives of course are opposed to “throwing more money” at this group of people, and would no doubt argue that this group of people should be afforded only the care provided for in “Option Two” above. This of course would give rise to constitutional issues, and those issues would probably prevail in a legal challenge, but not in the “public opinion or sentiment” arena.
Health Care Reform Associated Costs
Assume for a moment that a single payer system were to be passed. That would ultimately result in a virtual eradication of all “for profit” health insurance companies. One of the issues that would then have to be resolved would be what would happen to the billions of dollars that health insurance companies have collected and are holding as their hedge against future expenses? Any move by the government to seize those funds would meet great resistance for the simple fact that the monies were legally collected. Any efforts to force insurance companies to continue to pay for treatments that have begun would also face significant legal challenges because that requirement would be contrary to the contracts that private citizens entered into with private companies or entities. Ultimately, the prognosis is that the insurance companies and their share holders would ultimately have extensive windfall profits – once of course, the lawyers had taken their fees for challenging the government on these issues. That could take years, and would extremely expensive for the taxpayer who would be paying for the defense of these types of lawsuits and challenges.
Another consequence of health care reform is the loss of private and corporate investment in the American economy. Insurance companies routinely invest the premiums that they collect into various investment vehicles to maximize their profits and to provide a hedge against unexpected costs covering the health claims to be filed. A significant amount of the profits health insurance companies post each year is returns on their investments, and not from premiums collected. It is not logical to assume that “Joe the Plumber” will begin to invest the savings he receives from a single payer system vs. a private insurance system. Ultimately, his actual savings are not going to be as great as is being prognosticated by the proponents of a single payer system.
Of course, with the failure of private insurance companies is the impact that the failures would have on small businesses – the independent agents – as well as all the employees of these insurance companies. There is little doubt that a single payer health care system operated by the government or a government entity would be able to employ all these people. We then have the costs associated with tens of thousands of people being out of work for indefinite periods of time. This will once again sap the taxpayers.
Already, there is a move to unionize nurses around the country. The United American Nurses – AFL -CIO is out organizing – and pressuring Congress to make it easier to organize. According to their web site:
“UAN RNs set the standard for registered nurses in organizing, collective bargaining and ground-breaking contracts. As an affiliate of the AFL-CIO, UAN staff nurses stand proudly with millions of workers across our country.”
With a national health care system which is negotiating wages for medical professionals, there is little doubt that nurses will be at the bargaining table wanting more and more. More money. More benefits. Better working conditions. The end result: Higher medical costs.
Following the nurses, will be the nurses aids. Then the medical technicians which no hospital or medical practice an operate without. The end result: Higher medical costs.
One of the current obstacles to the health care reform passage is fees to be paid to doctors. This week, there is an unfunded bill in the Senate that would hand doctors $247 billion more than they would otherwise receive for their Medicare services over a ten year period. This bill has been introduced primarily to “buy” support from physicians of the health care reform bills. If physicians are this powerful without a union, consider how powerful they will be when they unionize. There can be little doubt that over time, they too will unionize, especially if their salaries are to be based on merit and performance. They will be demanding better working conditions and benefits.
Health care unions will be able to hold the entire health care program hostage. It is doubtful that they would go on strike, because the services that they provide are essential, but they would be able to participate in work slow downs, which would impact the public greatly. Ultimately, they will be able to get what they demand.
Whether health professionals unionizing would be beneficial to the overall scheme of health care, such as better services and more dedicated employees, is open to debate. It is important to keep in mind that the most criticized unions in America today are teacher’s unions. They are blamed for many of the perceived ills of the education system, such as maintaining a “status quo” for unqualified educators. Whether this same affliction would affect health care unions is difficult to say, however with an influx of new patients to the health care system, such is a distinct possibility.
Economics Will Prevail
Proponents of health care reform continually point out that between 18,000 and 22,000 people die each year without health insurance. In considering this figure, it is important to note that this is an aggregate figure and does not include anomalies such as individuals who voluntarily are without health insurance or those who die in accidents prior to medical care being accessed. The number of Americans who are without insurance by their own free will is largely unknown. The number of people without health insurance is estimated to be approximately 40 million people – approximately 13% of the population. Even with current reforms being proposed, it is still estimated that 10 million American will still be uninsured.
For Americans to be concerned about only 13% of the population is a rarity. Rather than having altruistic concerns for the less fortunate, the primary motivations for health care reform are primarily efforts designed to reduce individual’s own medical costs, inclusive of health insurance costs as well as burdens placed on the taxpayers by uninsured people. To feign concern for the less fortunate is most likely disingenuous since proponents are all hoping to reduce their own costs in the process.
Proponents uniformly claim that those who do not have health insurance cannot afford coverage. Again, there is no reliable data to support this claim being made across the board. They also claim that many who do have health insurance cannot afford that coverage, however fail to provide any statistical evidence to support that claim. Others claim that even though people may have health insurance fore go medical treatments because they are unable to afford the deductibles that are written into their health insurance policies. In making this, and the other claims, proponents of health care reform are not providing any statistical evidence or information, other than anecdotal, that people are genuinely unable to afford the coverage or deductibles, or are just unwilling to make the necessary sacrifices in other areas of their lives.
Proponents of health care reform are excited at the prospect of receiving tax credits for the purchase of health insurance, as well as lower premiums. These tax credits could be available for people earning up to $200,000 per year.
What people seem to be forgetting is that every $1 tax credit represents $1 less in taxes being collected at the federal and state level in states that also have income taxes. With a $1.4 trillion dollar deficit already, and most states facing budget shortfalls due to lower tax collections, the impact will be disastrous. When governments are short of revenue, they tax individuals and businesses. Proponents say that businesses and the rich should be taxed more heavily, which in theory sounds quite good. However, what they seem to ignore is the fact that the higher taxes a business has to pay, the prices of the goods and services increases accordingly. Hence, the cost of living goes up.
The revolving door of economics will block everyone’s path to financial security. When taxes go up, the costs of goods and services go up. When those costs go up, then the working person wants higher wages. Higher wages means that the costs of goods and services go up. No one’s standard of living actually rises. The only way that people’s standard of living can increase at that point is to utilize credit. The current economic climate demonstrates quite amply what happens when people begin relying on credit for things that they cannot afford.
Admittedly, there is a significant amount of waste and fraud in the current health system. Many things and people can be blamed for the waste. Unnecessary tests for example. Doctors can be blamed for trying to increase their own profits as well as for attempting to avoid malpractice suits. Pharmaceutical companies are blamed for the high costs of drugs, and for making what some consider to be excessive profits. The “blame game” and “blame list” can go on ad finitum, but it most frequently ignores one of the primary culprits for rising health care costs. That culprit is the medical services consumer.
The medical services consumer is very demanding. He demands that every effort be made to save a life, despite the impracticality of those actions. He wants his loved ones to be kept alive as long is possible – especially if he does not have to pay the bills himself. He would rather go to the emergency room when it is convenient for him, rather than either applying logical and well known home remedies or waiting for an opening with his personal physician. He wants a pill for every little minor thing. Of course, he doesn’t take all the pills that he is prescribed to take, but instead flushes them down the toilet, thus putting unnecessary demands on the environment. He demands that the medical system keep him in “tip top” health as he waddles out of Micky D’s with two quarter pounders and cheese for his mid-afternoon snack.
Add to this at minimum 30 million more people who suddenly will have unfettered access to health care services. The medical professionals are going to be overwhelmed and start demanding higher wages, more benefits and better working conditions. Rather than seeing medical costs go down, they will go up exponentially with the demands being placed on the system.
Health care reform certainly does look good in theory and on paper. All that people talk about today are the perceived and hoped for cost savings, primarily to and for themselves. No one seems to be looking at the potential consequences for and of health care reform. With an aging population, a single payer system will collapse under its own weight, and will require an influx of tax dollars. The savings you see today, will quickly be lost as all taxes are increased to pay for what you demand today.
Whether health care reform becomes a panacea or Pandora’s box remains to be seen. One thing may be obvious to thinking people. The consequences have not been fully considered.
Tags: America
Excellent analysis Old Codg. Them that want health care want everyone else to pay for them to get it. Normal for liberals who think everyone owes them everything.
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