Dr. Gray's Straight Talk

Honest and blunt healthcare discussion and advice.

The Rising Cost of Health Care – Part Two

Posted by Dr. Gray on Monday, November 3, 2008

My last column gave a hypothetical and generalized view of the financial workings of a private healthcare office. In this article, I’ll discuss why I disagree with “universal health care” (UHC), and some thoughts about how insurance should be used in this country.

There are a multitude of reasons why I oppose UHC. In no particular order, I’ll try to address many of them below.

1) Government-provided or -sponsored health care further removes the patient from the health care decision process.

The rise of managed care in the 1990’s is a perfect example of this. With the introduction of HMO’s, we immediately saw patient choice limited. Patients are told who to see, what will be allowed, and how much they’re going to pay. As many of you remember, this led to long lines, substandard care, impersonal relations with your doctors, inconvenient office locations, no patient control, and no doctor control. In short, a bureaucrat is placed in the position of making your health care choices for you; and he’s making choices based on the bottom line instead of your health. With all that, costs have continued to rise, and general health statistics have continued to decline.

2) UHC is not free!

This is one that upsets me. I often hear people talk about how “the government should provide free health care.” Let’s get one thing straight… the government has no money! As such, they can not provide you with anything. Every time you ask for anything from the government, what you are really doing is asking your neighbor to pay for it. Through increasing taxation, you are forcing your neighbor to pay for it. There are certain things a society is responsible for as a whole, but why should your neighbor be responsible for your health care? Put it another way… if you choose to take care of yourself, eat right, and exercise, why should you have to pay for your neighbor’s ailments related to smoking and obesity?

3) UHC will diminish patient choice and lead to rationing of care.

Think this won’t happen? Ask them in Canada or Great Britain. In fact, we need only look to… Oregon! In July of this year, a woman on the government-sponsored Oregon Health Plan was denied cancer treatment, and instead offered… death. As reported in the newspaper The Oregonian, “After her oncologist prescribed a cancer drug that would cost $4,000 a month, Wagner was notified that the Oregon Health Plan wouldn’t cover the treatment, but that it would cover palliative, or comfort, care, including, if she chose, doctor-assisted suicide.” This is only one example, but I’ve got volumes of research detailing this reality.

4) UHC will not lead to an increased mentality of prevention.

I keep hearing that increased access to care will cause more people to practice prevention. This is absolute hogwash. Right now… practicing a preventive lifestyle is free. A preventive lifestyle does not merely consist of mammograms and prostate checks. It is primarily making the right choices on a daily basis. Prevention is largely related to your dietary choices and activity level… not how many times you see the doctor. In fact, I would argue that UHC would actually decrease thoughts of prevention. Why worry about prevention when you can just run down and get treated for free, right?

5) UHC will stifle innovation and advancements in health care.

Nearly all advancements in pharmaceuticals and medical technology in the past 50 years have come from the United States. Why? Because there is financial incentive to do so. If the potential for profit is there, companies will invest and research for ways to fill that void. UHC, however, resists new treatment methods, techniques, and medications. A good example is the French physician who patented a new medication for dialysis patients that has become the standard of care in America because of its superiority. Practicing in London, he’s not able to use his own patented medication because the NIH refuses to pay for it; choosing instead the cheaper, yet less effective, old medication.

6) The federal government has no Constitutional authority or obligation to provide health care.

The fedgov’s primary role is supposed to be to protect our rights to life, liberty, and the pursuit of happiness. Notice, that role is to protect, not to provide. As per the tenth ammendment to the Constitution, anything not specifically delegated to the federal government in that document is reserved to the states or to the people. Every dollar that goes from the fedgov to this new entitlement program will take away from the fedgov’s ability to protect those rights. Freedom comes from our rights, not our government. If your freedom, or your healthcare, comes from your government, you are no longer free because they can also take it away.

Whatever happened to personal responsibility in this country? Why has the cost of health care risen in this country? Because the people have increasingly removed themselves from the responsibility of their health care decisions. Employer-provided insurance insulates the patient from the cost of insurance, and removes the patient’s right to use the market to their advantage. How many consider that a $20.00 per hour job with benefits is actually a $30.00 per hour job but one third of it goes to insurance premiums? If you were acting like it was your money… and it is your money… you would seek to find better coverage for less money, and take the balance home for your family. However, most fall into the trap of only making $20 per hour and taking whatever plan the company chooses. Do you think the company is going to choose the plan that’s best for you? Or do you think they are going to choose the plan that costs them the least?

Is insurance necessary? … Yes. But we are going about it the wrong way. It’s time to return the responsibility for health care decisions and finances to the individual. We should reject employer-provided insurance and take the increased pay instead. We should remove stifling laws that prevent competition between insurance companies and across state lines. Unfortunately, the insurance industry has not proven capable of regulating itself. As a cost for the decreased restrictions upon their industry, they should be required to practice full, complete, and open disclosure. Already charged with and funded, the FDA and the Department of Justice can start doing their jobs… and protect the American people, as opposed to selling out to the highest corporation. Why would they do that? Because people will be paying attention again.

Our mentality about insurance must change. Coverage should be low-cost, high deductible, and rarely used. Most regular doctor visits should be paid for out-of-pocket, saving insurance coverage for catastrophic events or illness only. When’s the last time you used your car insurance to pay for an oil change? What’s that… they didn’t pay for it? Then why did you have it done? What’s that… good maintenance? Why should your body be any different?

If your neighbor doesn’t take care of his car, neglects to perform maintenance, and hot rods it around town… should you be forced to fix it for him when it breaks down? No? But, he needs that car to get to work. He needs it to take care of his family. You seeing the parallel here? Responsibility lies with the consequences of one’s actions and choices. This applies across the board. Does this mean I disagree with any form of government health care assistance, such as Medicare, Medicaid, etc.? No. But it should be the exception, not the rule. Some people need help, that’s a fact. And the American people have proven themselves exceedingly generous when left to charitable giving. Having to resort to public support should be discouraged instead of encouraged. It should be used as temporary assistance to help someone out of their current situation, not as a permanent way of life, except in those cases involving permanent disability. Even then, private charities have proven more generous and more efficient than anything the federal government could ever sustain.

In conclusion, take control of your own health care. Value it and value your body. Take responsibility for the consequences of your actions and choices. Once you realize that you are the only one in control, making good choices becomes easy. Vote for more freedom, not more governmental control. Pay for your own insurance, and maintenance care. You’ll value it more, get more out of it, and you’ll live a longer, happier, healthier life.

One Response to “The Rising Cost of Health Care – Part Two”

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